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Long-term efficacy and safety of fluphenazine in patients with Tourette syndrome

Authors

  • Subhashie Wijemanne MD, MRCP,

    1. Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
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  • Laura J.C. Wu MD, PhD,

    1. Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
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  • Joseph Jankovic MD

    Corresponding author
    1. Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
    • Correspondence to: Prof. Joseph Jankovic, Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USA; josephj@bcm.edu

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  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

  • Drs. Wijemanne and Wu have nothing to disclose.

  • Below is Dr. Jankovic's full disclosure: During the past two years Dr. Jankovic has received: Research and Center of Excellence Grants: Allergan, Inc; Ceregene, Inc; CHDI Foundation; GE Healthcare; Huntington's Disease Society of America; Huntington Study Group; Ipsen Limited; Lundbeck Inc; Michael J Fox Foundation for Parkinson Research; Medtronic; Merz Pharmaceuticals; National Institutes of Health; National Parkinson Foundation; St. Jude Medical; Teva Pharmaceutical Industries Ltd; UCB Inc; University of Rochester; Parkinson Study Group. Compensation/honoraria for services as a consultant or an advisory committee member: Allergan, Inc; Auspex Pharmaceuticals, Inc; Ipsen Biopharmaceuticals, Inc.; Lundbeck Inc; Merz Pharmaceuticals; Teva Pharmaceutical Industries Ltd; UCB Biosciences; US World Meds. Royalties: Cambridge; Elsevier; Future Science Group; Hodder Arnold; Lippincott Williams and Wilkins; Wiley-Blackwell. During the past two years Dr. Jankovic has served on the following editorial boards and foundation advisory boards without financial compensation: Editorial boards: Medlink: Neurology; Expert Review of Neurotherapeutics; Neurology in Clinical Practice; The Botulinum Journal; PeerJ; Therapeutic Advances in Neurological Disorders; Neurotherapeutics; Tremor and Other Hyperkinetic Movements; Journal of Parkinson's Disease; UpToDate. Foundations and non-Profit Organizations: American Academy of Neurology; Benign Essential Blepharospasm Research Foundation; Dystonia Medical Research Foundation; International Essential Tremor Foundation; International Neurotoxin Association; Michael J Fox Foundation for Parkinson Research. Speakers Bureau: none. Stock Ownership: none.

ABSTRACT

Objectives

Haloperidol and pimozide are the only drugs currently approved by the U.S. Food and Drug Administration for treatment of Tourette syndrome (TS), but their potential side effects, which include tardive dyskinesia (TD), limit their use.

Methods

We performed a retrospective chart review of patients with TS treated with fluphenazine over a 26-year period.

Results

Among 268 patients with TS, fluphenazine was initiated at a mean age of 15.8 ± 10.7 years (range, 4.1–70.2) and titrated to an optimal dose of 3.24 ± 2.3 mg/day (range, 0.5–12.0), which was continued for an average of 2.6 ± 3.2 years (range, 0.01–16.8). Marked to moderate improvement was noted in 211 (80.5%). The most common side effects included drowsiness, fatigue, or both, observed in 70 (26.1%) patients. There were no cases of TD.

Conclusions

Fluphenazine appears to be safe and effective in the treatment of TS, and there were no cases of TD in this cohort treated up to 16.8 years. © 2013 International Parkinson and Movement Disorder Society

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