levetiracetam and Tourette-Syndrome

To evaluate the usefulness of levetiracetam (LEV) for the treatment of tics in patients with Tourette syndrome (TS) by means of a prospective, open-label, 12-week study.. Twenty-nine patients with TS who received LEV to control their tics were admitted to the study. The authors recorded the following variables: initial status (Yale Global Tic Severity Scale - YGTSS - and the scale of Modified Clinical Global Impression -MCGI), the clinical status at 3 months using the same scales, and clinical/medical impression of improvement.. The mean age of the patients studied was 12 years; 25 males (86%) and 4 females (14%). Participants received 800-2000 mg/day of LEV. Of the 29 patients, 21 children (72%) improved according to YGTSS and MCGI scores. Mean YGTSS Total Tic Score at baseline and after treatment with LEV were 67 and 44, respectively. The statistical analysis confirmed a significant improvement with a p-value of <0.001 on the YGTSS and MCGI. In 3 cases, treatment was suspended due to adverse effects.. Treatment with LEV can constitute a treatment option for tics in patients with TS. Double-blind trials of longer duration are needed in larger samples in order to establish both the benefit, as well as what patients are eligible for treatment.

Topics: Adolescent; Child; Dose-Response Relationship, Drug; Female; Humans; Levetiracetam; Male; Nootropic Agents; Piracetam; Prospective Studies; Psychiatric Status Rating Scales; Severity of Illness Index; Tourette Syndrome; Treatment Outcome

We compared the efficacy of clonidine and levetiracetam for treating tics in Tourette syndrome. Twelve subjects were enrolled; 10 (ages 8-27 years) with moderate to moderately severe tics completed a 15-week randomized, double-blind, flexible-dose crossover protocol. Initial medication doses were clonidine (0.05 mg, twice daily) or levetiracetam (10 mg/kg/day, divided twice daily). Doses were adjusted weekly, based on telephone assessment. The primary outcome measure was baseline-to-posttreatment (6-week) change in Total Tic Score of the Yale Global Tic Severity Scale. Secondary outcome measures included total Yale Global Tic Severity Scale and Clinical Global Impression scores and behavioral measures. The mean Total Tic Score improved significantly from baseline to posttreatment with clonidine (25.2 versus 21.8) compared with levetiracetam (22.7 versus 23.6) (P = 0.013). The mean total Yale Global Tic Severity Scale and Clinical Global Impression score did not change. For levetiracetam, no changes occurred in any scales. No significant change occurred in any secondary behavioral outcome measures for either group. The most commonly reported side effects were, for clonidine, sedation (n = 5), and for levetiracetam, irritability (n = 4). Treatment with clonidine, but not levetiracetam, resulted in a small reduction in Total Tic Score, with an effect size of 0.57.

Topics: Adolescent; Adrenergic alpha-Agonists; Adult; Child; Clonidine; Confidence Intervals; Cross-Sectional Studies; Double-Blind Method; Drug Administration Schedule; Female; Humans; Levetiracetam; Male; Nootropic Agents; Outcome Assessment, Health Care; Piracetam; Psychiatric Status Rating Scales; Severity of Illness Index; Tourette Syndrome; Young Adult

The objective of this study was to investigate the effectiveness of levetiracetam for the treatment of tics in children with Tourette syndrome (TS). Levetiracetam, an atypical anticonvulsant, has been suggested in open-label protocols to be an effective tic-suppressing agent in individuals with TS. A double blind, randomized, placebo-controlled, cross-over trial was performed to investigate this medication in children with moderate to moderately-severe tics. Subjects received, in a randomized sequence, 4-weeks of levetiracetam (maximum dose 30 mg/kg/day) or placebo, with a 2-week intervening washout period between cycles. Primary outcome measures included two separate scales from the Yale Global Tic Severity Scale; the Total Tic score and the Total overall score. Measures were assessed at baseline, prior to randomization, on Day 28 (end of Phase 1), on Day 42 (baseline for second phase) and on Day 70 (end of Phase 2). Twenty-two subjects (21 boys and 1 girl) with TS, mean age 12.2 +/- 2.3 years, range 8 to 16 years, participated. A mild reduction in tics occurred during both the levetiracetam and placebo treatment phases. There was no significant difference between treatments and no evidence of sequence or cross-over effects. In conclusion, Levetiracetam is not more beneficial than placebo in suppressing tics in children with TS.

Topics: Adolescent; Anticonvulsants; Child; Confidence Intervals; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Humans; Levetiracetam; Male; Piracetam; Severity of Illness Index; Time Factors; Tourette Syndrome

Some drugs currently used to treat tics in pediatric patients have drawbacks, including the risk of side effects. New therapeutic options with better safety profiles are needed. Levetiracetam is an antiepileptic drug with atypical mechanisms of action that might be beneficial for this indication. We evaluated the effects of levetiracetam on motor and vocal tics, behavior, and school performance in children and adolescents with tics and Tourette syndrome (TS). Sixty patients, < or =18 years of age, with tics and TS were enrolled in this prospective, open-label study. The initial starting dose of levetiracetam was 250 mg/day. The dosage was titrated over 3 weeks to 1,000 to 2,000 mg/day. Clinical outcomes were assessed with the Clinical Global Impression Scale, Yale Global Tic Severity Scale, and Revised Conners' Parent Rating Scale. Behavior and school performance were also recorded. All 60 patients showed improvements based on all of the scales used, and 43 patients improved with regard to behavior and school performance. Levetiracetam was generally well tolerated. Three patients discontinued treatment because of exaggeration of preexisting behavioral problems. Levetiracetam may be useful in treating tics in children and adolescents. Given its established safety profile, levetiracetam is a candidate for evaluation in a well-controlled trial.

Topics: Adolescent; Anticonvulsants; Child; Demography; Dose-Response Relationship, Drug; Educational Status; Female; Humans; Levetiracetam; Male; Piracetam; Prospective Studies; Psychiatric Status Rating Scales; Severity of Illness Index; Tics; Tourette Syndrome; Treatment Outcome

Topics: Adult; Anticonvulsants; Epilepsy, Frontal Lobe; Humans; Levetiracetam; Male; Piracetam; Polysomnography; Sleep Wake Disorders; Tourette Syndrome

Levetiracetam, an anti-epileptic agent that enhances GABAergic neurotransmission, is one of the newest alternative treatments of Tourette syndrome (TS). We present the case of a 23-year-old female patient suffering from TS since the age of 7, who exhibited poor response to a variety of agents (haloperidol, pimozide, clonidine and various adjunctive agents) and had four hospitalizations during the previous 2 years due to the deterioration of her clinical state. On her last admission, in addition to clonidine 600 microg/day (already part of her regimen for the previous 4 years), levetiracetam was prescribed, up to 2000 mg/day, progressively titrated over a 3-week period. The patient presented a significant improvement on her TS symptomatology (the score on the Yale Global Tic Severity Scale dropped from 70 at admission, to 25 five weeks later, at discharge), which was preserved during the subsequent 4 months, without any serious side-effect.

Topics: Adrenergic alpha-Agonists; Adult; Anti-Dyskinesia Agents; Anticonvulsants; Antipsychotic Agents; Clonidine; Drug Resistance; Female; Haloperidol; Humans; Levetiracetam; Pimozide; Piracetam; Tourette Syndrome; Treatment Outcome