How is Tourette syndrome treated?

There is no cure for Tourette’s and the aim of the treatment is to help control the tics interfering with everyday functioning and activities. If the tics are not as severe, then treatment may not be needed.

Medication

The following medications can help to control the tics or aid in reducing the symptoms of co-occurring conditions:

• Medications to lessen or block dopamine - Pimozide (Orap), haloperidol (Haldol) and Fluphenazine are known to aid in controlling tics by blocking or lessening the effects of dopamine in the brain. The side effects of these medications can include involuntary movements that are repetitive and/or weight gain. Dopamine is a neurotransmitter in the brain that aids in regulating emotional and movement responses.
• Botox (botulinum) injections – Injecting Botox into the affected muscle may be able to help stop motor and vocal tics as Botox prevents muscle movement of the injected area.
• ADHD (attention deficit hyperactivity disorder) medications – Stimulants including methylphenidate (Ritalin and Concerta being the most popular) and other medications that contain dextroamphetamine (Dexedrine and Adderall XR) have been found to help improve the patient’s concentration and attention span. However, in some patients with Tourette syndrome, certain ADHD medications have been found to make tics worse.
• Anti-seizure medications – Medications such as topiramate (Topamax) have recently been shown to reduce the symptoms of Tourette’s. Side effects may include drowsiness and weight loss.
• Central adrenergic inhibitors - These medications include guanfacine (Tenex) and clonidine (Catapres) – which are normally prescribed for hypertension (high blood pressure), and are able to help in controlling the behavioural symptoms such as rage and impulse control associated with Tourette’s. Side effects typically include drowsiness.
• Antidepressants – These aid in controlling symptoms of anxiety and depression. Medications typically include Fluoxetine (Prozac and Sarafem).

Therapy

• Behavioural therapy – Certain training techniques and strategies used by a medical professional can help ease the occurrence of tics and help the patient to control them. This includes Cognitive behavioural interventions for tics such as habit-reversal training. This helps the patient to identify when a tic is about to occur and how to move in a way that helps ease the tic, but not in a way that is obvious or inappropriate.
• Psychotherapy – This kind of treatment has been seen to be extremely effective in not only helping patients deal with Tourette’s, but it also helps in co-occurring conditions such as anxiety, depression and ADHD. This involves having several sessions with a trained professional such as a psychiatrist or psychologist, vocalising how the condition is affecting the patient’s life and identifying how to deal with it.
• DBS (deep brain stimulation) – When the patient is experiencing tics that are more severe and appear to be unresponsive to other means of treatment, a doctor may recommend DBS. This involves using a battery-operated medical device that is implanted in the patient’s brain. This delivers electrical stimulation to specific areas of the brain that control movement.