Side effect risks of using atypical neuroleptics in treating Tourette’s Syndrome
August 13, 2010 by Leslie E. Packer PhD
Filed under Research
The current pharmacological management for the tics of Tourette’s Syndrome usually consists of either a trial of clonidine or an atypical neuroleptic such as Risperdal, Geodon, Abilify, or Seroquel. Some atypical neuroleptics may be more effective in tic suppression than clonidine, but they have a more problematic side effect profile. A new study by Drs. Tamara Prignheim and Michelle Pearce that appeared in the July volume of Pediatric Neurology (abstract here) underscores the concerns and need for patient monitoring.
The researchers monitored all children with Tourette’s Syndrome at a single clinic who were taking neuroleptics for side effects every 6 months. The 73 children were followed for an average of over three years. One of their key findings was that 33 of the 73 children (45%) developed lipid abnormalities, although the type of abnormality appeared to be somewhat gender-related. A second important finding was that 36 of the children (49%) demonstrated abnormal body mass index percentiles. Abnormal body mass index correlated with having lipid abnormalities. Three of 73 children reportedly developed neurologic complications.
To help you appreciate the importance of their findings: lipid disorders are those characterized by high cholesterol and triglycerides. Lipid disorders increase the risk of atherosclerosis (hardening of the arteries) and high blood pressure, which means that lipid disorders increase the risk of heart disease or heart attack and stroke. Based on their sample, not all children being treated with these medications will develop metabolic complications, but if a significant minority do, you’ll want to remain vigilant. Because lipid disorders generally do not present with any signs or symptoms that you can detect, monitoring by a physician who can order lab tests is important.
As inconvenient as tics may be, tics are generally not dangerous to health. Lipid disorders can be a bigger problem than the tics you’re trying to treat. I know that many parents do not have adequate health insurance and may dread having to make an appointment to see the child’s psychiatrist or neurologist every few months, but the monitoring for side effects is important.
