Use of the "inverse neuroleptic" metoclopramide in Tourette Syndrome: An open case series
Use of the "inverse neuroleptic" metoclopramide in Tourette Syndrome: An open case series
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DOI：
10.1089/104454604773840562
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发表时间：
2004-03-01
影响因子：
1.9
通讯作者：
Castellanos, FX
中科院分区：
文献类型：
--
作者：
Acosta, MT;Castellanos, FX
抗精神病药物通常在抑制抽搐方面非常有效，但它们的许多不良反应限制了它们的用途。动物研究表明，与典型和非典型的神经镇静剂相比，甲氧氯普胺的作用仅限于大鼠的运动纹状体。根据这一观察和先前的两个病例报告，在10名抽动症患者中，甲氧氯普胺被公开开出并单独滴定以减少抽搐。所有患者在耶鲁全球抽搐严重程度量表上的平均改善幅度为55%。虽然我们没有观察到明显的锥体外系症状，包括迟发性运动障碍，但这些数据不足以支持临床建议，因为有许多局限性，包括缺乏对非抽动症异常运动的系统评级。然而，甲氧氯普胺的对照临床研究和额外的基础研究是有必要的。
Neuroleptics are generally highly effective in suppressing tics, but their many adverse effects limit their usefulness. Animal studies have shown that, compared with both typical and atypical neuroleptics, metoclopramide has effects that are regionally circumscribed to rat motor striatum. Based on this observation and two prior case reports, metoclopramide was openly prescribed and individually titrated to diminish tics in 10 patients with Tourette syndrome. All patients improved on the Yale Global Tic Severity Scale by an average of 55%. Although we did not observe frank extrapyramidal symptoms, including tardive dyskinesia, these data are not sufficient to support clinical recommendations because of many limitations, including the absence of systematic ratings of nontic abnormal movements. However, controlled clinical studies and additional basic investigations of metoclopramide are warranted.