Levetiracetam in Tourette syndrome: A randomized double blind, placebo controlled study

Abstract

Some drugs currently used to treat tics have drawbacks, including the risk of side effects such as tardive dyskinesia. Therapeutic options with better safety profiles are needed. Levetiracetam is an antiepileptic drug with atypical GABAergic effects that might be beneficial for this indication. To evaluate the effect of levetiracetam on motor and focal tics, behavior, and school performance in children and adolescents with tics and Tourette syndrome. Twenty-four patients, age 6–18 years, with tics and Tourette syndrome were enrolled in this prospective, double-blinded placebo randomized study for 8 weeks. Each group had 12 patients. The initial starting dose of levetiracetam was 250 mg. The dosage was titrated over 3 weeks to 1,000 to 2,000 mg. Clinical outcomes were assessed with the Clinical Global Impression Scale, Yale Global Tic Severity Scale, and Revised Conners’ Scale. Ten out of 12 patients in the levetiracetam group showed improvements based on all of the scales used and four patients improved with regard to behavior and school performance. Two patients dropped out. Nine patients out of 12 patients in the placebo group showed no improvement, one patient showed a great placebo effect, and two patients dropped out of the study. Levetiracetam was generally well tolerated. Two patients discontinued because of exaggeration of pre-existing behavioral problems. Levetiracetam may be useful in treating tics in children and adolescents. Given its established safety profile, levetiracetam is a candidate for additional evaluation.

Keywords

Levetiracetam - Tourette syndrome - tics - adolescents - children