OBJECTIVE: The pattern of dopamine antagonism by metoclopramide suggests benefits in the treatment of tic disorders. The purpose of this study was to examine the efficacy and safety of metoclopramide in the treatment of children and adolescents with tic disorders. METHOD: Twenty-seven medication-free patients (age 11.9 +/- 2.7 years) with Tourette's disorder or a chronic tic disorder participated in an 8-week double-blind, randomized, placebo-controlled trial of metoclopramide. Metoclopramide was started at 5 mg daily and titrated as needed to a maximum dose of 40 mg daily. Tics were rated every 2 weeks, and adverse effects, including weight, cardiac, and laboratory measures, were monitored. RESULTS: After 8 weeks of treatment, subjects receiving metoclopramide showed a 39% reduction in their total tic score on the Yale Global Tic Severity Scale, while subjects receiving placebo showed only a 13% reduction in tic severity (p = .001). Metoclopramide was well tolerated with no significant laboratory or cardiac changes noted other than an increase in serum prolactin. CONCLUSIONS: The results of this small controlled study suggest that metoclopramide is an effective and well-tolerated treatment for children and adolescents with tic disorders. Further trials are needed to confirm its efficacy and safety in pediatric patients and adults.
RCT Entities:
OBJECTIVE: The pattern of dopamine antagonism by metoclopramide suggests benefits in the treatment of tic disorders. The purpose of this study was to examine the efficacy and safety of metoclopramide in the treatment of children and adolescents with tic disorders. METHOD: Twenty-seven medication-free patients (age 11.9 +/- 2.7 years) with Tourette's disorder or a chronic tic disorder participated in an 8-week double-blind, randomized, placebo-controlled trial of metoclopramide. Metoclopramide was started at 5 mg daily and titrated as needed to a maximum dose of 40 mg daily. Tics were rated every 2 weeks, and adverse effects, including weight, cardiac, and laboratory measures, were monitored. RESULTS: After 8 weeks of treatment, subjects receiving metoclopramide showed a 39% reduction in their total tic score on the Yale Global Tic Severity Scale, while subjects receiving placebo showed only a 13% reduction in tic severity (p = .001). Metoclopramide was well tolerated with no significant laboratory or cardiac changes noted other than an increase in serum prolactin. CONCLUSIONS: The results of this small controlled study suggest that metoclopramide is an effective and well-tolerated treatment for children and adolescents with tic disorders. Further trials are needed to confirm its efficacy and safety in pediatric patients and adults.
Authors: Douglas W Woods; John C Piacentini; Lawrence Scahill; Alan L Peterson; Sabine Wilhelm; Susanna Chang; Thilo Deckersbach; Joseph McGuire; Matt Specht; Christine A Conelea; Michelle Rozenman; James Dzuria; Haibei Liu; Sue Levi-Pearl; John T Walkup Journal: J Child Neurol Date: 2011-05-09 Impact factor: 1.987
Authors: Tamara Pringsheim; Yolanda Holler-Managan; Michael S Okun; Joseph Jankovic; John Piacentini; Andrea E Cavanna; Davide Martino; Kirsten Müller-Vahl; Douglas W Woods; Michael Robinson; Elizabeth Jarvie; Veit Roessner; Maryam Oskoui Journal: Neurology Date: 2019-05-07 Impact factor: 9.910
Authors: Matt W Specht; Douglas W Woods; John Piacentini; Lawrence Scahill; Sabine Wilhelm; Alan L Peterson; Susanna Chang; Hayden Kepley; Thilo Deckersbach; Christopher Flessner; Brian A Buzzella; Joseph F McGuire; Sue Levi-Pearl; John T Walkup Journal: J Dev Phys Disabil Date: 2011-02
Authors: Lawrence Scahill; Douglas W Woods; Michael B Himle; Alan L Peterson; Sabine Wilhelm; John C Piacentini; Kevin McNaught; John T Walkup; Jonathan W Mink Journal: Mov Disord Date: 2013-05-16 Impact factor: 10.338