Case report: Exacerbation and provocation of tics by imipramine and sulpiride.

This paper deals with the problem of overlapping clinical effects of neurotropic agents in treating children with complex comorbidity. An 8-year-old boy suffering from a complexity of symptoms such as chronic motor tics, compulsions, phobias, anxious inhibition, and stuttering displayed the totality of Tourette's syndrome while taking imipramine. Sulpiride also enhanced motor and vocal tics. In the discussion, a review on the neurometabolic mechanisms in tic disease actually known is given, and on drugs proven to precipitate tics, which is the case in a number of neurotropic agents. Psychodynamics and famility dynamics are another issue to be regarded independently.