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Update on Current Medications for TS and Associated Disorders

Presenter: Dr. Roger Kurlan

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Dr. Kurlan discusses the medications that are commonly prescribed, those prescribed in the past and still used today as well as medications new to the market.

Comments(20)

  1. KelleyT says:

    What is your experience with SSRIs causing suicidal ideation in older adolescents with TS & OCD?

    • Dr. Roger Kurlan says:

      Suicidal ideation can sometimes occur during the first few weeks/months of SSRI treatment. Those with TS, OCD do not have any more risk for this problem.

  2. KelleyT says:

    Your thoughts on medical marijuana, hemp oil or cbd oils – are any effective?

    • Dr. Roger Kurlan says:

      There is little research on marijuana, hemp oil, cbd oil. They may indirectly lessen tics by relaxing the individual using them, but there is no current evidence that they directly suppress tics.

  3. KelleyT says:

    What has been your experience with gabapentin for anxiety?

    • Dr. Roger Kurlan says:

      Gabapentin is not a particularly useful medication for anxiety.

  4. KelleyT says:

    How does CBT benefit an essentially reflexive disorder?

    • Dr. Roger Kurlan says:

      OCD is not “reflexive”

  5. KelleyT says:

    We had success with the weight gain/metabolic disorder using Metformin while on Abilify, as an anti-weight gain medication. Is that recommended?

    • Dr. Roger Kurlan says:

      This would be a question for a pediatrician or Internist.

  6. KelleyT says:

    many pharmacological references recommend giving larger doses of guanfacine by breaking it up; ie….three times a day. ex. 6mg for an adolescent. Break it up to 2mg tid or 3mg bid. For larger doses in larger patients, is the once daily at night still appropriate at max doses?

    • Dr. Roger Kurlan says:

      Tenex is given in doses of 1-4mg/day. A single bedtime dose is fine for this dose range.

  7. KelleyT says:

    Some schools want to classify TS as a mental illness. But it is a neurobiological disorder. Do you categorize it as a cross -over disorder, mental disorder or neurological disorder?

    • Dr. Roger Kurlan says:

      I classify TS as a medical/neurological disorder.

  8. KelleyT says:

    Have any genes been identified related to TS?

  9. Dr. Roger Kurlan says:

    Tenex also only needs to be given once daily (usually at bedtime). There is no advantage of Intuniv, it is more expensive and has unpredictable absorption into the bloodstream/brain.

  10. Admin says:

    Your thoughts please on keppra and orap?

    • Dr. Roger Kurlan says:

      Orap is a classical antipychotic. It is almost never prescribed anymore because it can adversely affect the heart rhythm and long term EKG monitoring is needed. The other antipsychotics do not carry this risk. There are some anecdotal reports of Keppra reducing tics, but there is little research evidence.

  11. Admin says:

    Interested in your comment/thoughts: the MOA of AP’s (risperidone) causes hyperprolactinemia with concomitant hypotestosterone. The symptoms include total impotence, loss of libido (in 96% of pts) and a life threateningly drop in free and total testosterone.

    • Dr. Roger Kurlan says:

      All antipsychotics raise prolactin levels and this is rarely a problem.