Treating Childhood Tourettes With Neuroleptics

One of the most tragic situations in the treatment of children today involves the use of neuroleptics for the control of Tourette s disorder. 

Tourette s involves a combination of tics and spontaneous, inappropriate vocalizations, such as curse words. While claims have been made for a biological origin, none has been demonstrated. On the other hand, it is extremely well documented that neuroleptics frequently produce TD in children with far more disabling tics, spasms, and other abnormal movements. 

I have evaluated several children and young adults who developed severe cases of tardive dyskinesia following neuroleptic treatment for Tourette s. One, a 20-year-old man who had been treated with Risperdal, eventually recovered from Tourette s. However, his drug-induced severe abnormal tongue movements and jaw spasms have required treatment with Botox, and he may never fully recover from them. He had been able to live a happy and largely unimpaired life with Tourette s but the TD has severely impaired his school, occupational, and social life. 

The use of neuroleptics for the treatment of Tourette s does not meet a reasonable medical standard in terms of its riskrbenefit ratio. 

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