The Experts below are selected from a list of 180 Experts worldwide ranked by ideXlab platform
Floyd R. Sallee - One of the best experts on this subject based on the ideXlab platform.
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tic reduction with risperidone versus Pimozide in a randomized double blind crossover trial
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Donald L Gilbert, Gopalan Sethuraman, Robert J Batterson, Floyd R. SalleeAbstract:ABSTRACT Objective To compare the tic suppression, electrocardiogram (ECG) changes, weight gain, and side effect profiles of Pimozide versus risperidone in children and adolescents with tic disorders. Method This was a randomized, double-blind, crossover (evaluable patient analysis) study. Nineteen children aged 7 to 17 years with Tourette's or chronic motor tic disorder were randomized to 4 weeks of treatment with Pimozide or risperidone, followed by the alternate treatment after a 2-week placebo washout. The primary efficacy outcome measure was change in tic severity assessed by the Yale Global Tic Severity Scale (YGTSS). ECG results, weight gain, and side effects were also compared. Results Compared to Pimozide treatment, risperidone treatment was associated with significantly lower tic severity scores (YGTSS: baseline 43.3 ± 17.5, Pimozide 34.2 ± 14.2, risperidone 25.2 ± 13.6; p = .05). Weight gain during the 4-week treatment periods was greater for risperidone (mean 1.9 kg) than Pimozide (1.0 kg). No patient suffered a serious adverse event, but 6 of 19 subjects failed to complete the protocol. Neither medication was associated with ECG changes. Conclusions In this study, risperidone appeared superior to Pimozide for tic suppression but was associated with greater weight gain.
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relative efficacy of haloperidol and Pimozide in children and adolescents with tourette s disorder
American Journal of Psychiatry, 1997Co-Authors: Floyd R. Sallee, Lori Nesbitt, Cherry W. Jackson, Lauren Sine, Gopalan SethuramanAbstract:Objective: The authors evaluated the relative efficacy and safety of Pimozide and haloperidol in the treatment of Gilles de la Tourette’s syndrome in children and adolescents. Method: A double-blind, 24-week, placebo-controlled double crossover study of equivalent dose formulations of haloperidol and Pimozide was conducted with 22 subjects, aged 7‐16 years, with Tourette’s disorder who were randomly assigned to first one active drug treatment and then the other. Biweekly assessment and flexible dose titration mimicked clinical practice. The primary outcome variable was total score on the Tourette Syndrome Global Scale. Final outcome was determined after 6 weeks of each treatment (placebo, Pimozide, haloperidol), with a 2-week placebo baseline period and intervening 2-week placebo washout periods between treatments. Results: Pimozide proved significantly different from placebo in affecting the primary outcome variable, whereas haloperidol failed to have a significant effect. Haloperidol exhibited a threefold higher frequency of serious side effects and significantly greater extrapyramidal symptoms relative to Pimozide. Haloperidol-associated treatment-limiting adverse events were experienced by 41% of the patients. The therapeutic doses of Pimozide and haloperidol were equivalent (mean=3.4 mg/day, SD=1.6, and mean=3.5 mg/day, SD=2.2, respectively). Conclusions: At equivalent doses, Pimozide is superior to haloperidol for controlling symptoms of Tourette’s disorder in children and adolescents. (Am J Psychiatry 1997; 154:1057‐1062)
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Relative Efficacy of Haloperidol and Pimozide in Children and Adolescents With Tourette's Disorder
The American journal of psychiatry, 1997Co-Authors: Floyd R. Sallee, Lori Nesbitt, Cherry W. Jackson, Lauren Sine, Gopalan SethuramanAbstract:The authors evaluated the relative efficacy and safety of Pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome in children and adolescents. A double-blind, 24-week, placebo-controlled double crossover study of equivalent dose formulations of haloperidol and Pimozide was conducted with 22 subjects, aged 7-16 years, with Tourette's disorder who were randomly assigned to first one active drug treatment and then the other. Biweekly assessment and flexible dose titration mimicked clinical practice. The primary outcome variable was total score on the Tourette Syndrome Global Scale. Final outcome was determined after 6 weeks of each treatment (placebo, Pimozide, haloperidol), with a 2-week placebo baseline period and intervening 2-week placebo washout periods between treatments. Pimozide proved significantly different from placebo in affecting the primary outcome variable, whereas haloperidol failed to have a significant effect. Haloperidol exhibited a threefold higher frequency of serious side effects and significantly greater extrapyramidal symptoms relative to Pimozide. Haloperidol-associated treatment-limiting adverse events were experienced by 41% of the patients. The therapeutic doses of Pimozide and haloperidol were equivalent (mean = 3.4 mg/day, SD = 1.6, and mean = 3.5 mg/day, SD = 2.2, respectively). At equivalent doses, Pimozide is superior to haloperidol for controlling symptoms of Tourette's disorder in children and adolescents.
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Prolactin monitoring of haloperidol and Pimozide treatment in children with Tourette's syndrome
Biological psychiatry, 1996Co-Authors: Floyd R. Sallee, Gopalan Sethuraman, Douglas Dougherty, Nandagopal S. VrindavanamAbstract:Neuroleptic therapy of children and adolescents with Tourette's syndrome (GTS) is associated with unpredictable outcome and adverse drug responses (i.e., extrapyramidal symptoms). Assessing the potential outcomes in GTS from a physiologic marker such as plasma prolactin concentration is important in limiting exposure and optimizing therapy. In a double-blind, placebo-controlled, double crossover comparison of Pimozide and haloperidol therapy, prolactin, tic severity, and extraphyramidal symptoms were assessed at a 6-week end point. Twenty-six GTS patients (10.5 ± 2.6 years), experienced clinical response rates of 69% on 3.4 ± 1.6 mg Pimozide and 65% on 3.5 ± 2.2 mg/day haloperidol. Pimozide responders demonstrate elevated prolactin (26.1 ± 11.8 ng/mL) versus Pimozide nonresponders (10.5 ± 3.8 ng/mL) ( p = .05) and haloperidol treated patients ( p = .05). Prolactin may be a marker for tic response to Pimozide, and conversely, a potential marker for haloperidol-related incidence of extrapyramidal symptoms during haloperidol therapy.
Connie Marras - One of the best experts on this subject based on the ideXlab platform.
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Cochrane Review: Pimozide for tics in Tourette's syndrome
Evidence-Based Child Health: A Cochrane Review Journal, 2011Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search strategy We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale. Plain Language Summary Pimozide is an effective treatment for tics in Tourette Syndrome. Pimozide is a well-studied drug used to treat the tics (uncontrolled movements and noises) caused by Tourette Syndrome. There are concerns about side effects associated with Pimozide, so it would be helpful to know how it compares to other drugs, and newer drugs. The review authors searched the medical literature for clinical trials that compared Pimozide to other drugs, or a dummy drug (placebo), for treating tics in patients with Tourette Syndrome. The trials identified showed that Pimozide was more effective at reducing tics than placebo. It was slightly less effective than the drug haloperidol, but showed fewer side effects. There were no important differences between Pimozide and risperidone for either reduction of tics or side effects. In future, if trials could be run for longer, it would help the investigation of the nature of side effects caused by these drugs.
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The Cochrane Library - Pimozide for tics in Tourette's syndrome.
The Cochrane database of systematic reviews, 2009Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search methods We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale.
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Pimozide for tics in tourette s syndrome
Cochrane Database of Systematic Reviews, 2009Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search methods We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale.
Gopalan Sethuraman - One of the best experts on this subject based on the ideXlab platform.
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tic reduction with risperidone versus Pimozide in a randomized double blind crossover trial
Journal of the American Academy of Child and Adolescent Psychiatry, 2004Co-Authors: Donald L Gilbert, Gopalan Sethuraman, Robert J Batterson, Floyd R. SalleeAbstract:ABSTRACT Objective To compare the tic suppression, electrocardiogram (ECG) changes, weight gain, and side effect profiles of Pimozide versus risperidone in children and adolescents with tic disorders. Method This was a randomized, double-blind, crossover (evaluable patient analysis) study. Nineteen children aged 7 to 17 years with Tourette's or chronic motor tic disorder were randomized to 4 weeks of treatment with Pimozide or risperidone, followed by the alternate treatment after a 2-week placebo washout. The primary efficacy outcome measure was change in tic severity assessed by the Yale Global Tic Severity Scale (YGTSS). ECG results, weight gain, and side effects were also compared. Results Compared to Pimozide treatment, risperidone treatment was associated with significantly lower tic severity scores (YGTSS: baseline 43.3 ± 17.5, Pimozide 34.2 ± 14.2, risperidone 25.2 ± 13.6; p = .05). Weight gain during the 4-week treatment periods was greater for risperidone (mean 1.9 kg) than Pimozide (1.0 kg). No patient suffered a serious adverse event, but 6 of 19 subjects failed to complete the protocol. Neither medication was associated with ECG changes. Conclusions In this study, risperidone appeared superior to Pimozide for tic suppression but was associated with greater weight gain.
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relative efficacy of haloperidol and Pimozide in children and adolescents with tourette s disorder
American Journal of Psychiatry, 1997Co-Authors: Floyd R. Sallee, Lori Nesbitt, Cherry W. Jackson, Lauren Sine, Gopalan SethuramanAbstract:Objective: The authors evaluated the relative efficacy and safety of Pimozide and haloperidol in the treatment of Gilles de la Tourette’s syndrome in children and adolescents. Method: A double-blind, 24-week, placebo-controlled double crossover study of equivalent dose formulations of haloperidol and Pimozide was conducted with 22 subjects, aged 7‐16 years, with Tourette’s disorder who were randomly assigned to first one active drug treatment and then the other. Biweekly assessment and flexible dose titration mimicked clinical practice. The primary outcome variable was total score on the Tourette Syndrome Global Scale. Final outcome was determined after 6 weeks of each treatment (placebo, Pimozide, haloperidol), with a 2-week placebo baseline period and intervening 2-week placebo washout periods between treatments. Results: Pimozide proved significantly different from placebo in affecting the primary outcome variable, whereas haloperidol failed to have a significant effect. Haloperidol exhibited a threefold higher frequency of serious side effects and significantly greater extrapyramidal symptoms relative to Pimozide. Haloperidol-associated treatment-limiting adverse events were experienced by 41% of the patients. The therapeutic doses of Pimozide and haloperidol were equivalent (mean=3.4 mg/day, SD=1.6, and mean=3.5 mg/day, SD=2.2, respectively). Conclusions: At equivalent doses, Pimozide is superior to haloperidol for controlling symptoms of Tourette’s disorder in children and adolescents. (Am J Psychiatry 1997; 154:1057‐1062)
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Relative Efficacy of Haloperidol and Pimozide in Children and Adolescents With Tourette's Disorder
The American journal of psychiatry, 1997Co-Authors: Floyd R. Sallee, Lori Nesbitt, Cherry W. Jackson, Lauren Sine, Gopalan SethuramanAbstract:The authors evaluated the relative efficacy and safety of Pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome in children and adolescents. A double-blind, 24-week, placebo-controlled double crossover study of equivalent dose formulations of haloperidol and Pimozide was conducted with 22 subjects, aged 7-16 years, with Tourette's disorder who were randomly assigned to first one active drug treatment and then the other. Biweekly assessment and flexible dose titration mimicked clinical practice. The primary outcome variable was total score on the Tourette Syndrome Global Scale. Final outcome was determined after 6 weeks of each treatment (placebo, Pimozide, haloperidol), with a 2-week placebo baseline period and intervening 2-week placebo washout periods between treatments. Pimozide proved significantly different from placebo in affecting the primary outcome variable, whereas haloperidol failed to have a significant effect. Haloperidol exhibited a threefold higher frequency of serious side effects and significantly greater extrapyramidal symptoms relative to Pimozide. Haloperidol-associated treatment-limiting adverse events were experienced by 41% of the patients. The therapeutic doses of Pimozide and haloperidol were equivalent (mean = 3.4 mg/day, SD = 1.6, and mean = 3.5 mg/day, SD = 2.2, respectively). At equivalent doses, Pimozide is superior to haloperidol for controlling symptoms of Tourette's disorder in children and adolescents.
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Prolactin monitoring of haloperidol and Pimozide treatment in children with Tourette's syndrome
Biological psychiatry, 1996Co-Authors: Floyd R. Sallee, Gopalan Sethuraman, Douglas Dougherty, Nandagopal S. VrindavanamAbstract:Neuroleptic therapy of children and adolescents with Tourette's syndrome (GTS) is associated with unpredictable outcome and adverse drug responses (i.e., extrapyramidal symptoms). Assessing the potential outcomes in GTS from a physiologic marker such as plasma prolactin concentration is important in limiting exposure and optimizing therapy. In a double-blind, placebo-controlled, double crossover comparison of Pimozide and haloperidol therapy, prolactin, tic severity, and extraphyramidal symptoms were assessed at a 6-week end point. Twenty-six GTS patients (10.5 ± 2.6 years), experienced clinical response rates of 69% on 3.4 ± 1.6 mg Pimozide and 65% on 3.5 ± 2.2 mg/day haloperidol. Pimozide responders demonstrate elevated prolactin (26.1 ± 11.8 ng/mL) versus Pimozide nonresponders (10.5 ± 3.8 ng/mL) ( p = .05) and haloperidol treated patients ( p = .05). Prolactin may be a marker for tic response to Pimozide, and conversely, a potential marker for haloperidol-related incidence of extrapyramidal symptoms during haloperidol therapy.
Winfried V. Kern - One of the best experts on this subject based on the ideXlab platform.
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Open Access Pimozide Inhibits the AcrAB-TolC Efflux Pump in Escherichia coli
2016Co-Authors: Jürgen A. Bohnert, Sabine Schuster, Winfried V. KernAbstract:Abstract: Efflux pump inhibitors (EPIs) are attractive compounds to reverse multidrug-resistance in clinically relevant bacterial pathogens. In this study we tested the ability of the neuroleptic drug Pimozide to inhibit the Escherichia coli AcrAB-TolC efflux pump, whose overproduction confers resistance to various antimicrobial agents. A real-time Nile red efflux assay in the AcrAB – overproducing strain 3-AG100 revealed that Pimozide was capable of full inhibition of this pump at a concentration of 100 µM, which is far below its intrinsic MIC (>1mM). However, MIC assay demonstrated very little effect of Pimozide with regard to reduction in MICs of various antimicrobial compounds. Only oxacillin MICs were reduced twofold in the presence of Pimozide at 100 and 200 µM. Since Pimozide did considerably enhance accumulation of ethidium bromide in a fluorescence assay, ethidium bromide MIC assays in the presence and absence of this putative EPI were performed. They revealed that Pimozide was able to re-duce the MICs of ethidium bromide by 4-fold. In line with previous reports we suggest that the capability of EPIs to re-store the susceptibility to antimicrobial agents can be highly substrate-specific due to different substrate binding sites
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Pimozide Inhibits the AcrAB-TolC Efflux Pump in Escherichia coli.
The open microbiology journal, 2013Co-Authors: Jürgen A. Bohnert, Sabine Schuster, Winfried V. KernAbstract:Efflux pump inhibitors (EPIs) are attractive compounds to reverse multidrug-resistance in clinically relevant bacterial pathogens. In this study we tested the ability of the neuroleptic drug Pimozide to inhibit the Escherichia coli AcrAB-TolC efflux pump, whose overproduction confers resistance to various antimicrobial agents. A real-time Nile red efflux assay in the AcrAB – overproducing strain 3-AG100 revealed that Pimozide was capable of full inhibition of this pump at a concentration of 100 µM, which is far below its intrinsic MIC (>1mM). However, MIC assay demonstrated very little effect of Pimozide with regard to reduction in MICs of various antimicrobial compounds. Only oxacillin MICs were reduced twofold in the presence of Pimozide at 100 and 200 µM. Since Pimozide did considerably enhance accumulation of ethidium bromide in a fluorescence assay, ethidium bromide MIC assays in the presence and absence of this putative EPI were performed. They revealed that Pimozide was able to reduce the MICs of ethidium bromide by 4-fold. In line with previous reports we suggest that the capability of EPIs to restore the susceptibility to antimicrobial agents can be highly substrate-specific due to different substrate binding sites.
Tamara Pringsheim - One of the best experts on this subject based on the ideXlab platform.
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Cochrane Review: Pimozide for tics in Tourette's syndrome
Evidence-Based Child Health: A Cochrane Review Journal, 2011Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search strategy We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale. Plain Language Summary Pimozide is an effective treatment for tics in Tourette Syndrome. Pimozide is a well-studied drug used to treat the tics (uncontrolled movements and noises) caused by Tourette Syndrome. There are concerns about side effects associated with Pimozide, so it would be helpful to know how it compares to other drugs, and newer drugs. The review authors searched the medical literature for clinical trials that compared Pimozide to other drugs, or a dummy drug (placebo), for treating tics in patients with Tourette Syndrome. The trials identified showed that Pimozide was more effective at reducing tics than placebo. It was slightly less effective than the drug haloperidol, but showed fewer side effects. There were no important differences between Pimozide and risperidone for either reduction of tics or side effects. In future, if trials could be run for longer, it would help the investigation of the nature of side effects caused by these drugs.
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The Cochrane Library - Pimozide for tics in Tourette's syndrome.
The Cochrane database of systematic reviews, 2009Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search methods We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale.
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Pimozide for tics in tourette s syndrome
Cochrane Database of Systematic Reviews, 2009Co-Authors: Tamara Pringsheim, Connie MarrasAbstract:Background Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with Pimozide compared to other drugs is not known. Objectives To evaluate the efficacy and harms of Pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. Search methods We cross-referenced Pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. Selection criteria All randomized, controlled, double blind studies comparing Pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data collection and analysis Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Main results Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated ‘fair’ for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to haloperidol in one of three studies (the other two showed no significant difference between the drugs), which also showed significantly fewer side effects associated with Pimozide. No significant differences between Pimozide and risperidone were detected. Authors' conclusions Pimozide is an effective treatment for tics in Tourette Syndrome, though the number of trials comparing its effect to placebo and other drugs is limited. Trials of longer duration (minimum six months) are needed to investigate the longer-term effects of Pimozide compared to atypical neuroleptics. Future trials should use the Yale Global Tic Severity Scale to assess the main outcome measure, and quantify adverse events with the Extrapyramidal Symptoms Rating Scale.