Which medications in the drug class Antipsychotic Agents are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Answer

Antipsychotic Agents

These agents affect dopamine receptors but also affect serotonin receptors involved with frontal lobe functions.

Risperidone (Risperdal)

Risperidone is a mixed dopamine-serotonin antagonist that may produce less sedation than other antipsychotics. Theoretically, risperidone has a lower risk of tardive dyskinesia than haloperidol; it clearly produces fewer acute adverse effects.

Olanzapine (Zyprexa)

Olanzapine is an atypical antipsychotic that produces fewer acute parkinsonian, akathisic, or dystonic adverse effects than haloperidol. In schizophrenia, it has approximately 33%-50% the risk of tardive dyskinesia compared with haloperidol.

Ziprasidone (Geodon)

Ziprasidone is an atypical antipsychotic. In a head-to-head study, this agent caused less weight gain than olanzapine in schizophrenia.

Haloperidol (Haldol)

The anti-tic efficacy of haloperidol has been known for 40 years. It blocks postsynaptic mesolimbic dopaminergic D1 and D2 receptors in the brain. It also decreases hypothalamic and hypophyseal hormones.

Fluphenazine

Fluphenazine is a high-potency typical antipsychotic with pharmacology similar to that of haloperidol. It is proven to diminish tic severity.

Pimozide (Orap)

Pimozide is an atypical neuroleptic approved by the US Food and Drug Administration (FDA) for treatment of tics. It is rarely indicated in current practice, as it offers no substantial advantage over other high-potency neuroleptics (risperidone and olanzapine are better tolerated), has significant drug interactions, and poses a slight but serious risk of cardiac arrhythmia.


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