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Prog Neuropsychopharmacol Biol Psychiatry. 2016 Oct 3;70:227-36. doi: 10.1016/j.pnpbp.2016.02.003. Epub 2016 Feb 10.

Treatment-refractory Tourette Syndrome.

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University of Utah, Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT 84108, United States. Electronic address:
Baylor College of Medicine, Department of Neurology, 7200 Cambridge, Suite 9a/MS: BCM 609, Houston, TX 77030, United States.
University of Utah, Department of Neurology, 729 Arapeen Drive, Salt Lake City, UT 84108, United States; Banner Sun Health Research Institute, 10515 W. Santa Fe Drive, Sun City, AZ 85351, United States.


Tourette Syndrome (TS) is a complex neurodevelopmental condition marked by tics and frequently associated with psychiatric comorbidities. While most cases are mild and improve with age, some are treatment-refractory. Here, we review strategies for the management of this population. We begin by examining the diagnosis of TS and routine management strategies. We then consider emerging treatments for refractory cases, including deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and novel pharmacological approaches such as new vesicular monoamine transporter type 2 inhibitors, cannabinoids, and anti-glutamatergic drugs.


Cannabinoids; Deep brain stimulation; Tetrabenazine; Tics; Tourette Syndrome

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