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Abstract
We compared the efficacy of clonidine and levetiracetam for treating tics in Tourette
syndrome. Twelve subjects were enrolled; 10 (ages 8-27 years) with moderate to moderately
severe tics completed a 15-week randomized, double-blind, flexible-dose crossover
protocol. Initial medication doses were clonidine (0.05 mg, twice daily) or levetiracetam
(10 mg/kg/day, divided twice daily). Doses were adjusted weekly, based on telephone
assessment. The primary outcome measure was baseline-to-posttreatment (6-week) change
in Total Tic Score of the Yale Global Tic Severity Scale. Secondary outcome measures
included total Yale Global Tic Severity Scale and Clinical Global Impression scores
and behavioral measures. The mean Total Tic Score improved significantly from baseline
to posttreatment with clonidine (25.2 versus 21.8) compared with levetiracetam (22.7
versus 23.6) (P = 0.013). The mean total Yale Global Tic Severity Scale and Clinical
Global Impression score did not change. For levetiracetam, no changes occurred in
any scales. No significant change occurred in any secondary behavioral outcome measures
for either group. The most commonly reported side effects were, for clonidine, sedation
(n = 5), and for levetiracetam, irritability (n = 4). Treatment with clonidine, but
not levetiracetam, resulted in a small reduction in Total Tic Score, with an effect
size of 0.57.