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Case ReportOpen Access
Quetiapine for Tic Disorder : A Case Report
ChanOb T 
,
Kuntawongse N ,
Boonyanaruthee V
,
Kuntawongse N ,
Boonyanaruthee V TINNAKORN CHAN-OB, M.D.*,
NAHATHAI KUNTAWONGSE,M.D.*,
VUDHICHAI BOONYANARUTHEE, M.D.*
Tic disorders happen in nearly 20 per cent of children. There is no "best drug" to treat this
illness. Potent antipsychotics e.g. haloperidol and pimozide, are the most effective drugs but their
limitations are their extrapyramidal side effects (EPS). Risperidone has been proved on efficacy for
tic disorders but EPS still remain, even though it was claimed to be less. Thus, quetiapine, a newer
atypical neuroleptic with the same action as risperidone and produces fewer EPS, was included in
this study.
Objective:
To study the efficacy and side effects of quetiapine in tic disorders.
Method:
A case report of a 19-year-old female patient with tic disorder who had taken
haloperidol 2 mg/d with benzhexol HCl 2-4 mg/d, then switched to risperidone 1.5 mg/d with ben-
zhexol HCl 4 mg/d because of acute dystonia and oculogyric. She was then prescribed quetiapine,
50 mg/d as a starting dose without benzhexol HCl, because of the remaining symptoms and EPS.
The severity of the symptoms was assessed monthly using the Behavior Rating Scale. The dose
was increased by 50 mg/d weekly for a better outcome.
Results:
The tic was improved after the first week and disappeared for three weeks with
150 mg/d of quetiapine. However, the tic returned again, but less frequently (20% ). Thus, the dose
was stepped up to 200 mg/d. One week later, the patient reported that the tic has disappeared.
Conclusion:
Quetiapine showed the efficacy and fewest EPS in this patient. However, a
further clinically controlled trial must be carried out before quetiapine can become the first-line
treatment for tic disorders.
Key word
: Tic Disorder, Treatment, Quetiapine, Atypical Neuroleptic, Atypical Antipsychotic,
Tourette's Syndrome
NAHATHAI KUNTAWONGSE,M.D.*,
VUDHICHAI BOONYANARUTHEE, M.D.*
Tic disorders happen in nearly 20 per cent of children. There is no "best drug" to treat this
illness. Potent antipsychotics e.g. haloperidol and pimozide, are the most effective drugs but their
limitations are their extrapyramidal side effects (EPS). Risperidone has been proved on efficacy for
tic disorders but EPS still remain, even though it was claimed to be less. Thus, quetiapine, a newer
atypical neuroleptic with the same action as risperidone and produces fewer EPS, was included in
this study.
Objective:
To study the efficacy and side effects of quetiapine in tic disorders.
Method:
A case report of a 19-year-old female patient with tic disorder who had taken
haloperidol 2 mg/d with benzhexol HCl 2-4 mg/d, then switched to risperidone 1.5 mg/d with ben-
zhexol HCl 4 mg/d because of acute dystonia and oculogyric. She was then prescribed quetiapine,
50 mg/d as a starting dose without benzhexol HCl, because of the remaining symptoms and EPS.
The severity of the symptoms was assessed monthly using the Behavior Rating Scale. The dose
was increased by 50 mg/d weekly for a better outcome.
Results:
The tic was improved after the first week and disappeared for three weeks with
150 mg/d of quetiapine. However, the tic returned again, but less frequently (20% ). Thus, the dose
was stepped up to 200 mg/d. One week later, the patient reported that the tic has disappeared.
Conclusion:
Quetiapine showed the efficacy and fewest EPS in this patient. However, a
further clinically controlled trial must be carried out before quetiapine can become the first-line
treatment for tic disorders.
Key word
: Tic Disorder, Treatment, Quetiapine, Atypical Neuroleptic, Atypical Antipsychotic,
Tourette's Syndrome
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