Comparison of Weight Gain in Treatments for Tourette Syndrome: Tetrabenazine Versus Neuroleptic Drugs

Weight gain occurs with most neuroleptic drugs used to treat tics. Tetrabenazine, a vesicular monoamine transporter type 2 inhibitor, inhibits dopamine release. It is used to treat a variety of hyperkinetic movement disorders, including tics. Weight gain over time was compared in a group of pediatric tic patients taking only tetrabenazine with an age-matched group of tic patients taking only neuroleptic drugs. Age in the tetrabenazine group (n = 36, 32 males) at initial therapy was 13.4 (SD 3.3) years. They were monitored for 25.2 (SD 12.3) months. The average dose of tetrabenazine (all visits) was 54.4 (SD 26.6) mg/d. In the neuroleptic group (n = 41, 33 males), the age at therapy onset was 12.3 +/- 4.0 years. They were monitored for 18.9 (SD 14.8) months. Weight increase was 0.8 lb/mo in the tetrabenazine group compared with 1.7 lb/mo in the neuroleptic group (P = .006). Most patients who switched from a neuroleptic drug to tetrabenazine subsequently lost weight. Although the study was not designed to compare efficacy, this tended to be greater with tetrabenazine than with neuroleptic drugs.