Pregabalin in Tourette’s Syndrome: A Case Series

Upon admission, the 41-year-old patient scored 90 (Total Tic Score [TTS]=40; score range=0–50) on the Yale Global Tic Severity Scale (YGTSS; score range=0–100) and 6 on the Clinical Global Impressions Scale (CGI; score range=1–7). He was medication free for more than 2 years but smoked up to seven cannabis cigarettes a day. The patient, over the course of his lifetime, had taken typical and atypical antipsychotics, topiramate, and antidepressants and had had comorbid hypercholesterinemia. The younger patient (YGTSS score=95; TTS=45; CGI score=6 on admission day) had been taking 20 mg/day of aripiprazole for more than 4 years without sufficient improvement.

Because of comorbid generalized anxiety disorder, both patients were started on a dosage of 100 mg/day of pregabalin, which was increased to 600 mg/day from treatment day 4 onward. Because of insomnia, the older patient received 100 mg of quetiapine at night. In the younger patient, aripiprazole was reduced to 10 mg/day and, because of depressive symptoms, sertraline at 50 mg/day was administered. The older patient’s YGTSS score scaled down to 45 (TTS=25), and his CGI score was 4; the younger patient had a YGTSS score of 58 (TTS=28) and a CGI score of 4 only 7 days after onset of treatment.

After these interesting observations, we treated a third patient with Tourette’s syndrome without comorbidities (22 years old, Caucasian male; he was medication free for 5 years but, over his lifetime, had taken risperidone and valproate). On admission day, he scored 79 on the YGTSS (TTS=39) and 6 on the CGI. He received pregabalin as described above and experienced a marked reduction in tic intensity and frequency only 7 days after onset of treatment (YGTSS score=41; TTS=21; CGI score=4).

None of the patients reported any side effects. All subjects provided written informed consent for anonymized publication of their data.