1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-9-06-a 10.15844/pedneurbriefs-9-1-8 Attention and Learning Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Treatment of ADHD in Tourette’s Syndrome http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 01 1995 01 06 2016 9 1 6 6 Copyright: © 1995 The Author(s) 1995 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The treatment of attention-deficit hyperactivity disorder in Tourette’s syndrome: a double-blind placebo-controlled study with clonidine and desipramine

A double-blind, placebo-controlled study of clonidine (.05 mg 4xd) and desipramine (25 mg 4xd) treatment of attention-deficit hyperactivity disorder (ADHD) behaviors in 34 children with TS + ADHD is reported from the Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.

 Attention-Deficit Hyperactivity Disorder Child Behavior Checklist Global Linear Analogue

A double-blind, placebo-controlled study of clonidine (.05 mg 4xd) and desipramine (25 mg 4xd) treatment of attention-deficit hyperactivity disorder (ADHD) behaviors in 34 children with TS + ADHD is reported from the Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD. Desipramine was superior to clonidine in improving measures of ADHD, including parent-completed global linear analogue rating scale, hyperactivity subscale of the child behavior checklist (CBCL), and teacher CBCL subscales for nervous/overactive, anxious, and unpopular items. More than two thirds of families requested continuation of desipramine at the completion of the study. Neither drug made tics worse. [1]

COMMENT. Desipramine is a more effective medication than clonidine for the treatment of ADHD in children with Tourette’s syndrome. The authors hesitate to recommend the general use of desipramine. A review of the literature uncovered at least four sudden, unexplained deaths in children receiving desipramine. Careful monitoring, especially of the cardiovascular system, is advised.

Behavioral improvements found with tricyclic antidepressants and the positive effects of stimulant medication on cognitive tasks have prompted combined drug therapy of ADHD. Side effects occurred more frequently when a combination of desipramine and methylphenidate was employed compared to either medication used alone. (see Progress in Pediatric Neurology II, PNB Publ, 1994, pp210-211).

Bilineal transmission (from maternal and paternal sides) of Tourette’s syndrome, especially in families in which the proband’s symptoms were most severe, was a frequent finding (approx 1/3) in a study at the University of Rochester School of Medicine, NY, and University College London Medical School, London, UK. [2]

 Singer HS Brown J Quaskey S Rosenberg LA Mellits ED Denckla MB The treatment of attention-deficit hyperactivity disorder in Tourette’s syndrome: a double-blind placebo-controlled study with clonidine and desipramine Pediatrics 1995 Jan 95 1 74 81 7770313 Kurlan R Eapen V Stern J McDermott MP Robertson MM Bilineal transmission in Tourette’s syndrome families Neurology 1994 Dec 44 12 2336 42 7991122 10.1212/WNL.44.12.2336