Abstract
AbstractRecently interest has arisen concerning the genetic, pharmacologic and phenomenologic links between Gilles de la Tourette Syndrome (GTS) and Obsessive—Compulsive Disorder (OCD). Some theorize the two disorders may be phenotypic variations of the same neurobiologic defect. Previous studies have demonstrated serotonin (5HT) abnormalities in OCD patients and dopamine dysfunction in patients with tics and GTS. We probed the relationship between 5HT and dopamine in these disorders with a 14‐week, double‐blind, placebo‐controlled crossover trial of fluvoxamine (a specific 5HT reuptake inhibitor) versus sulpiride (a dopamine (D2) antagonist) followed by single‐blind combined therapy (4 weeks) in 11 subjects with comorbid OCD and GTS.Sulpiride monotherapy significantly reduced tics and non‐significantly improved OC symptoms. Fluvoxamine, either alone or combined with sulpiride, non‐significantly ameliorated tics and reduced OCD symptoms. Additionally, tics and OC symptoms covaried. These results are consistent with a possible coupling of dopaminergic and 5HT systems in comorbid OCD/GTS subjects.
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