Rebound phenomena in Tourette's syndrome after abrupt withdrawal of clonidine. Behavioral, cardiovascular, and neurochemical effects.

Abstract

Following an open trial of clonidine hydrochloride (3 to 8 micrograms/kg/day for 12 weeks), we studied the behavioral, cardiovascular, and neurochemical effects of abrupt clonidine withdrawal in seven patients with Tourette's syndrome aged 9 to 13 years. Five patients showed marked worsening of tics. After reinitiation of clonidine therapy, the time required for patients to return to prewithdrawal levels of tic symptoms ranged from two weeks to four months. Increases in motor restlessness, blood pressure, and pulse rate were also observed over the 72-hour period following abrupt withdrawal of clonidine. Plasma levels of free 3-methoxy-4-hydroxyphenylglycol, homovanillic acid, and urinary excretion of norepinephrine and epinephrine increased during the withdrawal period. Clonidine's effectiveness in Tourette's syndrome may be dependent on changes in dopaminergic as well as adrenergic mechanisms.

• Authors: J F Leckman, S Ort, K A Caruso, G M Anderson, M A Riddle, D J Cohen
• Journal: Archives of general psychiatry (Arch Gen Psychiatry) Vol. 43 Issue 12 Pg. 1168-76 (Dec 1986) ISSN: 0003-990X [Print] United States
• PMID: 3465278 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Serotonin
• Methoxyhydroxyphenylglycol
• Clonidine
• Norepinephrine
• Homovanillic Acid
• Epinephrine

Topics

• Adolescent
• Blood Pressure
• Child
• Clonidine (adverse effects, blood, therapeutic use)
• Epinephrine (urine)
• Homovanillic Acid (blood)
• Humans
• Male
• Methoxyhydroxyphenylglycol (blood)
• Norepinephrine (urine)
• Pulse
• Serotonin (blood)
• Substance Withdrawal Syndrome (diagnosis, etiology, physiopathology)
• Tourette Syndrome (drug therapy, metabolism, physiopathology)