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AAN 2026 | The current treatment paradigm for Tourette syndrome

Kinga Tomczak, MD, PhD, Boston Children’s Hospital, Boston, MA, reviews current treatment strategies for Tourette syndrome, including behavioural therapies and commonly used medications such as alpha-agonists and dopamine receptor antagonists. She highlights limited access and notable side effects, underscoring the need for safer, more effective options. This interview took place at the 78th American Academy of Neurology (AAN) Annual Meeting in Chicago, IL.

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Transcript

I’ll just start with a quick introduction that Tourette’s syndrome is defined as motor tics as well as presence of one or more vocal tics or phonic tics in individuals younger than 18 and these tics have to go on for 12 months or longer. And currently, at least in the United States, the American Academy practice guidelines are recommending starting with behavioral therapy and then medications...

I’ll just start with a quick introduction that Tourette’s syndrome is defined as motor tics as well as presence of one or more vocal tics or phonic tics in individuals younger than 18 and these tics have to go on for 12 months or longer. And currently, at least in the United States, the American Academy practice guidelines are recommending starting with behavioral therapy and then medications. Behavioral therapy that is used is called Comprehensive Behavioral Intervention for Tics, CBIT, or there’s habit reversal or exposure response prevention. But access to these medications is limited, and then we try to use currently available medications. And usually in clinical practice, we use off-label blood pressure medication alpha agonists, such as guanfacine or clonidine. And the second line are so-called dopamine 2 receptor antagonists or antipsychotics, most frequently prescribed are risperidone and abilify, as well as there are other antipsychotics. But unfortunately, these medications have side effects, such as for these first group alpha agonists, we often feel the patients have some fatigue or somnolence. It also can lower their blood pressure. And these other medications that may be effective, they often cause weight gain and metabolic side effects. Also, there is a risk of movement disorders related to the drug, such as akathisia, which is extra movements that the patients didn’t have before, or others. So therefore, there’s a pretty high discontinuation rate, and there’s an unmet need for other medications. And so that’s where we are here presenting the trial of a new drug.

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Disclosures

Dr Tomczak has been a clinical investigator for Noema Pharma and Emalex Biosciences (money was received by the institution) and has received consulting fees from Jazz Pharma, Emalex Biosciences, Frazier Sciences, AlphaSights, GLG, Guidepoint and Expert Connect.