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Pilot Study to Evaluate Pimavanserin for the Treatment of Motor and Behavioral Symptoms of Tourette Syndrome
Author(s) -
Billnitzer Andrew,
Jankovic Joseph
Publication year - 2021
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.13207
Subject(s) - tourette syndrome , clinical global impression , psychology , adverse effect , tics , psychosis , severity of illness , medicine , psychiatry , pathology , alternative medicine , placebo
Background Pimavanserin is a serotonin 2A receptor inverse agonist and antagonist used for the treatment of hallucinations and delusions in Parkinson's disease psychosis. Numerous studies support a modulatory role of serotonin in Tourette syndrome (TS). Objectives To determine whether or not pimavanserin affects TS symptoms. Methods In this open‐label study of TS adult patients, pimavanserin was titrated to 34 mg/day over 1 week and continued for an additional 7 weeks followed by a 2‐week washout. Tic severity, the primary outcome measure, was assessed by the Yale Global Tic Severity Scale Total Tic Severity score (YGTSS‐TTS). Secondary outcome measures included changes in the Yale‐Brown Obsessive Compulsive Scale (Y‐BOCS), the Tourette Syndrome Clinical Global Impression of Change (TS‐CGIC), the Tourette Syndrome‐Patient Global Impression of Impact (TS‐PGII), and the Gilles de la Tourette Syndrome – Quality of Life scale (GTS‐QOL). Results We enrolled 12 patients, but 2 dropped out after week 2 due to non‐serious side effects. In the 10 patients, mean (standard deviation (SD)) age 34 (12.9) who completed the study the mean (SD) baseline YGTSS‐TTS was 34 (9.3). This decreased by 3.6 (4.9) points at week 8, a 12% reduction in tic severity ( P = 0.03). This improvement is small and may not be clinically important. Significant improvement was noted in the TS‐CGIC, TS‐PGII and GTS‐QO. No serious adverse events were reported. Conclusions The results of this study suggest that pimavanserin is safe and associated with improvement in motor and non‐motor TS symptoms. These findings warrant further study by a larger, placebo‐controlled, trial.