Emerging treatments

Ecopipam

Ecopipam, a selective dopamine D1/D5 receptor antagonist, was found to reduce tics and was well tolerated in a randomised, placebo-controlled crossover study in children aged 7 to 17 years.[95]

Omega-3 fatty acids

Clinical observations have suggested therapeutic effects for omega-3 fatty acids in Tourette's syndrome (Tourette's disorder). However, the only double-blind, placebo-controlled study on omega-3 fatty acids available does not show efficacy in Tourette's syndrome.[96]

Repetitive transcranial magnetic stimulation therapy (rTMS)

A few preliminary studies of rTMS of the supplementary motor cortex have reported favourable outcomes in tics.[97][98] However, other studies have found no significant difference between rTMS and sham treatments when targeting the motor, premotor, or supplementary motor cortex.[99][100]

Cannabinoids

Several case reports of smoked cannabis and oral tetrahydrocannabinol (THC) suggest that cannabinoids may be effective for treating tics associated with Tourette's syndrome.[101] Two small placebo-controlled clinical trials evaluating oral THC identified significant improvements in tic symptoms when compared with placebo, supporting these initial clinical observations.[102][103] Although Cochrane analysis has suggested that insufficient evidence exists for routine recommendation of cannabinoids for tic suppression, this treatment may have a role in treatment refractory cases.[53][101][104]

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