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- Title
Between scylla and charybdis: treatment of depression in subject with gilles de la tourette syndrome.
- Authors
Petrykiv, S.; Arts, M.; De Jonge, L.
- Abstract
Introduction: Depression is a common associated condition with Gilles de la Tourette syndrome (GT). Evidence suggests that serotonine modulating drugs (like SSRI's) may worsen intensity of dyskinesia in subjects with GT, most probably through affecting of dopamine pathways. We provide a case rapport of a patient with GT, who has been successfully treated for depressive symptoms without worsening of dyskinesia. Objectives: To discuss effects of antidepressants on dyskinesia in patients with GT. Methods: A case rapport of a 46 y.o. male with GT who has been successfully treated with venlafaxine. Results: Clinical case of a 46 y.o., otherwise healthy, male with GT was diagnosed with major depression. The course of GT was complicated by prominent vocal and motor tics. Risperidon, as symptomatic treatment for tics, has been already stopped due to its negative impact on depression. Choosing the right antidepressant in this regard was a challenging issue. As evidenced by limited amount of studies, citalopram and fluoxetine enhance DA homeostasis through postsynaptic 5-HT2C stimulation, while noradrenalinemimetic agents might lower subcortical dopamine though negative feedback loop system. Conclusions: Treatment of depression in patients with GT must effectively target depressive symptoms and be safe on one hand, without deterioration of GT dyskinesia on the other hand. Due to scarcity of studies, predominantly limited to rodents, we cannot draw conclusions whether one antidepressant is better than the other. However, based of existing fundamental knowledge, we make assumption that treatment with SNRI's should meet the here above mentioned therapy goals.
- Subjects
TOURETTE syndrome; DYSKINESIAS; DISEASE complications; MENTAL depression; BEHAVIOR therapy
- Publication
European Psychiatry, 2020, Vol 63, pS94
- ISSN
0924-9338
- Publication type
Article