Long-term efficacy and safety of fluphenazine in patients with Tourette syndrome

Objectives: Haloperidol and pimozide are the only drugs currently approved by the U.S. Food and Drug Administration for treatment of Tourette syndrome (TS), but their potential side effects, which include tardive dyskinesia (TD), limit their use. Methods: We performed a retrospective chart review of patients with TS treated with fluphenazine over a 26-year period. Results: Among 268 patients with TS, fluphenazine was initiated at a mean age of 15.8±10.7 years (range, 4.1-70.2) and titrated to an optimal dose of 3.24±2.3 mg/day (range, 0.5-12.0), which was continued for an average of 2.6±3.2 years (range, 0.01-16.8). Marked to moderate improvement was noted in 211 (80.5%). The most common side effects included drowsiness, fatigue, or both, observed in 70 (26.1%) patients. There were no cases of TD. Conclusions: Fluphenazine appears to be safe and effective in the treatment of TS, and there were no cases of TD in this cohort treated up to 16.8 years.