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Fluvoxamine/Pimozide Treatment of Concurrent Tourette's and Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  02 January 2018

Pedro L. Delgado*
Affiliation:
Department of Psychiatry, Yale University School of Medicine, West Haven Veterans Administration Medical Center, West Haven, Connecticut 06516, USA
Wayne K. Goodman
Affiliation:
Department of Psychiatry, Yale University School of Medicine, Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, Connecticut 06508
Lawrence H. Price
Affiliation:
Department of Psychiatry, Yale University School of Medicine, Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, Connecticut 06508
George R. Heninger
Affiliation:
Department of Psychiatry, Yale University School of Medicine, Clinical Neuroscience Research Unit, Connecticut Mental Health Center, 34 Park Street, New Haven, Connecticut 06508
Dennis S. Charney
Affiliation:
Department of Psychiatry, Yale University School of Medicine, West Haven Veterans Administration Medical Center
*
Correspondence

Abstract

A 25–year-old man with a history of Tourette's syndrome presented for treatment of OCD symptoms. Fluvoxamine worsened tics, led to coprolalia, and did not help the OCD. The addition of pimozide dramatically reduced both OCD and Tourette's symptoms. Double-blind sequential discontinuation of fluvoxamine and pimozide confirmed that pimozide alone reduced only tics and the combination of fluvoxamine and pimozide was required for the improvement in OCD. Tics may reflect a subtype of OCD. Some OCD patients unresponsive to a 5–HT reuptake inhibitor alone may benefit from the addition of a dopamine antagonist.

Type
Brief Reports
Copyright
Copyright © The Royal College of Psychiatrists 

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