Tourette Updates

Reported August 18, 2003
Drug Benefits OCD and Binge Eating
By Shanida Smith, Ivanhoe Health Correspondent
GAINESVILLE, Fla. (Ivanhoe Newswire) -- Researchers from the
University of Florida are studying the drug topiramate for obsessive-
compulsive disorder and binge eating. Topiramate is an
anticonvulsant medication that is FDA-approved for epilepsy and
related disorders.
Investigators want to determine if the addition of topiramate to
typical treatment for OCD would help patients who have had only a
partial response to standard therapy. In an interview with Ivanhoe,
lead researcher Nathan Shapira, M.D., Ph.D., says, "About 40 to 50
percent [of patients] get almost no benefit from current treatments
and the other half typically get partial benefit, so there's a
significant room for improvement in terms of treatment."
In the current trial, half of the patients are given topiramate with
the standard treatment and the other half of patients are receiving
a placebo with medications they are already taking. The study is
being conducted at several sites across the country and
investigators hope to finish by next year.
Earlier studies using topiramate for binge eating disorder shows the
average starting binges were between four and a half to five times a
week for all patients. The patients on placebo went down to about
three binges a week while the patients on the treatment went down to
about 0.3 binges a week. Participants also experienced significant
weight loss. Dr. Shapira says, "Somewhere over 80 percent of
patients were to the point where they had no binge eating."
Phase III trials are beginning now at 20 sites around the United
States and researchers hope to enroll about 360 patients. Some
patients will receive topiramate and some patients will receive a
placebo. Currently, there are no FDA-approved treatments for binge
eating disorder.
This article was reported by Ivanhoe.com, who offers Medical Alerts
by e-mail every day of the week. To subscribe, go to:
http://www.ivanhoe.com/newsalert/.
SOURCE: Interview with Nathan Shapira, M.D., Ph.D., Aug. 10, 2003
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Addressing Adult ADHD
CHAPEL HILL, N.C. (Ivanhoe Newswire) -- If you had attention-deficit-
disorder or attention deficit-hyperactivity-disorder as a child,
there's a good chance you may still suffer its effects. Here's a
treatment that works for the adult population.
Susan Paris works in a school, but her own schooling brings back
painful memories. "I mostly remember it in junior high, having a lot
of "D's" on my report card," she tells Ivanhoe. No one knew she had
ADHD. "I was on a cloud all by myself," she says, "And didn't really
seem to be tuned into what the rest of the group was doing."
As an adult, Paris still struggles. "It takes me longer to do things
than other people, and so I end up taking work home with me."
Psychiatrist Richard Weisler, M.D., of University of North Carolina
at Chapel Hill, says it's an increasingly common story because many
doctors were never taught to look for ADHD in adults. "The good news
now is that we have treatments available to help people, that can
really change their lives in a very positive way."
Dr. Weisler led a study in which adults with ADHD were treated with
an extended-release amphetamine. Patients showed an average 44-
percent decrease in symptoms. "Patients really saw an improvement in
their ability to accomplish more, both at home and at work, feeling
better about themselves, being more in control, less agitated," he
says.
For Paris, it was the diagnoses that really healed the pain of
shame. She says, "There's a happier ending to this story than I
imagined years ago."
As many as 70 percent of children diagnosed with ADD or ADHD may
still experience symptoms as adults.
This article was reported by Ivanhoe.com, who offers Medical Alerts
by e-mail every day of the week. To subscribe, go to:
http://www.ivanhoe.com/newsalert/.
If you would like more information, please contact:
Crystal Hinson-Miller
Director of Public Relations
University of North Carolina at Chapel Hill
(919) 966-9115
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Human Interest Article
Marco youngster, family deals with Tourette's Syndrome
Wednesday, July 30, 2003
By Tiffany St. Martin, Staff Writer
When he is playing baseball — when he is in his element — no one has
any indication 12-year-old Nicholas Macchiarolo has a life-altering
disorder.
He may jump unexpectedly before he reaches the batter's box, but as
soon as he takes his stance he is focused and poised. Once he hits
the ball, he resumes twitching as he runs toward first base.

Nicholas, who will enter sixth grade at Marco Island Charter Middle
School in the fall, has Tourette's Syndrome, an inherited
neurological disorder that causes repeated involuntary body
movements and vocal sounds, or tics.
"It's not a mental thing, it's behavioral," said his mother, Toni,
who, along with husband Nick, owns Dry & Clean Carpet Cleaning. "He
has no control over it."
Doctors diagnosed Nicholas about four years ago, shortly after the
family moved to Marco Island from New York.
He underwent a series of tests, including an EKG and a CAT scan,
before they discovered Tourette's was causing his erratic behaviors,
which are similar to the urge to sneeze.
Nicholas experiences both motor and vocal tics, which can include
obsessive throat clearing, blinking, and neck and arm twitching. He
sometimes throws dishes, remote controls or whatever he may be
holding at the time of an attack into the air, but he always catches
them.
When Nicholas has severe tics, he hits himself in the face over and
over again. His friends or teachers may ask him what he is doing,
and he tells them he has no way of restraining himself.
So many of his peers questioned his behavior last year he eventually
stood up in front of the classroom and spoke openly to his fellow
students, telling them to overlook his actions.
"It's like me telling you not to blink," he said to them.
He occasionally can hold his tics in during school or in public, but
once he gets into a comfortable environment — such as his home — he
releases them in full force.
Nicholas' tics always are sudden. They begin and end at different
times, can last for days or months at a time and are different types
of tics.
"We never know when it's going to start, and we never know what's
going to come out," Toni said. "We just take it one day at a time."
He now is going through a "waxing and waning" period, meaning his
symptoms are not severe.
Although there is no cure for Tourette's Syndrome, treatments are
available. Nicholas takes Risperdal, which decreases his tics, and
Zoloft, which helps control his obsessive compulsive behavior. As
his tics increase, the amount of medicine he takes increases.
In the past the family has tried homeopathic, or natural, remedies
as well as acupuncture, which hurt Nicholas because his tics would
not allow him to keep still.
He has visited psychiatrists, neurologists and pediatricians, and he
sees a chiropractor for neck problems he sustains from his neck
twitches.
Most people accept Nicholas' behavior, but the family knows not
everyone understands the disorder. They were having dinner at a
local restaurant a few weeks ago when another customer said Toni
should learn to "control her child."
Toni said she and her husband treat and discipline Nicholas the same
way they do their other son, 7-year-old Anthony.
"Kids with Tourette's have to be treated like they're any other
child," Toni said. "They're not acting out, they're not misbehaving
or looking for attention.
They still can be successful."
Toni constantly tells both her children they can do or be whatever
they want.
The Macchiarolos do not know who in their family carried the
dominant gene. Toni said she often teases her husband, saying it was
his family.
He taunts back, saying it was her family.
Anthony has not yet shown any of the symptoms, but it still is hard
for him. Toni said he has returned home from school distraught
because kids were calling his older brother names.
The family belongs to a Tourette's Syndrome support group, which
helps them realize they are not alone in dealing with the disorder.
"It's good for us parents to vent to one another, so we don't
think, 'Am I the only one going through this?'" Toni said.
The Southwest Florida group is part of the Tourette Syndrome
Association, or TSA, and it will hold the Southwest Golf Fest in
Fort Myers on Oct. 11.
The charity golf tournament will feature former Florida Marlins
first baseman and outfielder Jim Eisenreich, who has triumphed over
his own struggles with Tourette's.
Local children with Tourette's, including Nicholas, will wear shirts
that read, "Ask me what makes me tic."
The object of the tournament is to raise money for Tourette's
Syndrome research and increase overall awareness of the disorder.
http://www.marcoeagle.com/03/07/marco/d951083a.htm
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