Tic Clinical Trial
Official title:
Double-Blind, Placebo-Controlled Trial of N-acetylcysteine (NAC) for the Treatment of Children With Tourette Syndrome
Verified date | July 2014 |
Source | Yale University |
Contact | n/a |
Is FDA regulated | No |
Health authority | United States: Institutional Review Board |
Study type | Interventional |
Tourette syndrome is a childhood-onset neuropsychiatric disorder characterized by multiple
motor and vocal tics that last for at least a year in duration. Currently, there exist
several effective pharmacological treatments for childhood tics including alpha-2 agonist
medications (guanfacine and clonidine) and neuroleptics (antipsychotic) medications. These
medications, however, have significant side-effects and are only partially efficacy in
treating tics.
N-acetylcysteine (NAC) is a natural supplement that acts as an antioxidant and glutamate
modulating agent. NAC has been used safely for decades in doses 20-40 times higher than in
this trial as an antidote for acetaminophen overdose. The only side-effect commonly seen
with NAC is nausea and this side-effect is seldom seen in the doses used in this trial.
NAC has recently been demonstrated to be effective in a double-blind, placebo-controlled
trial in adults with trichotillomania (chronic hair pulling). Hairpulling is hypothesized to
be closely related to tics because these conditions (1) have similar clinical
characteristics -- both groups typically experience urges before engaging in pulling or
tics, (2) neuroimaging studies suggest they involve similar brain circuits -- the basal
ganglia, (3) the same pharmacological treatments (neuroleptics) may be effective for both
conditions and (4) they tend to be inherited together in families. In other trials NAC has
evidence of some efficacy in treating diverse psychiatric conditions such as bipolar
depression, schizophrenia and cocaine dependence.
The investigators are conducting this trial to determine if NAC is an effective treatment
for tics.
Status | Completed |
Enrollment | 31 |
Est. completion date | January 2014 |
Est. primary completion date | January 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 8 Years to 17 Years |
Eligibility |
Inclusion Criteria: - Children aged 8-17 years. - Primary diagnosis of Tourette syndrome or chronic tic disorder. - Duration of tics greater than 1 year. - Significant Current tic symptoms: Current YGTSS score greater than or equal to 22 with a TS diagnosis or greater than or equal to 14 with a chronic tic disorder. Exclusion Criteria: - Comorbid bipolar disorder, psychotic disorder, substance use disorder, developmental disorder or mental retardation (IQ<70). - Recent change (less than 4 weeks) in medications that have potential effects on tic severity (such as neuroleptic medications, dopamine agonists, alpha-2 agonists (guanfacine, clonidine or prazosin), SSRIs, clomipramine, naltrexone, lithium, psychostimulants, or anxiolytics). Medication change is defined to include dose changes or medication discontinuation. - Recent change in behavioral treatment for Tourette syndrome or comorbid conditions (i.e. OCD) within the last 4 weeks or initiation of behavioral therapy for tics within the last 12 weeks. - Asthma requiring medication use within the last 3 months - Known hypersensitivity or previous anaphylactoid reaction to acetylcysteine or any components in its preparation - Positive pregnancy test or drug screening test. - Previous use of N-acetylcysteine (dose greater than 600mg for more than 2 weeks) |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Yale Child Study Center | New Haven | Connecticut |
Lead Sponsor | Collaborator |
---|---|
Yale University | American Academy of Child Adolescent Psychiatry. |
United States,
Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Judd F, Katz F, Katz P, Ording-Jespersen S, Little J, Conus P, Cuenod M, Do KQ, Bush AI. N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial. Biol Psychiatry. 2008 Sep 1;64(5):361-8. doi: 10.1016/j.biopsych.2008.03.004. Epub 2008 Apr 23. — View Citation
Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI. N-acetyl cysteine for depressive symptoms in bipolar disorder--a double-blind randomized placebo-controlled trial. Biol Psychiatry. 2008 Sep 15;64(6):468-75. doi: 10.1016/j.biopsych.2008.04.022. Epub 2008 Jun 5. — View Citation
Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res. 2009 Dec;67(6):497-501. doi: 10.1016/j.jpsychores.2009.09.002. Review. — View Citation
Grant JE, Odlaug BL, Kim SW. N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2009 Jul;66(7):756-63. doi: 10.1001/archgenpsychiatry.2009.60. — View Citation
Ng F, Berk M, Dean O, Bush AI. Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol. 2008 Sep;11(6):851-76. doi: 10.1017/S1461145707008401. Epub 2008 Jan 21. Review. — View Citation
Singer HS, Morris C, Grados M. Glutamatergic modulatory therapy for Tourette syndrome. Med Hypotheses. 2010 May;74(5):862-7. doi: 10.1016/j.mehy.2009.11.028. Epub 2009 Dec 21. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Improvement in Tic Severity | Yale Global Tic Severity Scale (Total Tic Score) | 12 weeks | No |
Secondary | Improvement of Premonitory Urges | Premonitory Urge for Tics Scale (PUTS) | 12 weeks | No |
Secondary | Improvement in OCD Severity | Childrens' Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) | 12 weeks | No |
Secondary | Overall Improvement | Clinical Global Improvement Scale | 12 weeks | No |
Secondary | Adverse Effects | Pediatric Adverse Events Rating Scale | 12 weeks | No |
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