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To investigate the effect of drugs acting on the endogenous opioid system, we studied 10 adults with Tourette's syndrome who received propoxyphene hydrochloride(260 mg/day),naltrexone hydrochloride(50 mg/day),and placebo in a double-blinded,randomized clinical trial.Using a self-report scale (Tourette's Syndrome Symptom List),subjects noted a significant(p<0.04) lessening of tics after treatment with naltrexone when compared with placebo.An improvement in performance on the Trial Making B test,a measure of attention and visuomotor sequencing and planning,occurred after receiving naltrexone when compared with placebo(p<0.08)or propoxyphene(p< 0.02).The Trial Making B test best discriminated the treatments(p<0.02, analysis of variance).No other treatment effects were observed for several other measures of tic severity,attentional ability,or obsessive-compulsive symptoms.Our findings indicate that pharmacological manipulation of the endogenous opioid system does influence symptoms of Tourette's syndrome. |
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