Aims Children with Tourette syndrome are frequently given neuroleptics to suppress tics. These agents are generally associated with weight gain and other metabolic consequences which would clearly be of particular concern in this population. We examined weight and BMI data in cohort of children attending a specialist clinic.
Methods The records of 133 children with Tourette syndrome were examined. Weight, height and BMI were recorded for all patients at first consultation, and for 32 of these patients longitudinal growth data for over a year was available. The major limitation was the unexpected patchiness of the records. Patients were subdivided into groups dependant on the treatment they had received—No treatment (n=18), neuroleptics, aripiprazole only and treatment for other co-morbidities. Each weight or height measurement was compared to standardised scores according to British 1990 Growth Reference Data using calculation of a Z -score relative to the 50th centile.
Results Of the 133 patients 102 were male and 25 were females all under the age of 18 (mean age 14.02 (SD 3.6)). Of those, 45 had been treated with neuroleptics, 59 had not received drug treatment prior or subsequent to first visit and 29 had been treated for other co-morbidities. Untreated patients had slightly increased height, weight and BMI baseline average z-scores (0.43, 0.62, and 0.89 respectively) at initial consultation and these values were also similar for those already taking neuroleptics. For patients with longitudinal data of greater than one year (n=32) a t-test between those taking neuroleptics (18) and no medication (14) comparing changes in z-score from baseline to follow-up for height weight and BMI did not demonstrate any significant differences. Of those taking neuroleptics 6 were prescribed aripiprazole and had not been exposed previously to other agents. This group similarly showed no significant changes in their growth characteristics.
Conclusions Children with medicated or unmedicated TS are slightly heavier at baseline than control data, a finding whose significance is hard to interpret. These children when given neuroleptics don't in this modest sample appear to suffer from the significant weight gain beyond their expected growth curve reported in the general neuroleptic literature and the same applied to the newer agent aripiprazole which for which there is evidence that weight gain is less common than with alternative drugs. While clearly limited by a lack of longitudinal data this study provides preliminary indication that at the generally low doses that are used for treating tics in children, neuroleptics may not cause significant weight gain in the majority of patients.
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