Tourette syndrome is a mental disease, have probably existed as long as humans have. Tourette syndrome treatment ranged from psychotherapy to shock therapy, lobotomy, and even exorcism.
A few reports of single cases that responded to various tourettes syndrome psychotherapy treatments can be found in the early literature on Tourette syndrome. In retrospect, these single case histories are likely to have coincided with the periodical waning of symptoms that is so characteristic of the disorder.
The presence of copralalia in the more severe and easily diagnosed cases led analytic therapists to theorize, often imaginatively, about the causes of TS, but nothing was accomplished in the way of long term relief of symptoms. Mild cases, especially those not exhibiting coprolalia, were simply characterized as “nervous” as is not infrequently the case today.
The common sense approaches of the time, usually various types of physical or psychological punishment, met with equal lack of success but were not recommended in the medical literature.
The discovery of haloperidol effect set the scene for a completely new and far more efficacious approach to the treatment of TS symptoms. Indirectly, by changing the attitude of the treating physicians from one of hopelessness to hopefulness, the advent of treatment with haloperidol also stimulated into the nature and pathogenesis of this perplexing disorder.
For a decade, haloperidol reigned supreme as the only treatment for TS, but this position was soon challenged by newer drugs with fewer side effects. Before considering the individual drugs available today, certain guidelines about the use of drugs in the treatment of Tourette’s syndrome should be considered.
First, a diagnosis of TS does not by any means imply that a patient should be treated with drugs. On the contrary, each case must be carefully evaluated. TS covers a broad spectrum of severity, from very mild forms with minor tics to full blown severe cases with violent involuntary movements, loud barking, coprolalia, and so on. Luckily, most cases diagnosed today fall within the milder range and severe cases of TS remain relatively rare.
Second, the effect of a given set of symptoms can vary enormously among patients. Certain symptoms in one individual may lead to major coping problems, whereas in another way may constitute a relatively minor inconvenience.
Third, many patients are particularly sensitive to the side effects of medications and prefer to endure their symptoms. This decision, however, is more wisely made after trials on medications than before. Before choosing to try medication, both the patient and the doctor should come to an understanding about which symptoms to target.