Reactions 519 - 17 Sep 1994

★Clomipramine

First report of tics: case reportA 29-year-old man experienced the exacerbation of motor

tics and the appearance of vocal tics after he tookclomipramine [Anafranil®] as therapy for obsessive-compulsive disorder.

The patient, who was diagnosed as having obsessive-compulsive disorder, simple motor tics (mainly eye blinking),and schizoid personality disorder was started on clomipramineat a dosage that was increased to 300 mg/day. The patient’sobsessive-compulsive behaviour improved within 4–6 weeks.However, he began to experience vocal tics and motor tics ofhis hands and legs. Examination revealed tourettism; hissymptoms included the original eye blinking, diffuse motortics of his upper and lower limbs, and vocal tics.

Clomipramine therapy was discontinued by gradualtapering and the patient showed a gradual improvement insymptoms after 3 weeks. A month after clomipramine therapywas stopped the vocal and peripheral motor tics disappeared,but the eye blinking persisted. There was a concurrentexacerbation of the obsessive-compulsive disorder which wassubsequently successfully treated with fluoxetine.

Author comment: ‘To the best of our knowledge, this is thefirst report of the emergence of Tourette-like signs to CMI[clomipramine].’Moshe K, et al. Clomipramine-induced Tourettism in obsessive-compulsivedisorder: clinical and theoretical implications. Clinical Neuropharmacology 17:338-343, Aug 1994 - Israel 800289846

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Reactions 17 Sep 1994 No. 5190114-9954/10/0519-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved