An open label trial of fluoxetine (20-40 mg/d) was conducted in 32 Tourette syndrome patients with obsessive-compulsive disorder at the Department of Neurology, University of Rochester School of Medicine, NY. A subjective improvement in obsessions and compulsions occurred in 81% of 26 patients (13 children and 13 adults) who were treated for 3-8 months and a significant reduction in scores on the Leyton Obsessional Inventory occurred for both the adult and child groups. No serious adverse reactions were reported in either group. Side-effects included dyspepsia and nausea (4), skin rash (2), drowsiness (1) and mild hypomanic behavior (1). [1]

COMMENT. Fluoxetine is a new antidepressant that inhibits serotonin reuptake and is effective for psychiatric patients with obsessive-compulsive disorder. It appears to produce fewer and less toxic side-effects than clomipramine. The improvement in obsessive-compulsive disorder was most dramatic for the child sample of patients and may be a useful addition to the treatment of obsessive-compulsive disorder in Tourette syndrome.