Sara Pawlowski, M.D., associate professor of psychiatry at UVM’s Larner College of Medicine and division chief for primary care mental health integration at the University of Vermont Health Network

(JANUARY 18, 2023) Sara Pawlowski, M.D., associate professor of psychiatry at UVM’s Larner College of Medicine and division chief for primary care mental health integration at the University of Vermont Health Network, commented to Medscape about a phase 2 trial showing that the medication ecopipam, in development for Tourette syndrome in children and adolescents, reduces Tourette’s tics without common side effects.

Several things should be considered with this research, Pawlowski explained. One is that, though the results show a reduction in tics, the study lasted only 12 weeks and “tics can last a lifetime,” she noted. “They also can ebb and flow with major life events, stressors, and various other variables. So, I wonder how the effects of improvement can be teased out from the natural ebb and flow of the condition in a 3-month window, which is a snapshot into the course of a known relapsing, remitting, lifetime, and chronically variable condition.”

Pawlowski said that although effective medications are needed, she urges focusing on better access to nonmedication treatments “that work for children and adolescents” as children who start taking the medications early may take them for the rest of their lives.

Also, while the research didn’t find weight gain in the ecopipam group, the side effects they did find in the group, including headache and insomnia, “do impact a child’s life,” she noted.

“We also can’t be reassured that over the course of chronic treatment there wouldn’t be movement disorders or metabolic disorders that emerge. Those are side effects or disorders that can emerge surreptitiously over time, and more time than 12 weeks,” she said.

Findings of the multicenter, double-blind, trial funded by the drug maker, Emalex Biosciences, were published online in Pediatrics.