Case report : Exacerbation and provocation of tics by imipramine and sulpiride.
European Child and Adolescent Psychiatry, 2, 169 - 176.
(pdf file)

This paper deals with the problem of overlapping clinical effects of neurotropic agents in treating children with complex comorbidity.

Case: An 8-year old boy suffering from a complexity of symptoms such as chronic motor tics, compulsions, phobias, anxious inhibition, and stuttering displayed the totality of Tourette's syndrome while taking imipramine.
- Sulpiride also enhanced motor and vocal tics.

In the discussion, a review on the neurometabolic mechanisms in tic disease actually known is given, and on drugs proven to precipitate tics, which is the case in a number of neurotropic agents.
Psychodynamics and family dynamics are another issue that is discussed independently.

1/ Introduction: a) Case Report, b) Therapy and Development, c) Further Comments on the Background of the Cource of Illness:
2/ Discussion: a) Family History, b) Perinatal Risk Factory, c) Comorbidity, d) Provocation of Tics by Sulpiride and Imipramine:
3/ Conclusions .