This publication is intended to provide information about medication currently in use for TS treatment. Readers are cautioned against taking and/or changing medications based on this information without first consulting a physician. Such names appear only as information for our members. TSAO assumes no liability whatsoever for the use of any product or service mentioned.

Medication	Action	Comments	Adverse Effects
Haloperidol (Haldol) Neuroleptic	Alters the effects of dopamine in the CNS. Alsohas anticholinergic and alpha-adrenergic blocking activity. Expected therapeutic effect: decrease in motor and phonic tics.	Most side effects are dose relatedand can be resolved by decreasing dosage. Anti-parkinsonian medication (e.g.0.5mg/day of benztropine) can sometimesbe used to alleviate side effects. Additive hypotension with antihypertensives, nitrates, or alcohol. Additive CNS depression with other CNS depressants. Concurrent use with epinephrine may result in severe hypotension and tachycardia. Acute encephalopathic syndrome may occur when used with lithium.	Motor drug-induced parkinsonism, akinesia, akathisia, acute dystonia, tardivedyskinesia, oculogyric crisis, extrapyramidal reactions, restlessness CNS sedation, drowsiness, decrease in cognitive function, anxiety Autonomic dry eyes/ mouth, urinary retention, diaphoresis, hypersalivation GI increase appetite, weight gain, anorexia, constipation, hepatitis Other dysphoria, social and school phobias, heat stroke, polydipsia, impotence,photosensitivity, rashes, galactorrhea, hyperpyrexia, anemia, leukopenia
Pimozide (Orap) Neuroleptic	Alters the effects of dopamine in the CNS. Possessesanticholinergic and alpha-adrenergic blocking activity. Expected therapeutic effect: decrease in motor and phonic tics.	Better tolerated than haloperidol and probably is of equal efficacy. EKG routinely ordered to monitor rhythm abnormalities. (U waves, inverted T waves, and Q-T prolongation.) Not generally a problem.	In general, side effects are similar to haloperidol, but may be less severe and appear in fewer patients.
Fluphenazine(Prolixin) Neuroleptic	Alters the effects of dopamine in the CNS. Possesses anticholinergic and alpha-adrenergic blocking activity. Expected therapeutic effect: decrease in motor and phonic tics.	May cause false positive pregnancy test. May turn urine pink or reddish brown.	In general side effects are the same as those listed for haloperidol, but, like Orap, some patients tolerate it better.
Thiothixene (Navane) Neuroleptic	Alters the effect of dopamine in the CNS. Expected therapeutic effect: decrease in motor and phonic tics.	In event hypotension occurs, epinephrine should not be used as a pressor agent since a paradoxical further lowering of BP may result. EKG changes usually reverse and frequently disappear on continued therapy. May cause false positive pregnancy test.	Adverse affects similar to those for haloperidol. In addition, may have tachycardia, hypotension,non specific EKG changes, amenorrhea.
Chlorpromazine (Thorazine) Neuroleptic	Alters the effect of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking activity. Expected therapeutic effect: decrease in motor and phonic tics.	Sudden death, apparently due to cardiac arrest, has been reported. Skin pigmentation may occur following prolonged usage. Ocular changes characterized by deposition of fine particulate matter in the lens and cornea.	In general, side effects same as forhaloperidol with an addition of two or three further symptoms. Noted EKG changes involving Q-T wave distortion, skin pigmentation changes, and eye changes.
Trifluoperazine (Stelazine) Neuroleptic	Alters the effect of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking action. Expected therapeutic effect: decrease in motor and phonic tics.	May cause falsepositive pregnancy test. May cause false positive liver bilirubin test. CBC and liver function tests should be monitored .	In general,side effects similar to haloperidol. Additionally may cause Q wave and T wave changes, blood dyscrasia.
Thioridazine (Mellaril) Neuroleptic	Alters the effects of dopamine in the CNS. Possesses significant anticholinergic and alpha adrenergic blocking activity. Expected therapeutic effect: decrease in motor and phonic tics. Improvement in behavior.	Additive hypotension with other antihypertensive agent, nitrates, and acute ingestion of alcohol. Additive CNS depression with other CNS agents including antihistamines,narcotic analgesics, sedative/hypnotics. Lithium decreases blood level. May mask early signs of lithium toxicity and increases the risk of extrapyramidalreactions. Concurrent use with epinephrine may result in severe hypotension and tachycardia. Increased risk of agranulopcytosis with antithyroid agents.	In general, side effects similar to haloperidol. Additionally may cause hepatictoxicity.
Risperidone (Risperdal) Neuroleptic	Dopamine and serotonin receptor antagonist. Expected therapeutic effect: decrease in motor and phonic tics. Improvement in behavior.	May be tolerated better than other neuroleptics,with fewer side effects.	In general side effects similar to haloperidol.
Clomipramine (Anafranil) Antidepressant Antiobsessive	Potentiates the effect of serotonin (antiobsessionaleffect) and norepinephrine in the CNS. Also has moderate anticholinergic properties. Expected therapeutic effect: decrease in obsessing, decrease in compulsions,possible decrease in tics, decrease in depression.	May block therapeutic response to antihypertensives. Use with clonidine may cause hypertensive crisis. Additive CNS depression with other CNS depressants including alcohol, antihistamines,narcotic, analgesics, and sedative/hypnotics. Adrenergic and anticholinergic side effects may be additive with other agentsthat have the same properties. Nicotine or cigarette smoke may increase metabolism and decrease effectiveness.	Motor muscle weakness, extrapyramidal reactions CNS Seizures, sedation, drowsiness, lethargy, aggressive behavior. Autonomic dry eyes and mouth, blurred vision, vestibular disturbances, urinary retention GI constipation, weight gain, Other impotence, photosensitivity, gynecomastia, hyperthermia
Fluoxetine(Prozac) Antidepressant	Inhibits the uptake of serotonin in the CNS. Expected therapeutic effect: decrease in obsessing, decrease in compulsions,possible decrease in tics, decrease in depression.	Additive hypotension with antihypertensive agents. Additive CNS depression with other CNS depressants including alcohol, antidepressants,antihistamines, MAO inhibitors, narcotic analgesics, sedative/hypnotics. Phenobarbital may increase metabolism and decrease effectiveness. Concurrent use with lithium may produce acute encephalopathy, decreased chlorpromazine absorption, increased excretion of lithium, increased riskof extrapyramidal reactions. Decreases vasopressor response to epinephrine and norepinephrine. Concurrent use with beta blockers may result in inhibition of metabolism of one or both drugs producing an increased response. Increased risk of anticholinergic effects with other agents having anticholinergic properties.	Motor extrapyramidal reactions, tardive dyskinesia, weakness, seizures CNS sedation, anxiety, insomnia, headache, tremor, dizziness, fatigue, mania,abnormal dreams Autonomic dry eyes and mouth, urinary retention, blurred vision, excessive sweating GI Constipation, ileus, anorexia, diarrhea Other hypotension, tachycardia, photosensitivity, hyperthermia, rare suicidalideation, cough, flu-like syndrome, impotence
Sertraline HCL (Zoloft) Antidepressant	Potent selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. Does not inhibit MAO. Expected therapeutic effect: decrease in depression, decrease in aggressive behavior, possible decrease in obsessions and compulsions.	Reports of fatal reactions withgiven with MAO inhibitors. Recommended that at least 14 days should elapsebetween usage. 32% decrease in valium clearance. 8% increase in prothrombin time. Should monitor upon initiation or discontinuation of use with warfarin.	Motor ataxia, abnormal coordination, abnormal gait, tremor, dizziness CNS confusion, hyperesthesia, migraine, nystagmus, vertigo, twitching, insomnia Autonomic dry mouth, sweating, hypersalivation, urinary retention GI dysphagia, fecal incontinence, anorexia, weight gain, diarrhea Other aggressive reaction, amnesia, abnormal dreams, depersonalization, emotionallability, hallucination, gynecomastia, male sexual dysfunction, skin discoloration,skin odor, myalgia
Bupropion (Wellbutrin) Antidepressant	Decreases neuronal reuptake of dopamine inthe CNS. Diminished neuronal uptake of serotonin and norepinephrine (less than tricyclic antidepressants). Expected therapeutic effect: decrease in depression, increased ability to concentrate. Possible decreasein obsessions and compulsions.	Increased risk of adversereactions when used with levodopa or MAO inhibitors. Increased risk of seizures with phenothiazines, antidepressants, cessationof benzodiazepines, or cessation of alcohol. If dose is missed, omit dose and return to regular dosing schedule. Do not double dose. Increased risk of seizure.	Motor tremor, ataxia/incoordination, seizure, dyskinesia, vertigo CNS seizures, agitation, insomnia, psychoses, mania, headache, mania/hypomania,hallucinations, depression, memory impairment, depersonalization, mood instability GI dry mouth, nausea, change in appetite, weight gain or loss, constipation,dysphagia, stomatitis Other edema, EKG abnormalities, rashes, alopecia, gynecomastia, nocturia, vaginalirritation, sexual dysfunction, enuresis, urinary incontinence, menopause,shortness of breath, visual disturbance, flu-like syndrome
Paroxetine HCL (Paxil) Antidepressant	Potentiation of serotonergic activity in the CNS resultingfrom inhibition of neural reuptake of serotonin. Very weak effects on norepinephrine and dopamine neuronal reuptake. Expected therapeutic effect: decrease in depression, decrease in aggressive behavior.	Phenobarbitolmay decrease effectiveness. Cimetidine may increase concentrations in plasma by 50%. Co-administration of certain antidepressants (e.g., nortriptyline, amitriptyline,imipramine, desipramine and fluoxetine) should be approached with caution.	Motor myoclonus CNS insomnia, agitation, anxiety, headache, parethesia, CNS stimulation, asthenia,somnolence, dizziness Autonomic dry mouth, sweating, blurred vision GI constipation, increased or decreased appetite, dyspepsia, diarrhea Other fever, taste perversion, male sexual disturbance, urinary frequency, myalgia
Venlafaxine hydrochloride (Effexor) Antidepressant	Potent inhibitor of neuronal serotonin andnorepinephrine reuptake and weak inhibitors of dopamine reuptake. Expected therapeutic effect: decrease in depression, possible decrease in obsessions and compulsions.	When discontinueddose should be tapered slowely over a 2 week period. At least 14 days should elapse between discontinuation of an MAOI and initiationof therapy with Effexor. In addition, at least 7 days should be allowedafter stopping Effexor before starting an MAOI. Dose may need to be reduced by 50% for patients with hepatic impairment.	Motor tremor, hypertonia,ataxia, hyperkinesia, rare dystonia CNS Migraine, asthenia, somnolence, dizziness, nervousness, anxiety, insomnia Autonomic Dry mouth and eyes, blurred vision sweating GI Nausea, constipation, anorexia, diarrhea Other abnormal ejaculation/orgasm, impotence
Fluvoxamine (Luvox) Antidepressant	Potent inhibitor of presynaptic neuronal reuptakeof serotonin Expected therapeutic effect: decrease in depression, decrease in obsessions and compulsions.	Thecoadministration of fluvoxamine 100 mg/day and propranolol (Inderol) resulted in a fivefold increase in propranolol plasma concentration and a slightdecrease in heart rate.	Motor tremor, hypodinesia CNS somnolence, headache, agitation, dizziness, asthenia Autonomic dry mouth GI nausea/vomiting, constipation, anorexia Other insomnia, syncope
Desipramine HCL (Norpramin) Tricyclic antidepressant	Blocks re-uptake of norepinephrine.Has significant anticholinergic properties. Expected therapeutic effect: decrease in depression, increased ability toconcentrate, decrease in emotionally labile behavior.	Should not be given in conjunction with, or within2 weeks of, treatment with MAO inhibitor; hyperpyretic crisis and deathhave occurred. Not recommended for children. Sudden death resulting from cardiac arrest has been reported in childrenusing this medication. Prolongation of QRS or QT wave intervals on EKG are significant for toxicity.	Motor incoordination, ataxia, extrapyramidal symptoms, seizures CNS disorientation, anxiety, insomnia, nightmares, hypomania, drowsiness, Autonomic dry mouth, blurred vision, urinary retention, sweating, urinary frequency GI anorexia, constipation, weight gain Other itching, photosensitivity, gynecomastia, galactorrhea, decreased libido,alopecia, EKG changes
Imipramine (Tofranil) Tricyclic antidepressant	Potentiates the effect of serotoninand norepinephrine. Has significant anticholinergic properties. Expected therapeutic effect: decrease in depression, increased ability toconcentrate, decrease in emotionally labile behavior.	May cause hypotension and tachycardia when used with MAO inhibitors. Avoid concurrent use-discontinue 2 weeks prior to start of imipramine. May prevent therapeutic response to most antihypertensive. May cause severe hypertension when used with clonidine. Avoid concurrentuse.	CNS drowsiness, sedation, confusion, agitation, hallucination, insomnia Autonomic dry mouth and eyes, blurred vision, urinary retention GI constipation Other photosensitivity, hypotension, EKG changes, arrhythmias
Buspirone HCL (Buspar) Antianxiety	Binds to serotonin and dopamine receptors inthe brain (enhances serotonin transmission while blocking dopamine transmission).Increases norepinephrine metabolism in the brain. Expected therapeutic effect: decrease in emotionally labile behavior.	Usewith MAO inhibitors may result in hypertension. Avoid use with alcohol	Motor incoordination, tremor, fatigue CNS dizziness, insomnia, nervousness, drowsiness, excitement, personality changes,paresthesia, numbness Autonomic blurred vision, nasal congestion, altered taste or smell, dry mouth andeyes, sweating, urinary hesitancy GI diarrhea, constipation, nausea Other myalgia, chest pain, palpitations, tachycardia, hypo or hypertension
Diazepam (Valium) Antianxiety Sedative /hypnotic	Depresses the CNS, probably by potentiatinggamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferentpathways. Expected therapeutic effect: decrease in anxiety.	Concurrentuse with alcohol, antidepressants, antihistamines, and narcotic analgesics results in additive CNS depression. Cimetidine, oral contraceptives, disulfiram, fluoxetine, ionized, propranolol,ketoconazole, metoprolol, propoxphene, or valproic acid may enhance itsactions. Sedative effects may be decreased by theophylline.	CNS dizziness, drowsiness, lethargy, hangover, paradoxical excitation, mentaldepression, headache Autonomic blurred vision GI nausea, constipation Other respiratory depression, tolerance, psychological dependence, physical dependence.
Clorazepate (Tranxene) Antianxiety Sedative /hypnotic Benzodiazepine	Acts at many levels in the CNS to produceanxiolytic effect and CNS depression (by stimulating inhibitory GABA receptors).Produces skeletal muscle relaxation (by inhibiting spinal polysynaptic afferentpathways). Expected therapeutic effect: decrease in anxiety.	May decreaseefficacy of levodopa. Other drug interactions similar to diazepam.	Side effects similar to those of diazapam.
Alprazolam (Xanax) Sedative /hypnotic Benzodiazepine	Acts at many levels in the CNS to produce anxiolytic effect. Depresses the CNS, probably by potentiating gamma aminobutyricacid (GABA), an inhibitory neurotransmitter. Expected therapeutic effect: decrease in anxiety.	Drug interactions same as Tranxene.	Sideeffects similar to those of diazapam.
Carbamazepine (Tegretol) Anticonvulsant	Decreases synaptic transmission in the CNS. Expected therapeutic effect: decrease in aggressive behavior, decrease in emotionally labile behavior.	May decrease effectiveness of oral contraceptives, benzodiazepines, and otheranticonvulsants. Concurrent use (within 14 days) of MAO inhibitors may result in hyperpyrexia,hypertension, seizure and death. Verapamil, diltiazem, propoxphene, or erythromycin increases carbamazepinelevels and may cause toxicity.	Motor ataxia CNS vertigo, drowsiness, psychosis, visual hallucinations Autonomic blurred vision, urinary retention or hesitancy GI hepatitis Other Congestive heart failure, syncope, hypo- or hypertension, photosensitivity,aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, leukocytosis,eosinophilia
Clonazepam (Klonipin) Anticonvulsant	Produces anticonvulsant and sedative effectsin the CNS. Mechanism is unknown but is probably similar to that of benzodiazepines,has a high affinity for the y- gamma aminobutyric acid (GABA) receptor,increasing synaptic serotonin. Expected therapeutic effect: decrease in aggressive behavior, decrease in emotionally labile behavior,decrease in tics.	Longterm effects on growth and maturation in children not known. Concurrent use of alcohol, antidepressants, antihistamines, and narcoticanalgesics will result in additive CNS depression. Cimetidine, oral contraceptives, disulfiram, fluoxetine, ionized, propranolol,ketoconazole, metoprolol, propoxphene, or valproic acid may enhance itsactions. Sedative effects may be decreased by theophylline.	Motor Ataxia, choreiform movements CNS drowsiness, behavioral changes, abnormal eye movements, nystagmus Autonomic increased respiratory secretions, urinary retention, hypersalivation GI constipation, hepatitis Other palpitations, anemia, leukopenia, thrombocytopenia, eosinophilia, fever,increase in libido
Clonidine (Catapres) Antihypertensive Alpha blocker	Stimulates alpha adrenergic receptors in theCNS. Result is inhibition of cardioacceleration and vasoconstriction center. Adrenergic agonist, but stimulates inhibitory neurons in the CNS. In higherdoses ceases inhibitory effects and causes an increase in sympathetic arousal. Expected therapeutic effect: decrease in tics, increased attention, decrease in emotionally labile behavior.	Additivesedation with CNS depressants including alcohol, antihistamines, narcoticanalgesics, and sedative/hypnotics. Withdrawal phenomenon may be exaggerated by concurrent tricyclic antidepressants. Do not discontinue abruptly.	CNS drowsiness, nightmares, nervousness, depression Autonomic dry mouth and eyes GI constipation Other hypotension, bradycardia, palpitations, impotence, weight gain, withdrawalphenomenon
Guanfacine (Tenex) Antihypertensiv eAlpha blocker	Stimulates CNS alpha adrenergicreceptors, resulting in decreased sympathetic outflow. Expected therapeutic effect: decrease in motor tics, improvement in mood.	Additive hypotension with other antihypertensive agents, nitrates, and acute ingestion of alcohol. Additive CNS depression may occur with other CNS depressants, includingalcohol, antihistamines, narcotic analgesics, tricyclic antidepressants,and sedative/hypnotics.	CNS drowsiness, weakness, fatigue, dizziness, headache, insomnia, depression Autonomic dry mouth GI constipation, abdominal pain, nausea Other Tinnitus, dyspnea, impotence
Propranolol(Inderol) Antihypertensive Beta blocker	Blocks stimulation of beta1 and beta 2 receptorsites. Expected therapeutic effect: decrease in emotionally labile behavior, decrease in rage attacks, decreasein obsessive symptoms, possible improvement in tics.	Concurrent use with amphetamines,cocaine, ephedrine, epinephrine, norepinephrine, phenylephrine, or pseudoephedrinemay result in excess alpha-adrenergic stimulation, hypertension, and bradycardia. May produce hypertension within 14 days of MAO inhibitor. Cimetidine may decrease metabolism and increase the effects of propranolol. Do not withdraw abruptly.	CNS fatigue, weakness, depression, insomnia, dizziness Autonomic dry eyes, blurred vision, nasal stuffiness GI constipation, diarrhea, nausea, vomiting Other bronchospasm, bradycardia, pulmonary edema, hypo or hyperglycemia, impotence,Raynaud's phenomenon
Nifedipine (ProcardiaXL) Antihypertensive Calcium channel blocker	Acts on slow calcium channels invascular smooth muscle and myocardium, producing vasodilation. Expected therapeutic effect: decrease in tic symptoms.	Additive hypotensionwith antihypertensives. May increase blood levels and risk of toxicity with digoxin. Cimetidine may slow metabolism and lead to toxicity.	CNS dizziness, giddiness, headache Autonomic flushing, warmth, sweating, nasal congestion, sore throat GI nausea, constipation, flatulence Other dyspnea, cough, hypotension, wheezing, tachycardia, arrhythmias, fever,heart failure, muscle cramping
Verapamil(Isoptin) Antihypertensive Calcium channel blocker	Inhibits calcium transport into myocardialand vascular smooth muscle cells, resulting in inhibition of excitationcontraction coupling and subsequent contraction. Expected therapeutic effect: decrease in motor tics, improvement in mood.	Mayincrease or decrease lithium levels. Increase risk of toxicity from theophylline. Increased risk of bradycardia, congestive heart failure, and arrhythmiaswhen used with beta-adrenergic blocking agents or disopyramide. Additive hypotension with antihypertensive agents, acute ingestion of alcohol,nitrates, or quinidine.	CNS dizziness, headache, fatigue GI constipation,abdominal discomfort Other bradycardia, hypotension, edema, heart block, sinus arrest, pulmonary edema
Methylphenidate HCL (Ritalin ) CNS stimulant	Produces CNS and respiratory stimulation withweak sympathomimetic activity. Expected therapeutic effect: increased attention span in attention deficit disorder. Caution: may cause increase in motor tics. May cause onset of TS.	Adversereactions can usually be reduced by decreasing dosage or omitting dose in afternoon or evening. Toxic psychosis has been reported. Long term therapy may stunt growth. Treatment should be assessed periodically. Improvement may be sustained when the drug is either temporarily or permanently discontinued. Drug treatment usually may be discontinued after puberty.	Motor increase in motor tics, restlessness, tremor, hyperactivity, akathisia,dyskinesia CNS insomnia, irritability, dizziness, headache, nervousness Autonomic blurred vision, dry mouth GI nausea, anorexia, cramps, constipation, weight loss Other leukopenia, fever, tachycardia, palpitation, hyper or hypotension, metallictaste
Dextro amphetamine (Dexedrine) CNS stimulant	Produces CNS stimulation by releasing norephinephrine from nerve endings. Expected therapeutic effect: increased attention span in attention deficit disorder. Caution: may cause increase in motor tics. May cause onset of TS.	Additive adrenergic effects with other adrenergicagents. Use with MAO inhibitors can result in hypertensive crisis. Large doses of ascorbic acid decreases effect. Phenothiazines may decrease effect. May antagonize the response to antihypertensive. Increased risk of cardiovascular side effects with beta blockers or tricyclicantidepressants.	Side effects similar to those of Ritalin with an addition of psychological dependence, physical dependence, increasedlibido, decrease in seizure threshold
Pemoline(Cylert) CNS stimulant	Produces CNS stimulation, which may be mediatedby dopamine. Expected therapeutic effect: increase in attention span in attention deficit disorder. Caution: may cause increase in motor tics. May cause onset of TS.	Long term therapy may stunt growth. Additive CNS stimulation with other CNS stimulants or adrenergics, including decongestants Take medication in a.m. to avoid sleep disturbances.	Side effects similar to those of Ritalin with the addition of dyskinetic movements, sweating, decrease in seizure threshold.
Lithium (Lithobid) Antimanic Antidepressant	Alters cation transport in nerve and muscle.May also influence re-uptake of neurotransmitters. Expected therapeutic effect: given concurrently with antidepressant may enhance response to serotonergic agents.	May prolong the action of neuromuscular blocking agents. Encephalopathic syndrome may occur with haloperidol. Diuretics, methyldopa, probenecid, indomethacin, and other nonsteroidalanti inflammatory agents may increase the risk of toxicity. Lithium may decrease the effects of chlorpromazine. Chlorpromazine may mask early signs of lithium toxicity. Large changes in sodium intake (medication or food) may alter the renalelimination of lithium. Increasing sodium intake will increase renal excretion.	Motor muscle weakness, rigidity, hyperirritability, ataxia, tremors, psychomotorretardation CNS headache, impaired memory, lethargy, drowsiness, confusion, seizure, restlessness,aphasia, hyperirritability Autonomic tinnitus, blurred vision, dry mouth GI nausea, anorexia, epigastric bloating, abdominal pain, diarrhea, metallictaste, weight gain Other EKG changes, hypotension, arrhythmias, polyuria, nephrogenic diabetes insipidus,renal toxicity, acneiform erruption, folliculitis, pruritis, diminishedsensation, alopecia, hyper- or hypothyroidism, goiter, hyperglycemia, leukocytosis

References: Physicians' Desk Reference 1992, 46th edition.
Davis's Drug Guide For Nurses, third edition1993, Judith Hopfer Deglin,PharmD, April Hazard Vallerand,
MSN, RN, F.A. Davis Company, Philadelphia.

REPRINTED FROM: Wang, C., & Curry, L. (Eds.) Tourette Syndrome A Continuing EducationCourse for Registered Nurses, Tourette Syndrome Association - Southern CaliforniaChapter. TSA-SC Reseda, CA 1993.

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