Talk:Tourette syndrome

• Talk:Tourette syndrome/Archive1
• Talk:Tourette syndrome/Archive2 (?? - 01:25, 16 February 2006)

Nicotine

I took the link to the nicotine page to read about this substance as this article on Tourette Syndrome says that physicians caution against using it to treat Tourette's because of its carcinogenic traits. However, the nicotine page states in its introduction that the substance is not carcinogenic. An inconsistency of 'fact'-stating that perhaps should be cleared up?

Doesn't matter. More importantly, nicotine is not effective in treating Tourette's. Sandy 00:06, 6 February 2006 (UTC)

On a related note I removed the reference in the Marinol paragraph about the animal studies that showed that nicotine and Marinol are effective adjucts in treating TS for these reasons: First, I think the fact that it is about both Marinol and nicotine confuses things. Second, it is not really a study on Marinol or nicotine monothearpy, it is a study on using them as an adjuct to neuroleptics. Third, and most importantly, it is only an animal study and therefore proves nothing about treating humans with TS.

— Preceding unsigned comment added by 206.59.61.72 (talk • contribs) 01:50, 15 February 2006 (UTC)

The first sentence in the Experimental treatments section refers to nicotine. It quotes Swerdlow's 2005 paper (see references). His specific words are: "Consequently, drugs often reported to be effective in individual cases or case series fail in controlled trials. One notable example is nicotine, which produced profound and prolonged tic reduction in case reports, but these effects were not reproduced in the first controlled trial reported 13 years later." Unsigned user, please explain why you continue to edit the entry ? The addition of the word "patches" adds what for the reader? I will change it back. Sandy 00:47, 16 February 2006 (UTC)

I'm not trying to promote nicotine thearpy at all I hope you realize. I just thought "patches" would be more precise, because there are other ways of consuming nicotine. You can also smoke, or use the gum. Just saying nicotine doesn't make it clear to the reader that nobody has ever suggested that people with TS smoke, for example.206.59.61.72 18:14, 16 February 2006 (UTC)

By restricting the discussion to "patches", on the other hand, you are talking about a delivery system rather than the actual ingredient. The more correct statement is about the ingredient, not the delivery vehicle. Sandy 19:00, 16 February 2006 (UTC)

Should we include Dr. Tourette's full name?

I used to think that his full name was Gilles de la Tourette. Then I found out that it was Georges Gilles de la Tourette. Then I found out (in the wiki article about him) that his full name was Georges Albert Édouard Brutus Gilles de la Tourette.

He had a very long name. How much of it should we put into this article? Maybe someone who speaks some French could help us.206.59.61.72 22:47, 15 February 2006 (UTC)

His name makes sense to me, but I speak other languages and am accustomed to longer names. Think in terms of "de la." I don't know if it matters what is on the picture caption, since his full name is specified in the text ?? Sandy 23:13, 15 February 2006 (UTC)

I should clarify further: for contemporary English-speaking purposes, his last name is Gilles de la Tourette, and his first name is Georges. His full name is included in the Wikipedia article about him, but not on the Tourette syndrome article. It could also be included in the text here, but may confuse people who aren't accustomed to longer names, as it did you ?? Sandy 17:11, 16 February 2006 (UTC)

With a name like that he was probably an aristocrat which usually have very long names with the distinctive de which is often the name of a village or town of which they marquis, conte or baron, I think we should include his complete name--Khalid hassani 00:07, 17 February 2006 (UTC)

Well, not everyone who has a de in their long last name is an aristocrat <blush>, but I added it since several have raised the need. Thanks ! Sandy 00:12, 17 February 2006 (UTC)

Verifiable, reliable sources

Returning to the issue of verifiable and reliable sources. Because Oliver Sacks' fictionalized writings are not subject to peer review, they may need to be placed in context for a medical article. That is, the factual basis for his descriptions of fictionalized characters should be established, particularly since not all TS professionals agree with all of his views and statements about Tourette's. Attempting to establish that the fictional character "Carl Bennett" was based upon a real person, I included mention of Mort Doran in the following sentence:

Neurologist and writer Oliver Sacks describes a physician with severe TS, (Canadian Mort Doran, M.D., a pilot and surgeon in real life, although a pseudonym was used in the book), whose tics remit almost completely while he is performing surgery.

I found my reference, which is Morton L. Doran's bio from a TSA conference. He has spoken at many TSA conferences, evidenced by Google Groups posts to alt.support.tourette, the newsgroup. I don't know how to cite a conference, so I am including the information here, hoping someone will help with how to cite it.

The Tourette Syndrome Association, Inc., Connecticut Chapter
1998 Educators' Conference
Understanding and Managing Tourette Syndrome, and the Associated Disorders, Obsessive Compulsive Disorder & Attention Deficit Hyperactivity Disorder in the Classroom.
Friday, November 6, 1998
With Keynote Speaker Morton L. Doran, MD,
Surgeon written about in
The Man Who Mistook His Wife for a Hat by Oliver Sacks, MD
at Western Connecticut State University
Westside Campus, Danbury, CT
"This year's keynote speaker is Morton L. Doran, MD. Dr. Doran is a practicing surgeon, professor of medicine and recreational pilot who has had Tourette Syndrome since early childhood. He was featured in a book, The Man Who Mistook His Wife for a Hat by Oliver Sacks, MD, a perceptive look at living successfully with neurobiological disorders. Dr. Doran was the featured surgeon in New Yorker magazine's article about a surgeon with TS. He is a dynamic and highly respected spokesperson for the Tourette Syndrome Association in the USA and Canada." — Preceding unsigned comment added by SandyGeorgia (talk • contribs) 16:52, 16 February 2006 (UTC)

Mediation

Hi, I'm your friendly cabal mediator. Sandy has requested mediation on this page. This isn't any kind of formal thing, well it will probably fluctuate in formality. The most important thing is that I'm not here to pass judgement or place blame, I'm just a third person who will attempt to look at your dispute in an impartial fashion and try and help you build consensus.

To the anonymous user, could you please outline your side of the story on the mediation page, thanks! :) - FrancisTyers 11:14, 16 February 2006 (UTC)

Ok, first thing I'd like to see is some kind of precedent for either of your points of view. Check out the Wikipedia articles on other neurological disorders and see how they deal with experimental treatments. I note that the page on Parkinson's disease does not have any information on experimental treatments, however the article on Multiple sclerosis mentions Cannabis but only briefly (one sentence). Please try and be terse, limiting yourself to listing the article and its position. I may move discussion that strays from the point. - FrancisTyers 23:02, 16 February 2006 (UTC)

Okay, well there were three articles. The first was a study of 12 people that found that Marinol was effective for TS and have very few adverse effects. The Second was about a longer larger study that had the same conclusion, and noticed that Marinol's effectiveness increased the longer people took it. The third paper noted that people with TS taking Marinol experienced a general trend toward improving their cognative functioning. These studies were funded by the TSA. I realize that the summary of the studies sounds NPOV, but if you look at the actual abstracts, I am not making any exaturations. Perhaps I should delete the information about the smaller study, since the larger study had the same conclusion.206.59.61.72 23:12, 16 February 2006 (UTC)

I focused on featured articles, in the biology and medicine section, as they have been subjected to medical review. Asthma includes a paragraph on alternative medicine, and although I don't know all the terminology, it appears to have one sentence on each "alternative", summarizing the actual medical research supporting (or not) the treatment. Multiple sclerosis includes a section called "Therapies under investigation", which includes between 1 and 3 sentences on each therapy that is the active subject of current research (not our case). Pneumonia, Prostate cancer and Tuberculosis do not seem to include experimental treatments or treatments in development. I know the MCotW is currently working on AIDS, so I went to see what's there, although it is not yet a featured article. It has one sentence summarizing current research, and a section summarizing the usefulness and research regarding alternative medicine. The other medical articles seem to support a brief summary of experimental or in research treatment modalities, but not lengthy discussions of each. Sandy 23:21, 16 February 2006 (UTC)

Let's see the article on glaucoma has a very long paragraph about marijuana treatment. Much longer than the Marinol paragraph. 206.59.61.72 23:23, 16 February 2006 (UTC)

I note that the glaucoma article has a very light edit history, possibly reflecting low editor participation and limited to no (?) medical review. I can't judge the accuracy or relevancy of what is there. Sandy 23:28, 16 February 2006 (UTC)

The Multiple sclerosis article had this to say:"MS patients who use Cannabis report a soothing of the painful muscle spasms and improved muscle coordination. Some are able to walk unaided when they were previously unable to do so. It also helps blurred vision, tremors, loss of bladder control, insomnia and depression." So in fact our mediator was wrong when he said there was only one sentence in the MS article on cannibus! You can't explain away everything.206.59.61.72 23:34, 16 February 2006 (UTC)

I noticed that the rest of the MS article is cited and referenced, but those 3 sentences are not. We might check the edit history to see if they were added after medical review? I didn't find references for those entries in the References section, but I did find a website about cannabis that was added to External Links. Sandy 23:50, 16 February 2006 (UTC)

It seems to me that the article on Parkinson's Disease does address quite a very alternative and experimental treatments, including stem cells, etc. It does not have a subjection for experiment treatments, it is all just in one very long section on treatment.206.59.61.72 23:41, 16 February 2006 (UTC)

In fact I have found no precident for the "disclaimer" sentence that the Marinol paragraph has at all! Deleting it would make it more breif.206.59.61.72 23:45, 16 February 2006 (UTC)

Now the paragraph is just 3 sentences. Sandy did say that all Marinol deserves is two or three sentences.206.59.61.72 23:48, 16 February 2006 (UTC)

To be accurate, the two or three would need to reflect the safety concerns raised in RxList. Sandy

Schizophrenia is/was a featured article. It has a long section on cannabis, but as a potential causative factor in the condition. Under treatment, it discusses dietary supplements with a paragraph (3 sentences). It has an entire section on alternative approaches, but that paragraph addresses views of schizophrenia, rather than treatment. In summary, I haven't found a medical article that devotes more than a sentence or three to experimental treatments, but if we were to get Marinol down to 3 sentences, the safety issues raised in RxList should be mentioned as to why it is not likely to become a widespread treatment for the *majority* of patients with TS, who are children, since the prevalance of tics is higher in children than adults, as it is a condition (unlike schizophrenia) which tends to remit with maturity. Sandy 00:07, 17 February 2006 (UTC)

Sandy the RX list is just the package inserts. All package inserts on stimulants tell people not to use the stimulants with TS. Should we put that in the article? As you know, the package inserts made by companies list as many things as possible, even things that are not proven, for liabity purposes. We should include the rxlist information on the stimulants if we are going to include RX list information on marinol. Now as far as the article on schizophrenia, if that article had stuff on how marijuana makes schizophernia worse, fine. But there is NO evidence of Marinol making TS worse! Also, any speculation on how likely Marinol treatment is to become widespread amongst children or adults in the future is pure POV speculation and does not belong in this article! You don't have a crystal ball! Now there are just 2 sentences on Marinol anyway!206.59.61.72 00:15, 17 February 2006 (UTC)

Also, all the rxlist information about all of the neuroleptic drugs show much worse side effects than anything the rxlist says about Marinol! Haldol is used on children all the time! Marinol is a lot safer than Haldol.206.59.61.72 00:18, 17 February 2006 (UTC)

I think you've done a fine job on what you've done with it. But, not everyone knows what THC is, and Marinol is a more common name than dronabinol, which redirects to TSH on Wikipedia anyway. Would this work for you??

Controlled research on treating Tourette's with tetrahydrocannabinol, a synthetic version of the main psychoactive substance found in cannabis (brand name Marinol®), showed the patients taking Marinol® had a significant reduction in tic severity without serious adverse effects, and more significant reduction in tic severity was reported with longer treatment. The researchers reported a trend towards improvement in cognitive functioning in patients taking Marinol, before and after treatment. Sandy 00:41, 17 February 2006 (UTC)

That seems alright, but I just made the letter THC into a link. That would be shorter than tetrahydrocannabinol and still links to the same article.

Well I removed the link to drabinol, but someone else put it back up. So I guess it will stay. Unfortunatly, THC stands for too many articles.206.59.61.72 04:39, 17 February 2006 (UTC)

Oh I think I see what you want. Okay I just added that THC is the main psychoactive chemical in cannibus.206.59.61.72 04:49, 17 February 2006 (UTC)