The Department of Psychiatry at Icahn School of Medicine at Mount Sinai has opened a new center to investigate and treat tics, obsessive compulsive disorder (OCD), and related disorders, which are estimated to affect more than 2 million people in the United States. The new center, at 1240 Park Avenue and 96th Street, serves patients in a clinical setting that is located down the hall from a research facility that will conduct clinical trials, genetic analysis, and functional brain imaging to learn more about the disorders.
Operated by the Division of Tic, Obsessive-Compulsive, and Related Disorders (DTOR), the center “is in the vanguard of academic psychiatry because it embraces the concept that tic disorders and OCD frequently overlap and are life-cycle disorders, not separate child and adult disorders,” says Wayne Goodman, MD, Chairman of the Department of Psychiatry at Icahn School of Medicine, and the Esther and Joseph Klingenstein Professor of Psychiatry. “We are among the first medical centers to put this important concept into practice in a way that improves patient care and research.”
By housing the clinical and research sides within close proximity of one another, the center will enable Mount Sinai to expand its framework for evaluating these disorders based on clinical observation and neurobiology.
“We are taking a fresh look at how patients present problems with respect to domains of function, and analyzing these from different levels,” says Dorothy Grice, MD, Chief of Mount Sinai’s Obsessive-Compulsive and Related Disorders Program, and Professor of Psychiatry.
Tourette’s Disorder, a neuropsychiatric condition characterized by multiple motor and vocal tics, typically begins in childhood and is frequently associated with OCD and Attention Deficit Hyperactivity Disorder (ADHD). A family history of Tourette’s and OCD are known risk factors for the disorder, which has a prevalence rate three times greater in males than females.
Barbara Coffey, MD, MS, Director of the Tics and Tourette’s Clinical and Research Program at Mount Sinai, says, “Approximately one-third of children with Tourette’s Disorder continue to suffer from moderate to severe symptoms in adulthood, and most patients with Tourette’s also present with other disorders, including OCD and ADHD.”
Approved medications, including pimozide, haloperidol, and off-label agents such as the alpha agonists, can help reduce tics and manage the related disorders, but their efficacy is limited and associated with side effects such as weight gain, insomnia, depression, and agitation. The Tics and Tourette’s program is now recruiting patients for several new clinical trials for treatment of tics with novel agents.
In many children with OCD or tics, cognitive behavioral therapy can be effective. In the most severe and treatment-resistant cases of OCD, deep brain stimulation may be considered.
In addition to Drs. Goodman, Coffey and Grice, DTOR’s clinical faculty includes other expert psychologists and psychiatrists.
This article was first published in Inside Mount Sinai.