A young woman challenged by Tourette’s Syndrome and other struggles, meets a man and takes a road trip that spirals out of control.
Marcie, a young woman with Tourette’s Syndrome (TS), meets Seth while shop-lifting and the two spontaneously take off to Canada in this dark romantic drama. When denied in their attempt to obtain Haldol without a prescription, they steal L-Dopa instead, which worsen Marcie’s symptoms. Marcie’s rage attacks, portrayed as being caused by TS, continually land them in deeper trouble until the situation escalates to an unfortunate ending.
Neuropsychological Review
Ariana Tart-Zelvin
Niagara, Niagara is a dark romantic drama about two teenagers that run away with each other. One of the main characters, Marcie, has a severe case of Tourette’s Syndrome (TS) and is not medicated for the majority of the film...
Marcie, a young woman with Tourette’s Syndrome (TS), meets Seth while shop-lifting and the two spontaneously take off to Canada in this dark romantic drama. When denied in their attempt to obtain Haldol without a prescription, they steal L-Dopa instead, which worsen Marcie’s symptoms. Marcie’s rage attacks, portrayed as being caused by TS, continually land them in deeper trouble until the situation escalates to an unfortunate ending.
Neuropsychological Review
Ariana Tart-Zelvin
Niagara, Niagara is a dark romantic drama about two teenagers that run away with each other. One of the main characters, Marcie, has a severe case of Tourette’s Syndrome (TS) and is not medicated for the majority of the film...
She exhibits simple motor tics and complex vocal tics (including palilalia, or the involuntary repetition of one’s own words, and coprolalia). Coprolalia, also known as involuntary swearing or socially inappropriate remarks, is an uncommon symptom of Tourette’s that only affects about 10% of the Tourette population, but remains a frequent stereotype in fiction. Niagara, Niagara accurately defines tics and explains that not all Tourette’s patients experience the same symptoms. However, the film incorrectly defines echolalia as repeating one’s own words. Echolalia, repeating words said by others, is not one of her symptoms. Marcie makes efforts to integrate her tics into everyday movements, which is common among those with motor tics. Rage attacks, like Marcie’s, are also rare among those with Tourette’s – however, when TS appears along with Obsessive-Compulsive Disorder and/or Attention-Deficit Hyperactivity Disorder, which is common, the likelihood of experiencing such episodes increases (Budman, Bruun, Parks, & Olson, 1998). Marcie may suffer from obsessive-compulsive behaviors as well as TS, as suggested by her need to sort colors and some distinct motor movements, but she never states that diagnosis. As a result, it would be understandable for viewers to think that those symptoms are part of Tourette’s Syndrome.
Marcie is somewhat successful in managing her tics at the beginning of the film through a combination of strategies. The medication Marcie takes to manage her Tourette’s, haloperidol, is referred to in the film by its brand name: Haldol. Haloperidol’s most important role in the treatment of Tourette’s is as a dopamine-antagonist, which means the medication blocks dopamine receptors in the brain (Robertson, 2000). While taking haloperidol, 84% of people with Tourette’s encounter side effects, and only 20-30% take it for extended periods of time. Common side effects of haloperiodol include dystonia (involuntary muscle contractions), akathisia (a feeling of inner restlessness), Parkinsonism (tremors and other movement symptoms similar to Parkinson’s disease),and bradykinesia (general slowness of movement). The longer someone takes haloperidol, the higher their risk of developing a movement disorder (Sallee, Nesbitt, Jackson, Sine, & Sethuraman, 1997). In the film, Marcie explains to the pharmacist that she has taken haloperidol since she was a young child; she would therefore be at high risk for neuroleptic-related movement disorders. Currently, the use of haloperidol is being phased out (Robertson, 2000).
In addition to taking haloperidol for her tics, Marcie claims that alcohol helps to suppress her tics. Müller-Vahl, Kolbe, and Dengler (1997) found that 69% of people with TS do indeed experience an amelioration of their tics when they consume alcohol. Marcie also tells Seth that sexual intercourse reduces her tics as well, which has not yet been a topic of investigation in academic research. During the film, when Marcie does not have access to haloperidol, she proceeds to drink and have sex with Seth instead. By the end of the film, Marcie no longer has any handle on her tics. The exacerbation of her symptoms is at least partially related to the fact that she is not taking her medication. Medication is an important part of managing severe Tourette’s Syndrome,.
Overall, the film poorly presents a complicated case of Tourette’s and has little educational value given the plethora of misconceptions and inaccuracies that are present. That said, the film does provide for a good discussion on the common misconceptions of Tourette’s Syndrome if the discussion is conducted by someone knowledgeable in regards to the disorder.
References
Budman, C.L., Bruun, R.D., Parks, K.S., & Olson, M.E. (1998). Rage attacks in children and adolescents with Tourette’s disorder: A pilot study. Journal of Clinical Psychiatry, 59(11), 576-580.
Müller-Vahl, K.R., Kolbe, H., & Dengler, R. (1997). Gilles de la Tourette syndrome, influence of nicotine, alcohol, and marijuana on the clinical symptoms. Nervenartzt, 68(12), 985-989.
Robertson, M.M. (2000). Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123, 425-462.
Sallee, F.R., Nesbitt, L., Jackson, C., Sine, L., & Sethuraman, G. (1997). Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette’s disorder. The American Journal of Psychiatry, 154(8), 1057-1062.
Marcie is somewhat successful in managing her tics at the beginning of the film through a combination of strategies. The medication Marcie takes to manage her Tourette’s, haloperidol, is referred to in the film by its brand name: Haldol. Haloperidol’s most important role in the treatment of Tourette’s is as a dopamine-antagonist, which means the medication blocks dopamine receptors in the brain (Robertson, 2000). While taking haloperidol, 84% of people with Tourette’s encounter side effects, and only 20-30% take it for extended periods of time. Common side effects of haloperiodol include dystonia (involuntary muscle contractions), akathisia (a feeling of inner restlessness), Parkinsonism (tremors and other movement symptoms similar to Parkinson’s disease),and bradykinesia (general slowness of movement). The longer someone takes haloperidol, the higher their risk of developing a movement disorder (Sallee, Nesbitt, Jackson, Sine, & Sethuraman, 1997). In the film, Marcie explains to the pharmacist that she has taken haloperidol since she was a young child; she would therefore be at high risk for neuroleptic-related movement disorders. Currently, the use of haloperidol is being phased out (Robertson, 2000).
In addition to taking haloperidol for her tics, Marcie claims that alcohol helps to suppress her tics. Müller-Vahl, Kolbe, and Dengler (1997) found that 69% of people with TS do indeed experience an amelioration of their tics when they consume alcohol. Marcie also tells Seth that sexual intercourse reduces her tics as well, which has not yet been a topic of investigation in academic research. During the film, when Marcie does not have access to haloperidol, she proceeds to drink and have sex with Seth instead. By the end of the film, Marcie no longer has any handle on her tics. The exacerbation of her symptoms is at least partially related to the fact that she is not taking her medication. Medication is an important part of managing severe Tourette’s Syndrome,.
Overall, the film poorly presents a complicated case of Tourette’s and has little educational value given the plethora of misconceptions and inaccuracies that are present. That said, the film does provide for a good discussion on the common misconceptions of Tourette’s Syndrome if the discussion is conducted by someone knowledgeable in regards to the disorder.
References
Budman, C.L., Bruun, R.D., Parks, K.S., & Olson, M.E. (1998). Rage attacks in children and adolescents with Tourette’s disorder: A pilot study. Journal of Clinical Psychiatry, 59(11), 576-580.
Müller-Vahl, K.R., Kolbe, H., & Dengler, R. (1997). Gilles de la Tourette syndrome, influence of nicotine, alcohol, and marijuana on the clinical symptoms. Nervenartzt, 68(12), 985-989.
Robertson, M.M. (2000). Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123, 425-462.
Sallee, F.R., Nesbitt, L., Jackson, C., Sine, L., & Sethuraman, G. (1997). Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette’s disorder. The American Journal of Psychiatry, 154(8), 1057-1062.
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