Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Authors
Pringsheim, T. Holler-Managan, Y. Okun, M. S. Jankovic, J. Piacentini, J. Cavanna, A. E. Martino, D. Muller-Vahl, K. Woods, D. W. Robinson, M. Jarvie, E. Roessner, V. Oskoui, M.
Year
2019
Journal
Neurology
Volume
92
Pages
907-915
Objective To systematically evaluate the efficacy of treatments for tics and the risks associated with their use. Methods This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 participants if a crossover trial), except for neurostimulation trials, for which no minimum sample size was required. To obtain additional information on drug safety, we included cohort studies or case series that specifically evaluated adverse drug effects in individuals with tics. Results There was high confidence that the Comprehensive Behavioral Intervention for Tics was more likely than psychoeducation and supportive therapy to reduce tics. There was moderate confidence that haloperidol, risperidone, aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders, elevated prolactin levels, sedation, and effects on heart rate, blood pressure, and ECGs. Conclusions There is evidence to support the efficacy of various medical, behavioral, and neurostimulation interventions for the treatment of tics. Both the efficacy and harms associated with interventions must be considered in making treatment recommendations.

Oversett med Google Translate
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Type of intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Other Problems

Tics and Tourettes

Intervention

Pharmacological Treatment

Sedatives

Antipsychotics

Age group

School Aged Children (6-12 years)

Adolescents (13-18 years)

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