Pharmacological Treatment of Tourette Disorder in Children.

IF 1.5 4区 医学 Q2 PEDIATRICS Journal of child and adolescent psychopharmacology Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI:10.1089/cap.2023.0026
Afra Can, Jennifer Vermilion, Jonathan W Mink, Peter Morrison
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Abstract

Background: Tourette disorder (TD) is a neurodevelopmental disorder characterized by childhood onset of tics lasting more than one year, with multiple motor tics and at least one phonic tic at some point during the course of the symptoms. Treatment of tics may include psychoeducation, non-pharmacologic treatment, or pharmacologic treatment. We review pharmacologic treatment here. Methods: We performed a literature review on pharmacologic treatments for TD. Results: There is no current evidence to suggest that medications impact the prognosis of tic disorders, so current clinical guidelines recommend reassurance of the patient and family and monitoring if there is no change in function or quality of life due to tics. If treatment is indicated, it must be chosen based on the needs of each individual patient. Comprehensive behavioral intervention for tics (CBIT) is considered first-line management for most individuals with bothersome tics, especially if they are mild to moderate in severity. Pharmacotherapy should be considered when tics are impairing daily functioning, causing social problems, accompanied by other neuropsychiatric symptoms, or when the patient is not likely to benefit from CBIT. Current recommended pharmacotherapy options include alpha-2 adrenergic agonists, dopamine modulators, GABAergic medications, dopamine depleters, and botulinum toxin injections. Additionally, there are other novel medications that are being studied in ongoing clinical trials. Conclusions: This review summarizes available pharmacotherapy options for TD in children. It provides an overview of new medications and offers guidance to physicians when selecting appropriate treatments. If medications are indicated for tic management, treatment should be chosen based on the needs of the individual patient.

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儿童抽动症的药物治疗。
背景:抽动障碍(TD)是一种神经发育障碍,其特征是儿童时期开始出现持续一年以上的抽动,在症状过程中会出现多次运动性抽动和至少一次发音性抽动。对抽搐的治疗可包括心理教育、非药物治疗或药物治疗。我们在此回顾一下药物治疗。方法我们对 TD 的药物治疗进行了文献综述。结果目前没有证据表明药物治疗会影响抽搐症的预后,因此现行的临床指南建议对患者和家属进行安抚,并在抽搐导致功能或生活质量没有改变的情况下进行监测。如果需要治疗,则必须根据每个患者的需求进行选择。抽搐综合行为干预(CBIT)被认为是大多数令人烦恼的抽搐患者的一线治疗方法,尤其是抽搐程度为轻度至中度的患者。当抽搐影响日常功能、造成社交问题、伴有其他神经精神症状,或者患者不太可能从 CBIT 中获益时,应考虑药物治疗。目前推荐的药物治疗方案包括α-2肾上腺素能激动剂、多巴胺调节剂、GABA能药物、多巴胺耗竭剂和肉毒毒素注射。此外,还有其他新型药物正在进行临床试验研究。结论:本综述总结了治疗儿童 TD 的现有药物疗法。它概述了新的药物,并为医生选择适当的治疗方法提供了指导。如果需要使用药物治疗抽搐,应根据患者的个体需求选择治疗方法。
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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
61
审稿时长
>12 weeks
期刊介绍: Journal of Child and Adolescent Psychopharmacology (JCAP) is the premier peer-reviewed journal covering the clinical aspects of treating this patient population with psychotropic medications including side effects and interactions, standard doses, and research on new and existing medications. The Journal includes information on related areas of medical sciences such as advances in developmental pharmacokinetics, developmental neuroscience, metabolism, nutrition, molecular genetics, and more. Journal of Child and Adolescent Psychopharmacology coverage includes: New drugs and treatment strategies including the use of psycho-stimulants, selective serotonin reuptake inhibitors, mood stabilizers, and atypical antipsychotics New developments in the diagnosis and treatment of ADHD, anxiety disorders, schizophrenia, autism spectrum disorders, bipolar disorder, eating disorders, along with other disorders Reports of common and rare Treatment Emergent Adverse Events (TEAEs) including: hyperprolactinemia, galactorrhea, weight gain/loss, metabolic syndrome, dyslipidemia, switching phenomena, sudden death, and the potential increase of suicide. Outcomes research.
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