European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

被引：0
作者：
Veit Roessner
Heike Eichele
Jeremy S. Stern
Liselotte Skov
Renata Rizzo
Nanette Mol Debes
Péter Nagy
Andrea E. Cavanna
Cristiano Termine
Christos Ganos
Alexander Münchau
Natalia Szejko
Danielle Cath
Kirsten R. Müller-Vahl
Cara Verdellen
Andreas Hartmann
Aribert Rothenberger
Pieter J. Hoekstra
Kerstin J. Plessen
机构：
[1] TU Dresden,Department of Child and Adolescent Psychiatry
[2] University of Bergen,Department of Biological and Medical Psychology, Faculty of Psychology
[3] Haukeland University Hospital, Regional Resource Center for Autism, ADHD, Tourette Syndrome and Narcolepsy Western Norway, Division of Psychiatry
[4] St George’s Hospital,Department of Neurology
[5] St George’s University of London,Paediatric Department
[6] Herlev University Hospital,Child and Adolescent Neurology and Psychiatry, Department of Clinical and Experimental Medicine
[7] University of Catania,Institute of Clinical Sciences
[8] Vadaskert Child Psychiatric Hospital and Outpatient Clinic,Child Neuropsychiatry Unit, Department of Medicine and Surgery
[9] University of Birmingham,Department of Neurology
[10] University of Insubria,Institute of Systems Motor Science
[11] Charité Universitätsmedizin Berlin,Department of Neurology
[12] University of Lübeck,Department of Bioethics
[13] Medical University of Warsaw,Division of Neurocritical Care and Emergency Neurology, Department of Neurology
[14] Medical University of Warsaw,Department of Psychiatry
[15] Yale School of Medicine,Department of Neurology
[16] University Medical Center Groningen,Clinic for Child and Adolescent Psychiatry and Psychotherapy
[17] Rijks Universiteit Groningen,Department of Child and Adolescent Psychiatry
[18] GGZ Drenthe Mental Health Institution,Division of Child and Adolescent Psychiatry, Department of Psychiatry
[19] Clinic of Psychiatry,undefined
[20] Social Psychiatry and Psychotherapy,undefined
[21] Hannover Medical School,undefined
[22] PsyQ Nijmegen,undefined
[23] Parnassia Group,undefined
[24] TicXperts,undefined
[25] Sorbonne Université,undefined
[26] Pitié-Salpetriere Hospital,undefined
[27] National Reference Center for Tourette Disorder,undefined
[28] Pitié Salpetiere Hospital,undefined
[29] University Medical Center Gottingen,undefined
[30] University of Groningen,undefined
[31] University Medical Center Groningen,undefined
[32] Lausanne University Hospital,undefined
[33] University of Lausanne,undefined
[34] Child and Adolescent Mental Health Centre,undefined
[35] Mental Health Services,undefined
[36] Capital Region of Denmark,undefined
来源：
European Child & Adolescent Psychiatry | 2022年 / 31卷
关键词：
Tics; Tourette syndrome; Pharmacotherapy; Medication; Treatment;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
In 2011, the European Society for the Study of Tourette Syndrome (ESSTS) published the first European guidelines for Tourette Syndrome (TS). We now present an update of the part on pharmacological treatment, based on a review of new literature with special attention to other evidence-based guidelines, meta-analyses, and randomized double-blinded studies. Moreover, our revision took into consideration results of a recent survey on treatment preferences conducted among ESSTS experts. The first preference should be given to psychoeducation and to behavioral approaches, as it strengthens the patients’ self-regulatory control and thus his/her autonomy. Because behavioral approaches are not effective, available, or feasible in all patients, in a substantial number of patients pharmacological treatment is indicated, alone or in combination with behavioral therapy. The largest amount of evidence supports the use of dopamine blocking agents, preferably aripiprazole because of a more favorable profile of adverse events than first- and second-generation antipsychotics. Other agents that can be considered include tiapride, risperidone, and especially in case of co-existing attention deficit hyperactivity disorder (ADHD), clonidine and guanfacine. This view is supported by the results of our survey on medication preference among members of ESSTS, in which aripiprazole was indicated as the drug of first choice both in children and adults. In treatment resistant cases, treatment with agents with either a limited evidence base or risk of extrapyramidal adverse effects might be considered, including pimozide, haloperidol, topiramate, cannabis-based agents, and botulinum toxin injections. Overall, treatment of TS should be individualized, and decisions based on the patient’s needs and preferences, presence of co-existing conditions, latest scientific findings as well as on the physician’s preferences, experience, and local regulatory requirements.
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页码：425 / 441
页数：16
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