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David Baxter

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Aripiprazole May Ameliorate Tic Disorder Symptoms in Children and Adolescents
August 23, 2007

NEW YORK (Reuters Health) -- The atypical antipsychotic aripiprazole appears to be an efficacious and fairly well tolerated treatment for children and adolescents with tic disorders, according to findings published in the July issue of the Journal of Clinical Psychiatry.

"Although the standard tic treatments haloperidol and pimozide are both effective in reducing tics, they cause diverse adverse effects such as sedation, cognitive blunting, and extrapyramidal symptoms (EPS)," write Dr. Hanik K. Yoo and colleagues from the University of Ulsan College of Medicine, Seoul, Korea.

Aripiprazole has dual agonist and antagonist actions toward dopaminergic imbalance and partial serotonin-2A receptor antagonism, they note. In an open-label, 8-week trial, the researchers examined the efficacy and tolerability of aripiprazole in 24 subjects (mean age 11.8 years) with DSM-IV-diagnosed tic disorders.

The mean dose of aripiprazole was 9.8 mg/day. After 8 weeks of treatment, there was a 52.8% decrease in the Total Tic score, from 26.7 to 12.6 (p < 0.001).

Nineteen patients (79.1%) improved much or very much according to the Clinical Global Impressions-Improvement scale. The CGI-Severity of Illness scale score was lowered from 5.5 to 3.0 (p < 0.001), the investigators found.

Six (25%) of the 24 participants discontinued treatment prematurely "due to intolerable adverse effects," the team reports.

"Fourteen children and adolescents (58.3%) experienced one or more unwanted side effects, and eight patients had transient and/or tolerable adverse effects," Dr. Yoo's team found. "The most common side effects of aripiprazole were hypersomnia (37.5%), nausea (20.8%), headache (16.6%), EPS (8.3%), and akathisia (8.3%)."

The researchers note that this was an uncontrolled trial, but they conclude that "the result of this pilot study suggests that aripiprazole can be considered as an efficacious and safe drug for children and adolescents with tic disorders."

J Clin Psychiatry 2007;68:1088-1093.
 

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