期刊论文详细信息
BMC Psychiatry
Aripiprazole for the treatment of tic disorders in children: a systematic review and meta-analysis
Qin Guo4  Cai-Rong Zhu2  Ling-Li Zhang3  Hong Huang1  Chun-Song Yang2 
[1] Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China;West China School of Public Health, Sichuan University, Chengdu, China;West China Second University Hospital, Sichuan University, No.20,Third Section, Renmin NanLu, Chengdu 610041, Sichuan, People’s Republic of China;Department of Pediatrics, West China second hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China
关键词: Systematic review;    Children;    Tic disorders;    Aripiprazole;   
Others  :  1225005
DOI  :  10.1186/s12888-015-0504-z
 received in 2014-11-08, accepted in 2015-05-18,  发布年份 2015
PDF
【 摘 要 】

Background

Tic disorders (TDs) are common neuropsychiatric disorders in children. Typical antipsychotics, such as haloperidol and pimozide have been prescribed to control tic symptoms as first-line agents. However, adverse effects have led to the use of newer atypical antipsychotics. Aripiprazole is one of alternatives. The aim of this study was to evaluate the efficacy and safety of aripiprazole for children with TDs.

Methods

Randomized controlled trials (RCTs), quasi-RCTs and control studies evaluating aripiprazole for children with tic disorders were identified from PubMed, Embase, Cochrane library, Cochrane Central, four Chinese database and relevant reference lists. Quality assessment referred to the Cochrane Handbook for Systematic Reviews of Interventions.

Results

Twelve studies involving 935 participants were included. The general quality of included studies was poor. Only one study used placebo as a control and others used positive drug controls. Participants were aged between 4 and 18 years. The period of treatment ranged from 8 to 12 weeks. Seven studies (N = 600 patients) used the YGTSS scale as the outcome measurement, and there was no significant difference in reduction of the total YGTSS score between the aripiprazole and positive control groups (MD = −0.48, 95 % CI [−6.22, 5.26], P = 0.87, I 2  = 87 %). Meta-analysis of four of the studies (N = 285 patients) that compared aripiprazole with haloperidol showed that there was no significant difference in reduction of the total YGTSS score (MD = 2.50, 95 % CI [−6.93, 11.92], P = 0.60, I 2  = 88 %). Meta-analysis of two studies (N = 255 patients) that compared aripiprazole with tiapride showed that there was no significant difference in reduction of the total YGTSS score (MD = −3.15, 95 % CI [−11.38, 5.09], P = 0.45, I 2  = 86 %). Adverse events (AEs) were reported in 11 studies. Drowsiness (5.1 %–58.1 %), increased appetite (3.2 %–25.8 %), nausea (2 %–18.8 %) and headache (2 %–16.1 %) were common AEs.

Conclusion

In conclusion, aripiprazole appears to be a promising therapy for children with TDs. Further well-conducted RCTs are required to confirm this issue.

【 授权许可】

   
2015 Yang et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150917022704785.pdf 2127KB PDF download
Fig 8. 22KB Image download
Fig 7. 37KB Image download
Fig 6. 18KB Image download
Fig 5. 36KB Image download
Fig 4. 48KB Image download
Fig 3. 48KB Image download
Fig 2. 54KB Image download
Fig 1. 34KB Image download
【 图 表 】

Fig 1.

Fig 2.

Fig 3.

Fig 4.

Fig 5.

Fig 6.

Fig 7.

Fig 8.

【 参考文献 】
  • [1]Plessen KJ: Tic disorders and Tourette’s syndrome. Eur Child Adolesc Psychiatry 2013, 22(Suppl 1):S55-60.
  • [2]Jimenez-Shahed J: Tourette syndrome. Neurol Clin 2009, 27(3):737-55.
  • [3]Knight T, Steeves T, Day L, Lowerison M, Jette N, Pringsheim T: Prevalence of tic disorders: a systematic review and meta-analysis. Pediatr Neurol 2012, 47(2):77-90.
  • [4]Cavanna AE, Seri S: Tourette’s syndrome. Br Med J 2013, 347:1-6.
  • [5]Yang CS, Zhang LL, Zeng LN, Huang L, Liu YT: Topiramate for Tourette's syndrome in children: a meta-analysis. Pediatr Neurol 2013, 49(5):344-50.
  • [6]Gilbert D, Batterson J, Sethuramamn G, Sallee F: Tic reduction with risperidone versus pimozide in a randomized double-blind cross-over trial. J Am Acad Child Adolesc Psychiatry 2004, 43:206-14.
  • [7]Kim B, Lee B, Hwang J, Shin M, Cho S: Effectiveness and safety of risperidone for children and adolescents with chronic tic or Tourette’s disorder in Korea. J Child Adolesc Psychopharmacol 2005, 15:318-24.
  • [8]Dion Y, Annable L, Sandor P, Couinard G: Risperidone in the treatment of Tourette syndrome: a double-blind, placebo-controlled trial. J Clin Psychopharmacol 2002, 22:31-9.
  • [9]Ghanizadeh A, Haghighi A: Aripiprazole versus risperidone for treating children and adolescents with tic disorder: a randomized double blind clinical trial. Child Psychiatry Hum Dev 2013, 45(5):596-603.
  • [10]Yoo HK, Joung YS, Lee JS, Song DH, Lee YS, Kim JW, Kim BN, Cho SC: A multicenter, randomized, double-blind, placebo-controlled study of aripiprazole in children and adolescents with Tourette's disorder. J Clin Psychiatry 2013, 74(8):772-80.
  • [11]Ho CS, Chiu NC, Tseng CF, Huang YL: Clinical effectiveness of aripiprazole in short-term treatment of tic disorder in children and adolescents: anaturalistic study. Pediatr Neonatol. 2014, 55(1):48-52.
  • [12]Masi G, Gagliano A, Siracusano R, Berloffa S, Calarese T, Ilardo G, Pfanner C, Magazù A, Cedro C: Aripiprazole in children with Tourette's disorder and co-morbid attention-deficit/hyperactivity disorder: a 12-week, open-label, preliminary study. J Child Adolesc Psychopharmacol 2012, 22(2):120-5.
  • [13]Bowles TM, Levin GM: Aripiprazole: a new atypical antipsychotic drug. Ann Pharmacother 2003, 37:687-694.
  • [14]Yoo HK, Lee JS, Paik KW, Choi SH, Yoon SJ, Kim JE, Hong JP: Open-label study comparing the efficacy and tolerability of aripiprazole and haloperidol in the treatment of pediatric tic disorders. Eur Child Adolesc Psychiatry 2011, 20(3):127-35.
  • [15]Ghanizadeh A: Systemic review of aripiprazole for the treatment of children and adolescents with tic disorders. Neurosciences (Riyadh) 2012, 17(3):200-4.
  • [16]Federowicz VJ, Fombonne E: Metabolic side effects of atypical antipsychotics in children: a literature review. J Psychopharmacol 2005, 19(5):533-550.
  • [17]Yan WW: A review of diagnostic and statistical manual of mental disorder-III. Foreign Medical Sciences (Section of Psychiatry) 1981, 6:5-9.
  • [18]Pringsheim T, Marras C: Pimozide for tics in Tourette's syndrome. Cochrane Database Syst Rev 2009, 15(2):1-15.
  • [19]Leckman JF, Towbin KE, Ort SI, et al.: Clinical assessment of tic disorder severity. In Tourette’s Syndrome and Tic Disorders. John Wiley& Sons, New York, NY; 1988:55-78.
  • [20]WorId Health Organization: The ICD-10 Classification of Mental and Behavioral Disorders Diagnostic Criteria for Research. WHO, Geneva; 1993.
  • [21]The Branch of Psychiatry of Chinese Medical Association. Chinese Classification and Diagnostic Criteria of Mental Disorders-3 (CCMD-3). Science and Technology Press of Shandong Province. 2001.
  • [22]Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ: The Yale global tic severity scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989, 28(4):566-573.
  • [23]Walkup JT, Rosenberg LA, Brown J, Singer HS: The validity of instruments measuring tic severity in Tourette’s syndrome. J Am Acad Child Adolesc Psychiatry 1992, 31(3):472-477.
  • [24]Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
  • [25]Wang YH, Chen ZM, Wang XS: The efficacy of aripiprazole and tiapride for Tourette disorders in children. Shandong Medical Journal 2013, 53(39):58-59.
  • [26]Liu YY, Chen YH, Chen H, Liu ZS: A control study of aripiprazole and tiapride treatment for tic disorders in children. Chin J Contemp Pediatr 2010, 12(6):421-424.
  • [27]Liu ZS, Chen YH, Zhong YQ, Zou LP, Wang H, Sun D, Wang DB, Liao JX: A multicenter controlled study on aripirazole treatment for children with Tourette syndrome in China. Chin J Pediatr 2011, 49(8):572-576.
  • [28]Cheng ZM, Lei QH: Comparative study of Aripiprazole and Haloperidol in the treatment of tic disorder. Medical Journal of Chinese People's Health 2012, 24(4):402-403.
  • [29]Ren ZB, Jin WD, Wang HQ: A comparative study of aripiprazole and haloperidol treatment for tic disorders in children. Chinese Journal of Nervous and Mental Diseases 2012, 38(4):222-224.
  • [30]Zhao ZL, Guo P, Guo H: The efficacy of aripiprazole and haloperidol treatment for tic disorders in children. World Health Digest Medical Periodieal 2011, 8(29):111-113.
  • [31]Guo F, Qin X, Guo SQ, Li YL: Aripiprazole and haloperidol in the treatment of tic disorder of childhood. China Journal of Health Psychology 2013, 21(12):1767-1768.
  • [32]Gao R, Zhou YD, Huang ZY, Tang JH, Lu HP: An open label control study of aripiprazole and haloperidol in the treatment of tic disorder for children. Sichuan Mental Health 2013, 26(4):300-302.
  • [33]Liang YZ, Zhou FC, Zheng Y, Yang JH, Liu J, Wang P, Qi YJ, Chen X, Zhou YM: Comparative study of aripiprazole in the treatment of Tourette syndrome. Chinese Journal of Nervous and Mental Disease 2010, 36(2):111-112.
  • [34]Cohen SC, Leckman JF, Bloch MH: Clinical assessment of Tourette syndrome and tic disorders. Neurosci Biobehav Rev 2013, 37(6):997-1007.
  • [35]Waldon K, Hill J, Termine C, Balottin U, Cavanna AE: Trials of pharmacological interventions for Tourette syndrome: a systematic review. Behav Neurol 2013, 26(4):265-73.
  文献评价指标  
  下载次数:119次 浏览次数:19次