Systematic review: Pharmacological treatment of tic disorders - Efficacy of antipsychotic and alpha-2 adrenergic agonist agents

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:37

Review

Weisman, Hannah¹  Qureshi, Imraan A.²  Leckman, James F.¹  Scahill, Lawrence^2,3  Bloch, Michael H.^1,2 

[1] Yale Univ, Sch Med, Yale Child Study Ctr, New Haven, CT 06520 USA

[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06520 USA

[3] Yale Univ, Sch Med, Sch Nursing, New Haven, CT 06520 USA

关键词: Antipsychotic agents;    Alpha-2 adrenergic agonist;    Tic disorders;    Attention-deficit/hyperactivity disorder;    Meta-analysis;   

DOI  :  10.1016/j.neubiorev.2012.09.008

来源: Elsevier

【 摘 要 】

We conducted a meta-analysis of randomized, placebo-controlled trials to determine the efficacy of antipsychotic and alpha-2 agonists in the treatment of chronic tic disorders and examine moderators of treatment effect. Meta-analysis demonstrated a significant benefit of antipsychotics compared to placebo (standardized mean difference (SMD) = 0.58 (95% confidence interval (CI): 0.36-0.80). Stratified subgroup analysis found no significant difference in the efficacy of the 4 antipsychotic agents tested (risperidone, pimozide, haloperidol and ziprasidone). Meta-analysis also demonstrated a benefit of alpha-2 agonists compared to placebo (SMD = 0.31 (95% confidence interval CI: 0.15-0.48). Stratified subgroup analysis and meta-regression demonstrated a significant moderating effect of co-occurring ADHD. Trials which enrolled subjects with tics and ADHD demonstrated a medium-to-large effect (SMD = 0.68 (95%CI: 0.36-1.01) whereas trials that excluded subjects with ADHD demonstrated a small, non-significant benefit (SMD = 0.15 (95%CI: -0.06 to 0.36). Our findings demonstrated significant benefit of both antipsychotics and alpha-2 agonists in treating tics but suggest alpha-2 agonists may have minimal benefit in tic patients without ADHD. Published by Elsevier Ltd.

【 授权许可】

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