Pharmacopsychiatry 2019; 52(01): 07-15
DOI: 10.1055/s-0043-124872
Review
© Georg Thieme Verlag KG Stuttgart · New York

Comparative Efficacy and Safety of Antipsychotic Drugs for Tic Disorders: A Systematic Review and Bayesian Network Meta-Analysis

Chunsong Yang*
1  Department of Pharmacy, Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University
2  Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
,
Zilong Hao*
3  Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
,
Ling-Li Zhang
1  Department of Pharmacy, Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University
2  Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
,
Cai-Rong Zhu
4  West China School of Public Health, Sichuan University
,
Ping Zhu
4  West China School of Public Health, Sichuan University
,
Qin Guo
5  Department of Pediatrics, West China Second Hospital, Sichuan University
› Author Affiliations
Further Information

Publication History

received 02 September 2017
revised 04 December 2017

accepted 10 December 2017

Publication Date:
05 March 2018 (eFirst)

Abstract

Objective The purpose of this study was to evaluate the efficacy and safety of antipsychotic drugs for tic disorders (TDs) in a network meta-analysis.

Methods PubMed, Embase, Cochrane Library, and 4 Chinese databases were searched. Randomized controlled trials (RCTs) evaluating the efficacy of antipsychotic drugs for TDs were included.

Results Sixty RCTs were included. In terms of tic symptom score, compared with placebo, haloperidol, risperidone, aripiprazole, quetiapine, olanzapine, and ziprasidone can significantly improve tic symptom score (standardized mean differences [SMD] ranged from −12.32 to −3.20). Quetiapine was superior to haloperidol, pimozide, risperidone, tiapride, aripiprazole, and penfluridol for improving tic symptom score (SMD ranged from −28.24 to −7.59). Compared with tiapride, aripiprazole could significantly improve tic symptom score (SMD=−4.27). Compared with all other drugs, penfluridol was not effective. Atypical antipsychotics were generally well tolerated.

Conclusions Atypical antipsychotics (risperidone and aripiprazole) appear to be the most robust evidence-based options for the treatment of TDs. Quetiapine may be a promising therapy. Ziprasidone and olanzapine are also effective, but the evidence is lacking. Further high-quality directly comparing different pharmacological treatment studies are justified.

* Chunsong Yang and Zilong Hao contributed equally to this study.


Supplementary Material