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Treatment of tics in Tourette’s syndrome with aripiprazole
Tourette’s syndrome (TS) is a neuropsychiatric disorder characterized by involuntary motor and vocal tics as well as a variety of behavioral disturbances1. Although the etiology of TS is unknown, there is evidence that the pathophysiology of TS involves an abnormality in the central dopaminergic system. In this context neuroleptics show some effects reducing tics1. Benefits of currently prescribed antipsychotics like haloperidol or risperdidone are limited by motor and vegetative side-effects. In this scenario aripiprazole (Abilify®) a novel atypical antipsychotic agent currently used for schizophrenia2 could be an ideal alternative treatment due to a favorable side effect profile.
We report three cases with TS in whom motor tics almost completely resolved with aripiprazole treatment assessed by two independent raters using time blind video sequences. Patients had no serious adverse events suggesting that aripiprazole, the most recent addition to the new class of atypical antipsychotics, may provide a new avenue for symptomatic relief in TS without side-effects associated with typical and atypical antipsychotics.
1. Jankovic J. N, Engl J Med 2001, 345:1184–92
2. Kane JM et al., J Clin Psychiatry 2002, 63: 763–71