Treatment of Tourette's Syndrom with Aripiprazole

Treatment of Tourette's syndrome with Aripiprazole Mathias Bartels M.D Department of Psychiatry, University of Tuebingen Tourette's syndrome (TS) is a neuropsychiatric disorder characterized by involuntary motor and vocal tics as well as a variety of behavioral disturbances 1. Although the etiology of TS is unknown, there is evidence that the pathophysiology of TS involves an abnormality in the central dopaminergic system. In support of this notion neuroleptics show some effect reducing tics 1. However, especially in children and adolescents with TS the benefits of currently prescribed antipsychotics such as haloperidol or risperdidone are limited by troublesome motor and vegetative side-effects among others. In this scenario aripiprazole (Abilify R) a novel atypical antipsychotic agent currently used for schizophrenia 2 could be an ideal alternative treatment due to a favorable side effect profile. Good responses in single case trials 3 encouraged us to try the substance in a open study. Here, we report 23 cases with TS in whom motor tics markedly resolved with aripiprazole treatment assessed by two independent raters (A.A.;C.P.) 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 the bothersome side-effects associated with typical and atypical antipsychotics. References 1. Jankovic J. Tourette's syndrome. N Engl J Med 2001, 345:1184–92. 2. Kane JM, Carson WH, Saha AR, et al. Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2002, 63: 763–71. 3. Kastrup A. Schlotter W. Plewnia C. Bartels M. Treatment of Tics in Tourette Syndrome with Aripiprazole. J Clin Psychopharmacology 2005, 25: 94–96