Department of General and Social Psychiatry ZH West, Psychiatric University Hospital Zurich, Zurich, Switzerland.
World J Biol Psychiatry. 2009;10(4 Pt 3):827-31. doi: 10.1080/15622970701762544.
Despite the ongoing development of neuroleptics, typical or first-generation neuroleptics are still considered as the first choice in the treatment of Gilles de la Tourette syndrome (GTS). In many European countries, tiapride is the first line of treatment favoured in most cases, while risperidone, pimozide and haloperidol are listed as second choice. Unfortunately, antipsychotics often show tachyphylactic effects in the treatment of GTS so that a switch to another neuroleptic agent becomes inevitable. Thus it is important to ensure a wide selection of different drugs is available. Another promising candidate in the treatment of tics may be aripiprazole, a D(2)-receptor partial agonist. We present the retrospective analysis of 10 clinical cases of adult patients from the tic clinics in Aachen (Germany) and Zurich (Switzerland) who were treated with aripiprazole. Tics and disturbances were assessed using the Yale Global Tic Severity Scale (YGTSS). All YGTSS-subscores, with the exception of the complexity of vocal tics, improved significantly. The data includes three cases with long-term intake for at least 18 months. During this period, no tachyphylactic effect was visible. A double-blind trial against placebo or other neuroleptics is advisable to verify the efficacy of aripiprazole in the pharmacotherapy of GTS.
尽管神经阻滞剂不断发展，典型或第一代神经阻滞剂仍被认为是治疗 Gilles de la Tourette 综合征（GTS）的首选药物。在许多欧洲国家，哌迷清在大多数情况下是首选的一线治疗药物，而利培酮、匹莫齐特和氟哌啶醇则被列为二线选择。不幸的是，抗精神病药在治疗 GTS 时常常表现出快速耐受效应，因此必须改用另一种神经阻滞剂。因此，确保有广泛的不同药物可供选择非常重要。另一种在治疗抽动方面有前途的候选药物可能是阿立哌唑，一种 D2 受体部分激动剂。我们回顾性分析了来自德国亚琛和瑞士苏黎世抽动诊所的 10 例成年患者的临床病例，这些患者接受了阿立哌唑治疗。使用耶鲁总体抽动严重程度量表（YGTSS）评估抽动和障碍。除了发声抽动的复杂性外，所有 YGTSS 子评分均显著改善。该数据包括 3 例至少长期服用 18 个月的病例。在此期间，未观察到快速耐受效应。建议进行双盲试验，以安慰剂或其他神经阻滞剂为对照，以验证阿立哌唑在 GTS 药物治疗中的疗效。
