The Michael Trimble Neuropsychiatry Research Group, Department of Neuropsychiatry, BSMHFT, University of Birmingham, United Kingdom.
Eur J Paediatr Neurol. 2012 Jul;16(4):361-4. doi: 10.1016/j.ejpn.2011.12.001. Epub 2011 Dec 16.
National differences in licensing laws suggest that the use of medications for the treatment of Tourette syndrome differs between European countries. However, variability in prescribing practices has never been investigated. This study aims to systematically examine European prescribing practices in Tourette syndrome.
All members of the European Society for the Study of Tourette syndrome actively prescribing for paediatric and/or adult Tourette syndrome populations were invited to complete an online questionnaire covering pharmacological treatment of the five main symptom domains of Tourette syndrome: tics, attention-deficit hyperactivity symptoms, obsessive-compulsive symptoms, anxiety and depression.
Response rates were good, with 44/57 (77%) members returning the questionnaire. Risperidone (n=13), methylphenidate (n=21) and sertraline (n=17) were the most commonly prescribed medications for the treatment of tics, attention-deficit hyperactivity symptoms and obsessive-compulsive symptoms, respectively. However, there was a large variability in both the medication choices and the dosages used for each of these symptom domains.
This is the first large-scale survey on prescribing habits for the pharmacological management of Tourette syndrome in Europe. In general, dopamine blockers were widely used for tics, selective serotonin reuptake inhibitors for depression, obsessive-compulsive symptoms and anxiety, and stimulants for attention-deficit hyperactivity symptoms, but there was high variation within these choices. Future studies need to target specific patient groups.
各国的许可法律存在差异,这表明欧洲国家在治疗妥瑞氏综合征方面使用的药物可能存在差异。然而,处方实践的变异性从未被调查过。本研究旨在系统地检查欧洲妥瑞氏综合征的处方实践。
邀请欧洲妥瑞氏综合征研究学会的所有积极为儿科和/或成人妥瑞氏综合征患者开具处方的成员完成一份在线问卷,涵盖妥瑞氏综合征五个主要症状领域的药物治疗:抽动、注意力缺陷多动症状、强迫症症状、焦虑和抑郁。
回复率较高,有 44/57(77%)名成员返回了问卷。利培酮(n=13)、哌甲酯(n=21)和舍曲林(n=17)分别是治疗抽动、注意力缺陷多动症状和强迫症症状的最常用药物。然而,这些症状领域的药物选择和剂量使用都存在很大的差异。
这是欧洲首次对妥瑞氏综合征药物治疗处方习惯进行的大规模调查。一般来说,多巴胺阻滞剂广泛用于治疗抽动,选择性 5-羟色胺再摄取抑制剂用于治疗抑郁、强迫症症状和焦虑,兴奋剂用于治疗注意力缺陷多动症状,但这些选择中存在很大的差异。未来的研究需要针对特定的患者群体。