Neuner Irene, Nordt Carlos, Schneider Frank, Kawohl Wolfram
Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany.
Hum Psychopharmacol. 2012 Jul;27(4):364-9. doi: 10.1002/hup.2235. Epub 2012 Jun 15.
Tourette Syndrome (TS) is characterized by motor and vocal tics. Its pharmacological treatment is often a challenge because of the so-called tachyphylactic effects. Aripiprazole has been reported to be effective in small case series with short follow-up periods.
In a retrospective analysis, we assessed the effect of off-label treatments with aripiprazole in 20 adult patients (mean age 27.4) divided in a group of severely [67 Yale Global Tourette Severity Scale (YGTTS)-total] and moderately (43.3 YGTTS-total) affected patients. TS patients were treated with aripiprazole (mean 11.8 mg daily) and followed for up to 56 months.
Applying a random coefficient model, we found a significant benefit resulting from treatment with aripiprazole. This effect was larger in the severely affected patient group in comparison with the moderately affected patient group. The effect was stable over a time period up to 56 months.
Aripiprazole, a neuroleptic drug of the third generation with a partial D(2) -agonism is effective in moderately and severely affected adult Tourette patients. We add to the current knowledge through our data extending the follow-up interval up to a maximum of 56 months. All available clinical data strongly support the initiation of a double-blind placebo or other neuroleptic substance controlled trial.
Tourette综合征(TS)以运动和发声抽动为特征。由于所谓的快速耐受性效应,其药物治疗常常具有挑战性。据报道,阿立哌唑在随访期较短的小病例系列中有效。
在一项回顾性分析中,我们评估了阿立哌唑的超说明书治疗对20例成年患者(平均年龄27.4岁)的疗效,这些患者分为重度[耶鲁全球Tourette严重程度量表(YGTTS)总分67]和中度(YGTTS总分43.3)受累两组。TS患者接受阿立哌唑治疗(平均每日11.8毫克),随访长达56个月。
应用随机系数模型,我们发现阿立哌唑治疗产生了显著益处。与中度受累患者组相比,重度受累患者组的这一效应更大。该效应在长达56个月的时间段内保持稳定。
阿立哌唑是一种具有部分D(2)激动作用的第三代抗精神病药物 在中度和重度受累的成年Tourette患者中有效。我们通过将随访间隔延长至最长56个月的数据,增加了当前的知识。所有可用的临床数据都强烈支持开展双盲安慰剂或其他抗精神病药物对照试验。