Gill Jesjeet Singh
Department of Psychological Medicine, University Malaya, Kuala Lumpur 50603, Malaysia.
Healthcare (Basel). 2023 Sep 13;11(18):2531. doi: 10.3390/healthcare11182531.
Tourette syndrome is a complex neuropsychiatric condition that manifests in childhood and is often associated with other psychiatric comorbidities. This case report describes a young male with Tourette syndrome with major depressive disorder and attention deficit hyperactivity disorder (ADHD) who experienced troublesome side effects due to his existing medications (escitalopram, risperidone, and methylphenidate). In order to control his tics, ameliorate depressive symptoms, and eliminate side effects of stiffness and sedation, risperidone was switched to cariprazine, a third-generation antipsychotic medication with D3-D2 partial agonism. In addition, the antidepressant dose was also increased. With the new combination, the patient reported good control of his tics, together with significant improvement in depressive symptoms and no side effects. Based on this case and the reviewed literature, cariprazine might be a viable option for patients with Tourette syndrome with other comorbid illnesses who are prone to side effects of medication.
抽动秽语综合征是一种复杂的神经精神疾病，在儿童期出现，常与其他精神疾病共病。本病例报告描述了一名患有抽动秽语综合征并伴有重度抑郁症和注意力缺陷多动障碍（ADHD）的年轻男性，他因现有的药物治疗（艾司西酞普兰、利培酮和哌甲酯）而出现了令人烦恼的副作用。为了控制他的抽动症状，改善抑郁症状，并消除僵硬和镇静等副作用，将利培酮换为卡立普多，这是一种具有D3 - D2部分激动作用的第三代抗精神病药物。此外，抗抑郁药的剂量也增加了。采用新的联合用药后，患者报告抽动症状得到了良好控制，抑郁症状有显著改善，且无副作用。基于该病例及所回顾的文献，对于患有抽动秽语综合征且伴有其他共病、容易出现药物副作用的患者，卡立普多可能是一种可行的选择。
