Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Authors

Tamara Pringsheim, University of Calgary
Michael S. Okun, University of Florida - GainesvilleFollow
Joseph Jankovic, Baylor College of Medicine
John Piacentini, University of California - Los AngelesFollow
Andrea E. Cavanna, University of Birmingham and Aston University
Davide Martino, University of CalgaryFollow
Kirsten Muller-Vahl, Hannover Medical School
Douglas W. Woods, Marquette UniversityFollow
Michael Robinson, Tourette Association of AmericaFollow
Elizabeth Jarvie, University of Wisconsin - Madison
Veit Roessner, Technische Universitat Dresden
Maryam Oskoui, McGill University

Document Type

Article

Language

eng

Publication Date

5-2019

Publisher

American Academy of Neurology

Source Publication

Neurology

Source ISSN

0028-3878

Abstract

Objective

To systematically evaluate the efficacy of treatments for tics and the risks associated with their use.

Methods

This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 participants if a crossover trial), except for neurostimulation trials, for which no minimum sample size was required. To obtain additional information on drug safety, we included cohort studies or case series that specifically evaluated adverse drug effects in individuals with tics.

Results

There was high confidence that the Comprehensive Behavioral Intervention for Tics was more likely than psychoeducation and supportive therapy to reduce tics. There was moderate confidence that haloperidol, risperidone, aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders, elevated prolactin levels, sedation, and effects on heart rate, blood pressure, and ECGs.

Conclusions

There is evidence to support the efficacy of various medical, behavioral, and neurostimulation interventions for the treatment of tics. Both the efficacy and harms associated with interventions must be considered in making treatment recommendations.

Comments

Published version. Neurology, Vol. 92, No. 19 (May 2019) : 907-915. DOI. © 2019 American Academy of Neurology. Used with permission.

Recommended Citation

Pringsheim, Tamara; Okun, Michael S.; Jankovic, Joseph; Piacentini, John; Cavanna, Andrea E.; Martino, Davide; Muller-Vahl, Kirsten; Woods, Douglas W.; Robinson, Michael; Jarvie, Elizabeth; Roessner, Veit; and Oskoui, Maryam, "Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders" (2019). Psychology Faculty Research and Publications. 453.
https://epublications.marquette.edu/psych_fac/453