摘要
多发性抽动障碍(TS)是儿童期常见的神经精神疾病,临床特征表现为运动性抽动和发声性抽动,抽动症状在青春期后有所改善,但部分患者可能出现抽动相关的共患病。在传统治疗措施失败,且某些精神合并症使临床表现复杂化时,非典型抗精神病药物成为治疗TS的新选择。然而,非典型精神病药物治疗TS的研究证据比较有限。研究证据显示,非典型性抗精神病药物广泛应用于TS的治疗,其中利培酮是研究证据相对充足的有效药物,阿立哌唑是治疗TS具有较好前景的药物,齐拉西酮、奥氮平与喹硫平能改善抽动症状,但随机对照试验缺乏,有待进一步研究证实。甲氧氯普胺和氯氮平研究证据缺乏,且副作用明显,不推荐用于治疗TS。
Tourette＇s syndrome （TS） is a common neuropsychiatric disorder of childhood onset characterized by multiple motor and phonic tics. Tic symptoms are often improved in late adolescence, but some children and adults with TS may experience significant tic-related morbidity. When the conservative interventions are not successful, and when certain psychiatric comorbidities further complicate the clinical profile, treating TS with an atypical antipsychotic medication may be a reasonable second-tier approach. However, the evidence supporting the efficacy and safety of the atypical antipsychotics for treatment of tics is still very limited. The current studies show that risperidone is considered to have the most robust evidence for tic treatment efficacy in TS and aripiprazole is a promising therapy. Although ziprasidone, olanzapine and quetiapine can improve tic symptoms, the efficacy is needed to be confirmed in further studies due to the lack of randomized controlled trials. The evidence for metoclopromide and clozapine is limited and the side effect is obvious, so they are not recommended for the treatment of TS.
作者
杨春松
张伶俐
朱彩蓉
许群芬
Yang Chunsong Zhang Lingli Zhu Cairong Xu Qunfen(Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China West China School of Public Health, Sichuan University, Chengdu 610041, China)
出处
《中国药事》
CAS
2017年第1期7-11,共5页
Chinese Pharmaceutical Affairs
基金
国家自然科学基金(编号81373381)
