We aimed to clarify the current status of pharmacotherapy for tic disorders and comorbidities in Japan. We used a systematic survey to collate the consensus of Japanese experts and compare it with the recent international evidence.
We devised a questionnaire on pharmacotherapy for tics and comorbidities and sent it to Japanese experts on tic disorders. Based on the response to the first survey, we revised the questionnaire and conducted a second survey to determine the consensus among the experts on a 4-point Likert scale by the Delphi method.
The first survey revealed variability in preferred medications and dosages among the experts in Japan. However, we were able to build a general consensus on pharmacotherapy for tic disorders and comorbidities based on the second survey. Aripiprazole and risperidone were the first- and second-line medication for tic disorders, respectively. Agonists of α-2 adrenergic receptors were seldom prescribed. Fluvoxamine was the first-line medication for comorbid obsessive-compulsive disorder, and atomoxetine for comorbid attention deficit/hyperactivity disorder.
This study will help Japanese physicians choose medications for tic disorders more judiciously and will improve the quality of tic pharmacotherapy in Japan.
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American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM–5). Washington, DC, 2013.
- Tic disorders: administrative prevalence and co-occurrence with attention-deficit/hyperactivity disorder in a German community sample.Eur Psychiatry. 2011; 26: 370-374
- An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries.Dev Med Child Neurol. 2000; 42: 436-447
- A personal 35 year perspective on Gilles de la Tourette syndrome: assessment, investigations, and management.Lancet Psychiatry. 2015; 2: 88-104
- The behavioral spectrum of Gilles de la Tourette syndrome.J Neuropsychiatry Clin Neurosci. 2009; 21: 13-23
- American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). Practice parameter for the assessment and treatment of children and adolescents with tic disorders.J Am Acad Child Adolesc Psychiatry. 2013; 52: 1341-1359
- Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy.Can J Psychiatry. 2012; 57: 133-143
- Guidelines Group: European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment.Eur Child Adolesc Psychiatry. 2011; 20: 173-196
- Aripiprazole for Tourette's syndrome: a systematic review and meta-analysis.Hum Psychopharmacol. 2016; 31: 11-18
- Clinical effectiveness and patient perspectives of different treatment strategies for tics in children and adolescents with Tourette syndrome: a systematic review and qualitative analysis.Health Technol Assess. 2016; 20: 1-450
- Practitioner Review: Treatments for Tourette syndrome in children and young people - a systematic review.J Child Adolesc Psychopharmacol. 2016; 57: 988-1004
- Treatment practices in Tourette syndrome: the European perspective.Eur J Paediatr Neurol. 2012; 16: 361-364
- Tic disorders and obsessive-compulsive disorder in childhood.Japan J Child Adolescent Psychiatry. 2013; 54 (in Japanese): 175-185
- Commentary: Are alpha-2 agonist really effective in children with tics with comorbid ADHD? A commentary on Whittington et al. (2016).J Child Psychol Psychiatry. 2016; 57: 1005-1007
- Antipsychotic augmentation of selective serotonin reuptake inhibitors in resistant tic-related obsessive-compulsive disorder in children and adolescents: a naturalistic comparative study.J Psychiatr Res. 2013; 47: 1007-1012
- A promising preliminary study of aripiprazole for treatment-resistant childhood obsessive-compulsive disorder.J Child Adolesc Psychopharmacol. 2015; 25: 580-584
- Extended-release guanfacine does not show a large effect on tic severity in children with chronic tic disorders.J Child Adolesc Psychopharmacol. 2017; 27: 762-770
- Meta-analysis: risk of tics associated with psychostimulant use in randomized, placebo-controlled trials.J Am Acad Child Adolesc Psychiatry. 2015; 54: 728-736
Published online: February 19, 2019
Accepted: February 6, 2019
Received in revised form: February 3, 2019
Received: September 12, 2018
© 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.