Contemporary assessment and pharmacotherapy of Tourette syndrome.
To develop a guide to clinical assessment and pharmacotherapy for children and adults with Tourette syndrome (TS), we reviewed published literature over the past 25 years to identify original articles and reviews on the assessment and pharmacological treatment of Tourette syndrome, attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The literature search also included a survey of reviews published in book chapters. The assessment section was compiled from several reviews. Pharmacological treatments were classified into those with strong empirical support (as evidenced by two positive placebo-controlled studies for tics, OCD, or ADHD in TS samples); modest empirical support (one positive placebo-controlled study), or minimal support (open-label data only). We conclude that accurate diagnosis, including identification of comorbid conditions, is an essential step toward appropriate treatment for patients with TS. In many patients with TS, symptom management requires pharmacotherapy for tics or coexisting conditions. The evidence supporting efficacy and safety for medications used in patients with TS varies. But this evidence offers the best guide to clinical practice.
Scahill
Lawrence
L
Yale Child Study Center, 230 South Frontage Road, P.O. Box 207900, New Haven, CT 06520, USA. scahill@yale.edu
Erenberg
Gerald
G
Berlin
Cheston M
CM
Budman
Cathy
C
Coffey
Barbara J
BJ
Jankovic
Joseph
J
Kiessling
Louise
L
King
Robert A
RA
Kurlan
Roger
R
Lang
Anthony
A
Mink
Jonathan
J
Murphy
Tanya
T
Zinner
Samual
S
Walkup
John
J
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D009462:Neurology / Q000639:trends*; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy; D020323:Tics / Q000175:diagnosis; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000188:drug therapy*