title: Treatment practices in Tourette syndrome: the European perspective.
abstract: OBJECTIVE
  National differences in licensing laws suggest that the use of medications for the treatment of Tourette syndrome differs between European countries. However, variability in prescribing practices has never been investigated. This study aims to systematically examine European prescribing practices in Tourette syndrome.
  
  
  METHODS
  All members of the European Society for the Study of Tourette syndrome actively prescribing for paediatric and/or adult Tourette syndrome populations were invited to complete an online questionnaire covering pharmacological treatment of the five main symptom domains of Tourette syndrome: tics, attention-deficit hyperactivity symptoms, obsessive-compulsive symptoms, anxiety and depression.
  
  
  RESULTS
  Response rates were good, with 44/57 (77%) members returning the questionnaire. Risperidone (n=13), methylphenidate (n=21) and sertraline (n=17) were the most commonly prescribed medications for the treatment of tics, attention-deficit hyperactivity symptoms and obsessive-compulsive symptoms, respectively. However, there was a large variability in both the medication choices and the dosages used for each of these symptom domains.
  
  
  CONCLUSIONS
  This is the first large-scale survey on prescribing habits for the pharmacological management of Tourette syndrome in Europe. In general, dopamine blockers were widely used for tics, selective serotonin reuptake inhibitors for depression, obsessive-compulsive symptoms and anxiety, and stimulants for attention-deficit hyperactivity symptoms, but there was high variation within these choices. Future studies need to target specific patient groups.
authors.affiliation: The Michael Trimble Neuropsychiatry Research Group, Department of Neuropsychiatry, BSMHFT, University of Birmingham, United Kingdom.
authors.forename: Hugh
authors.initials: H
authors.lastname: Rickards
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
authors.forename: Rhiannon
authors.initials: R
authors.lastname: Worrall
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001007:Anxiety / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D000068180:Aripiprazole; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003000:Clonidine / Q000627:therapeutic use; D003863:Depression / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005060:Europe; D005473:Fluoxetine / Q000627:therapeutic use; D016666:Fluvoxamine / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D010820:Physicians; D010879:Piperazines / Q000627:therapeutic use; D011437:Propylamines / Q000627:therapeutic use; D011570:Psychiatry; D015363:Quinolones / Q000627:therapeutic use; D018967:Risperidone / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use; D013469:Sulpiride / Q000627:therapeutic use; D005879:Tourette Syndrome / Q000150:complications / Q000188:drug therapy* / Q000523:psychology
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D010879:Piperazines; D011437:Propylamines; D015363:Quinolones; D005473:Fluoxetine; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride; D013469:Sulpiride; D000068180:Aripiprazole; D018967:Risperidone; D003000:Clonidine; D016666:Fluvoxamine; D020280:Sertraline