Sodium valproate for the treatment of Tourette׳s syndrome in children: a systematic review and meta-analysis.
The aims are to evaluate the efficacy and safety of sodium valproate for children with Tourette׳s syndrome (TS). We searched PubMed, EMBASE, the Cochrane library, Cochrane Central, CBM, CNKI, VIP, WANG FANG database and relevant reference lists. Five RCTs (N=247) and five case series (N=163) studies were included. Only one RCT (93 patients) evaluated total YGTSS scores and there was significant difference in the reduction of total YGTSS scores between sodium valproate and the control group (3.50±4.59 vs 7.86±7.03, P<0.01). One RCT (30 patients) evaluated motor and vocal tics, and there was significant difference in the reduction of motor and vocal tics scores between sodium valproate and haloperidol (10.45±4.15 vs 14.92±3.01, P<0.01). Meta-analysis of three RCTs (N=124) showed there was no significant difference in the reduction of the number of tics between sodium valproate and the positive control group [Relative Risk (RR)=1.09, 95%CI (0.92, 1.30), P=0.30]. The pooled proportion in five case series studies which used tics symptom improvement self-defined by authors was 80.7% (95% CI: 73.7-86.2, I(2)=0). No fatal side effects were reported. In conclusion, based on the limited evidence, the routine use of sodium valproate for treatment of TS in children is not recommended. Further well-conducted trials that examine long-term outcomes are required.
Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. Electronic address: yangchunsong_123@126.com.
Chun-Song
CS
Yang
Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. Electronic address: zhlingli@sina.com.
Ling-Li
LL
Zhang
Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. Electronic address: 36377156@qq.com.
Yun-Zhu
YZ
Lin
Department of Pediatrics, West China Second Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. Electronic address: joy1122@163.com.
Qin
Q
Guo
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018682:GABA Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D005879:Tourette Syndrome / Q000188:drug therapy*; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use*
D018682:GABA Agents; D014635:Valproic Acid
Children systematic review; Sodium valproate; Tourette׳s syndrome