title: Aripiprazole for the treatment of tic disorders in children: a systematic review and meta-analysis.
abstract: BACKGROUND
  Tic disorders (TDs) are common neuropsychiatric disorders in children. Typical antipsychotics, such as haloperidol and pimozide have been prescribed to control tic symptoms as first-line agents. However, adverse effects have led to the use of newer atypical antipsychotics. Aripiprazole is one of alternatives. The aim of this study was to evaluate the efficacy and safety of aripiprazole for children with TDs.
  
  
  METHODS
  Randomized controlled trials (RCTs), quasi-RCTs and control studies evaluating aripiprazole for children with tic disorders were identified from PubMed, Embase, Cochrane library, Cochrane Central, four Chinese database and relevant reference lists. Quality assessment referred to the Cochrane Handbook for Systematic Reviews of Interventions.
  
  
  RESULTS
  Twelve studies involving 935 participants were included. The general quality of included studies was poor. Only one study used placebo as a control and others used positive drug controls. Participants were aged between 4 and 18 years. The period of treatment ranged from 8 to 12 weeks. Seven studies (N = 600 patients) used the YGTSS scale as the outcome measurement, and there was no significant difference in reduction of the total YGTSS score between the aripiprazole and positive control groups (MD = -0.48, 95 % CI [-6.22, 5.26], P = 0.87, I(2) = 87 %). Meta-analysis of four of the studies (N = 285 patients) that compared aripiprazole with haloperidol showed that there was no significant difference in reduction of the total YGTSS score (MD = 2.50, 95 % CI [-6.93, 11.92], P = 0.60, I(2) = 88 %). Meta-analysis of two studies (N = 255 patients) that compared aripiprazole with tiapride showed that there was no significant difference in reduction of the total YGTSS score (MD = -3.15, 95 % CI [-11.38, 5.09], P = 0.45, I(2) = 86 %). Adverse events (AEs) were reported in 11 studies. Drowsiness (5.1 %-58.1 %), increased appetite (3.2 %-25.8 %), nausea (2 %-18.8 %) and headache (2 %-16.1 %) were common AEs.
  
  
  CONCLUSIONS
  In conclusion, aripiprazole appears to be a promising therapy for children with TDs. Further well-conducted RCTs are required to confirm this issue.
authors.affiliation: 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. yangchunsong_123@126.com.|West China School of Public Health, Sichuan University, Chengdu, China. yangchunsong_123@126.com.
authors.forename: Chun-Song
authors.initials: CS
authors.lastname: Yang
authors.affiliation: 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. hh_ok7303@163.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Huang
authors.affiliation: 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. zhlingli@sina.com.|West China Second University Hospital, Sichuan University, No.20,Third Section, Renmin NanLu, Chengdu, Sichuan, 610041, People's Republic of China. zhlingli@sina.com.
authors.forename: Ling-Li
authors.initials: LL
authors.lastname: Zhang
authors.affiliation: West China School of Public Health, Sichuan University, Chengdu, China. cairong.zhu@hotmail.com.
authors.forename: Cai-Rong
authors.initials: CR
authors.lastname: Zhu
authors.affiliation: Department of Pediatrics, West China second hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China. joy1122@163.com.
authors.forename: Qin
authors.initials: Q
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D013981:Tic Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole; D006220:Haloperidol