Materiały źródłowe

• #1 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  There’s no cure for Tourette syndrome. Treatment is aimed at controlling tics that interfere with everyday activities and functioning. When tics aren’t severe, treatment might not be necessary. […] Medications to help control tics or reduce symptoms of related conditions include: […] Medications that block or lessen dopamine. Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap) can help control tics. […] Botulinum (Botox) injections. An injection into the affected muscle might help relieve a simple or vocal tic. […] ADHD medications. Stimulants such as methylphenidate (Metadate CD, Ritalin LA, others) and medications containing dextroamphetamine (Adderall XR, Dexedrine, others) can help increase attention and concentration. […] Central adrenergic inhibitors. Medications such as clonidine (Catapres, Kapvay) and guanfacine (Intuniv) typically prescribed for high blood pressure might help control behavioral symptoms such as impulse control problems and rage attacks.

• #2 Treatment – Tourette Association of America

  https://tourette.org/about-tourette/overview/treatment/

  Treatment is not always required for Tourette Syndrome (TS) and Tic Disorders. […] When tics become problematic or interfere with daily functioning, behavioral treatment or medication may be considered. […] Because each patient is unique, the individual or family should work with a clinician to determine an appropriate treatment plan. […] A clinician may recommend first treating one of the co-occurring conditions if it is more bothersome or problematic than the tics. […] It is usually best to begin with an effective treatment that is unlikely to cause any side effects. […] Possible Treatments Include: Comprehensive Behavioral Intervention for Tics (CBIT) […] Deep Brain Stimulation (DBS) […] Medications/Pharmacology […] Speech Therapies.

• #3 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Medication can reduce symptoms and improve quality of life of people with TS when needed. […] In an ideal world behavioural treatments would more often be a first choice. Unfortunately specialised therapists are often not available which increases the likelihood of medication being offered. In some patients medication can be highly effective and a better solution than behavioural options. […] Selecting treatment for TS is an individual process due to the wide range and severity of symptoms and the occurrence of associated conditions such as attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and depression. […] The decisions that need to be made include: whether or not to treat; which symptoms to treat – tics or the other conditions such as ADHD or OCD; whether a combination of medications is necessary to treat the different symptoms.

• #4 Tourette syndrome: Management – UpToDate

  https://www.uptodate.com/contents/tourette-syndrome-management

  Tourette syndrome (TS) is a neurologic disorder manifested by motor and phonic tics with onset during childhood. This topic will review the management of TS. Other aspects of TS are reviewed separately. […] The management of TS requires a careful assessment of the degree of functional impairment and effect on quality of life caused by tics and comorbid conditions. Education is indicated for all. […] Specific treatment of TS is guided by the need to treat the most troublesome symptoms, including both tics and comorbid conditions such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), behavioral problems, and mood disorders. Therefore, it is important to determine which of these conditions is causing the greatest impairment. Many patients require a combination of therapy to treat tics, ADHD, and OCD.

• #5 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  The primary type of behavioral therapy used is comprehensive behavioral intervention for tics (CBIT). […] According to the AAN guidelines, CBIT is more likely than psychoeducation or supportive therapy to reduce tic severity. […] Overall, CBIT is an understudied treatment for Tourette syndrome, with only 2 available studies of sufficient sample size, limiting reliability. […] The literature supporting definitive treatment of Tourette syndrome related tics is limited. […] Treatment is complicated by the waxing and waning of symptoms, existence of comorbid disorders, and a lack of robust studies identifying treatment with consistent outcomes. […] Overall, the choice of therapy, both non-pharmacologic and pharmacologic, must be individualized based on severity of symptoms, lifestyle, side effects, and response to previous treatment.

• #6 Behavioral Treatment for Tics That Works | Tourette Syndrome | CDC

  https://www.cdc.gov/tourette-syndrome/articles/behavioral-treatment-for-tics-that-works.html

  Comprehensive behavioral intervention for tics (CBIT) is a type of behavioral therapy that can help people with tics and tic disorders manage their tics better. CBIT can be effective for many people with tic disorders, including Tourette syndrome. […] Medication can help control tics, but it doesn’t always work. […] During the past decade, there has been increasing evidence that CBIT can be effective for many people with Tourette. Experts now suggest using it as the first approach to treatment because its effectiveness is similar to medications but with fewer side effects. […] But the evidence also shows that CBIT is not a „cure” for Tourette syndrome and does not help everybody; rather, CBIT is a tool that, when used appropriately, can help many people with Tourette syndrome manage their tics better and reduce the impact that tics may have on their lives.

• #7 New Guideline for Tourette Syndrome, Tic Disorders Emphasizes Behavioral Therapy as First-Line Intervention

  https://www.neurologylive.com/view/new-guideline-tourette-syndrome-tic-disorders-emphasizes-behavioral-therapy-firstline-intervention

  The guideline, which is endorsed by the Child Neurology Society and the European Academy of Neurology, is the first guideline on the topic for US-based clinicians. […] For patients with Tourette syndrome and other chronic tic disorders, a treatment approach that includes holistic and behavioral strategies, as well as medications may help improve tic management over time, according to new treatment guidelines from the American Academy of Neurology. […] The guidelines recommend a watch and wait approach for patients who present with tics that do not interfere with their activities of daily living, or cause them emotional or social distress. However, if patients are open to treatment, clinicians may initiate the use of Comprehensive Behavioral Intervention for Tics (CBIT) as first-line treatment, which utilizes relaxation training, habit-reversal training, and behavioral therapy.

• #8 Management of Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Management_of_Tourette_syndrome

  Behavioral therapies using habit reversal training (HRT) and exposure and response prevention (ERP) are first-line interventions, and have been shown to be effective. Comprehensive behavioral intervention for tics (CBIT) is based on HRT, the best researched behavioral therapy for tics. CBIT has been shown with a high level of confidence to be more likely to lead to a reduction in tics than other behavioral therapies or psychoeducation. […] When medication is used, the goal is not to eliminate symptoms. Instead, the lowest dose that manages symptoms without adverse effects is used, because adverse effects may be more disturbing than the symptoms being treated with medication. There are no medications specifically designed to target tics, although some antipsychotics (for example, pimozide) have been FDA-approved for treating Tourette’s.

• #9 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  The primary type of behavioral therapy used is comprehensive behavioral intervention for tics (CBIT). […] According to the AAN guidelines, CBIT is more likely than psychoeducation or supportive therapy to reduce tic severity. […] Overall, CBIT is an understudied treatment for Tourette syndrome, with only 2 available studies of sufficient sample size, limiting reliability. […] The literature supporting definitive treatment of Tourette syndrome related tics is limited. […] Treatment is complicated by the waxing and waning of symptoms, existence of comorbid disorders, and a lack of robust studies identifying treatment with consistent outcomes. […] Overall, the choice of therapy, both non-pharmacologic and pharmacologic, must be individualized based on severity of symptoms, lifestyle, side effects, and response to previous treatment.

• #10 Behaviour therapies in TS

  https://www.tourettes-action.org.uk/71-behavioural-therapies.html

  Behavioural therapies can be useful for most people with tic disorders, although evidence suggests that it is effective for children as young as five years of age and adults. […] The best scientifically validated behavioural treatment is called Habit Reversal Therapy (HRT), which has been researched since the 1970s. […] Another behavioural intervention which has emerging evidence is called Exposure and Response Prevention (ERP). […] Both therapies focus on getting used to the tense or uncomfortable feeling which precedes a tic (called premonitory urge) and tolerating the urge by resisting it or using an action until the urge to tic fades and the individual resists the tic. […] Studies show that most individuals who have a successful response to behavioural treatment typically experience a 30-40% reduction in tics.

• #11 Tourette Syndrome Clinic | Center for Psychological Services | Graduate School of Applied Professional Psychology

  https://gsapp.rutgers.edu/centers-clinics/center-psychological-services-cps/tourette-syndrome-clinic

  The TS Clinic at Rutgers specializes in providing cognitive behavioral therapy, a structured, goal oriented approach focused on developing coping skills, and modifying problematic thoughts, feelings, and behaviors. […] Comprehensive Behavioral Intervention for Tics (CBIT) is a structured evidenced-based non-medical intervention for tics based on cognitive behavioral therapy. […] The goals of CBIT are: Reduce the symptoms of the tic and tic urge, Develop tic management strategies, Boost social confidence and self-efficacy.

• #12 New therapies offer effective treatment for managing Tourette syndrome

  https://medicalxpress.com/news/2024-11-therapies-effective-treatment-tourette-syndrome.html

  New therapies offer effective treatment for managing Tourette syndrome […] Researchers at Kennedy Krieger Institute have made significant strides in improving the lives of patients with Tourette syndrome. Their recent publication highlights how behavioral therapies—an approach that teaches patients how to manage certain tics using behavioral strategies—are proving to be the most effective treatment. […] Dr. Hala Katato, the lead author on the publication from Kennedy Krieger’s psychiatry department, explains that tics can cause significant distress for many patients and that behavioral therapies provide patients with effective tools to manage their symptoms and are the recommended first-line treatment. […] The behavioral therapies in this research are: Habit reversal training, which helps patients become more aware of their tics and teaches them strategies to replace tic behaviors with alternative actions, like subtly squinting your eyes to counter eye-widening tics. Comprehensive behavioral intervention for tics, which builds on the foundation of habit reversal training by incorporating interventions and relaxation techniques, such as deep breathing and progressive muscle relaxation, to manage factors that can trigger tics. Exposure with response prevention, which focuses on helping patients experience the urge to tic without acting on it through gradual exposure. It aims to disrupt the pattern of premonitory urges (the sensations that typically precede tics) and reduce the need to perform a tic.

• #13 UNC Clinic for Tourette Syndrome and Tic Disorders | Department of Neurology

  https://www.med.unc.edu/neurology/divisions/child-neurology-1/unc-tourette-syndrome-and-tic-disorders-clinic/

  At UNC, we aim to give each child personalized care. […] This plan might include watching the tics without treatment, using Comprehensive Behavioral Intervention for Tics (CBIT), medication, or addressing other conditions. […] For many children, tics are very mild and may not warrant treatment. However, tics can sometimes be bothersome and negatively affect a child in many different ways including issues with self-esteem, bullying, and pain in rare cases. In these cases, treatment for tics may be warranted. […] The treatment of choice is a type of behavioral therapy called Comprehensive Behavioral Intervention for Tics (CBIT). CBIT is a specialized type of therapy designed to teach a child to recognize an urge to tic and then channel that urge into a non-tic activity. Greater than 50% of children who complete a course of CBIT go on to have long-term improvement in their tic control. […] Medication options also exist to help manage tics. There is no medication that is a cure for tics, but they can help improve both the frequency and/or severity of a child’s tics. Multiple medications exist to help tics.

• #14 Behaviour therapies in TS

  https://www.tourettes-action.org.uk/71-behavioural-therapies.html

  Behavioural therapies can be useful for most people with tic disorders, although evidence suggests that it is effective for children as young as five years of age and adults. […] The best scientifically validated behavioural treatment is called Habit Reversal Therapy (HRT), which has been researched since the 1970s. […] Another behavioural intervention which has emerging evidence is called Exposure and Response Prevention (ERP). […] Both therapies focus on getting used to the tense or uncomfortable feeling which precedes a tic (called premonitory urge) and tolerating the urge by resisting it or using an action until the urge to tic fades and the individual resists the tic. […] Studies show that most individuals who have a successful response to behavioural treatment typically experience a 30-40% reduction in tics.

• #15 Behaviour therapies in TS

  https://www.tourettes-action.org.uk/71-behavioural-therapies.html

  Behavioural therapies can be useful for most people with tic disorders, although evidence suggests that it is effective for children as young as five years of age and adults. […] The best scientifically validated behavioural treatment is called Habit Reversal Therapy (HRT), which has been researched since the 1970s. […] Another behavioural intervention which has emerging evidence is called Exposure and Response Prevention (ERP). […] Both therapies focus on getting used to the tense or uncomfortable feeling which precedes a tic (called premonitory urge) and tolerating the urge by resisting it or using an action until the urge to tic fades and the individual resists the tic. […] Studies show that most individuals who have a successful response to behavioural treatment typically experience a 30-40% reduction in tics.

• #16 Tourette Syndrome and Other Tic Disorders | Doctor

  https://patient.info/doctor/tourette-syndrome-and-other-tic-disorders

  A literature survey concluded that behavioural and psychosocial interventions (BPIs) should be the first-line approach for children and adolescents with tic disorders. […] Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). […] HRT involves developing awareness about the tics, developing motivation to change behaviour, adopting new responses to replace the tics and practising these new-found techniques in challenging situations. […] ERP is a similar therapy which involves patients confronting their fears and discontinuing their escape response. […] Moderate-to-severe tics should be treated pharmacologically and the patient referred to specialists (eg, a neurologist, mental health specialists).

• #17 Tourette Syndrome and Other Tic Disorders: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/289457-treatment

  Treatments for tics that have demonstrated efficacy in replicated controlled trials include the following: Dopamine D2 receptor antagonist therapy […] Patient education is very important for individuals with Tourette syndrome. Counseling and support including cognitive-behavioral therapy and social skills training should also be considered. […] The Tourette Syndrome Association and its local chapters can be a valuable aid in patient education. […] In a randomized controlled trial of habit reversal therapy (HRT), results differed significantly from those of a control therapy (massed practice; P < .001, analysis of variance). The HRT group had a 97% reduction in tics at 18-month follow-up, with 80% of patients tic-free.

• #18 New therapies offer effective treatment for managing Tourette syndrome

  https://medicalxpress.com/news/2024-11-therapies-effective-treatment-tourette-syndrome.html

  New therapies offer effective treatment for managing Tourette syndrome […] Researchers at Kennedy Krieger Institute have made significant strides in improving the lives of patients with Tourette syndrome. Their recent publication highlights how behavioral therapies—an approach that teaches patients how to manage certain tics using behavioral strategies—are proving to be the most effective treatment. […] Dr. Hala Katato, the lead author on the publication from Kennedy Krieger’s psychiatry department, explains that tics can cause significant distress for many patients and that behavioral therapies provide patients with effective tools to manage their symptoms and are the recommended first-line treatment. […] The behavioral therapies in this research are: Habit reversal training, which helps patients become more aware of their tics and teaches them strategies to replace tic behaviors with alternative actions, like subtly squinting your eyes to counter eye-widening tics. Comprehensive behavioral intervention for tics, which builds on the foundation of habit reversal training by incorporating interventions and relaxation techniques, such as deep breathing and progressive muscle relaxation, to manage factors that can trigger tics. Exposure with response prevention, which focuses on helping patients experience the urge to tic without acting on it through gradual exposure. It aims to disrupt the pattern of premonitory urges (the sensations that typically precede tics) and reduce the need to perform a tic.

• #19 New Therapies at Kennedy Krieger Offer Effective Treatment for Managing Tourette Syndrome | Kennedy Krieger Institute

  https://www.kennedykrieger.org/stories/news-and-updates/research-news-releases-1/new-therapies-kennedy-krieger-offer-effective-treatment-managing-tourette-syndrome

  Researchers at Kennedy Krieger Institute have made significant strides in improving the lives of patients with Tourette syndrome. Their recent publication highlights how behavioral therapies—an approach that teaches patients how to manage certain tics using behavioral strategies—are proving to be the most effective treatment. […] Dr. Hala Katato, the lead author on the publication from Kennedy Krieger’s psychiatry department, explains that tics can cause significant distress for many patients and that behavioral therapies provide patients with effective tools to manage their symptoms and are the recommended first-line treatment. […] The behavioral therapies in this research are: Habit Reversal Training helps patients become more aware of their tics and teaches them strategies to replace tic behaviors with alternative actions, like subtly squinting your eyes to counter eye-widening tics. Comprehensive Behavioral Intervention for Tics builds on the foundation of habit reversal training by incorporating interventions and relaxation techniques, such as deep breathing and progressive muscle relaxation, to manage factors that can trigger tics. Exposure with Response Prevention focuses on helping patients experience the urge to tic without acting on it through gradual exposure. It aims to disrupt the pattern of premonitory urges (the sensations that typically precede tics) and reduce the need to perform a tic.

• #20 Tourette’s syndrome

  https://www.nhs.uk/conditions/tourettes-syndrome/

  There’s no cure for Tourette’s syndrome, but treatment can help manage symptoms. […] Treatment may sometimes be recommended to help you control your tics. […] Treatment is usually available on the NHS and can involve: behavioural therapy, medicine. […] 2 types of behavioural therapy have been shown to reduce tics: habit reversal training this approach involves working out the feelings that trigger tics; the next stage is to find an alternative, less noticeable way of relieving the urge to tic, exposure with response prevention (ERP) this method trains you to better control your urge to tic; techniques are used to recreate the urge to tic to train you to tolerate the feeling, without doing the tic, until the urge passes. […] Some people’s tics are helped with medicines, but this is usually only recommended if the tics are more severe or affecting daily activities.

• #21 Tics or Tourette Syndrome and Medications

  https://www.cincinnatichildrens.org/health/t/tics-ts-meds

  Treatment with medication may be helpful when tics are associated with pain, social/psychological problems, functional interference, or classroom disruption. […] A behavioral treatment called Comprehensive Behavioral Intervention for Tics has been shown in carefully conducted research to be helpful for managing symptoms of Tourette Syndrome.

• #22 Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Tourette_syndrome

  When medication is used, the goal is not to eliminate symptoms. Instead, the lowest dose that manages symptoms without adverse effects is used, because adverse effects may be more disturbing than the symptoms being treated with medication. […] Complementary and alternative medicine approaches, such as dietary modification, neurofeedback and allergy testing and control have popular appeal, but they have no proven benefit in the management of Tourette syndrome. […] Deep brain stimulation (DBS) has become a valid option for individuals with severe symptoms that do not respond to conventional therapy and management, although it is an experimental treatment.

• #23 Tourette’s Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p651.html

  Tourette’s syndrome is a movement disorder most commonly seen in school-age children. […] Treatment can be behavioral, pharmacologic, or surgical, and is dictated by the most incapacitating symptoms. Alpha2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine-receptorblocking drugs are required for multiple, complex tics. […] Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected children. […] Alpha2-adrenergic agonists are useful in treating patients with Tourette’s syndrome, although they improve tics to a lesser degree than dopamine-receptorblocking drugs. […] Dopamine-receptorblocking drugs are the most effective treatment for tics. […] Medically refractory motor and disabling phonic tics such as coprolalia can be ameliorated by botulinum toxin (Botox) injections.

• #24 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  Only 3 agents (i.e., haloperidol, pimozide, and aripiprazole) have been approved by the FDA for the suppression of Tourette syndrome related tics. […] Because of the lack of a universally effective treatment, additional treatment options, including antiepileptic drugs, vesicular monoamine transporter type 2 (VMAT2) inhibitors, and cannabinoids, have been suggested; however, all require more study. […] The American Academy of Neurology (AAN) published practice guidelines in 2019. These guidelines stratified assessment of interventions labeled as probably or possibly more effective than placebo, which demonstrates the lack of definitive treatment data. […] Clonidine is a centrally acting imidazoline derivative that stimulates the 2 adrenergic receptors in the locus coeruleus in the brain stem, causing a reduced sympathetic outflow from the CNS.

• #25 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  All antipsychotic drugs work by modifying the effect of dopamine on the brain, specifically by blocking dopamine receptors, mainly the D2 receptor. […] Antipsychotic drugs can be further divided in to first, second and third generation. […] Haloperidol was the first medication used to treat tics but is now less often prescribed than second and third generation drugs because of the risk of side effects. […] Pimozide was widely used in Europe for the treatment of tics as studies showed that it is an effective treatment and causes fewer neurological side-effects than haloperidol. […] Second generation drugs are prescribed more often than first generation drugs because they are less likely to produce neurological side-effects. […] Aripiprazole is the main drug in this category and is commonly used for TS.

• #26 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  This agent is FDA approved for the treatment of tics in Tourette syndrome for children as young as 6 years. […] The AAN guidelines identify aripiprazole as probably more likely than placebo to reduce tic severity. […] Overall, risperidone is well tolerated in the treatment of Tourette syndrome related tics. […] The AAN categorizes risperidone as probably more effective than placebo in reduction of tic severity. […] In an effort to suppress tics and reduce risks associated with systemic drug exposure, studies have examined the efficacy of BTX injection. […] The AAN concluded that BTX treatment for Tourette syndrome related tics was probably more effective than placebo in adolescents and adults and stated the PMU might also improve. […] Several non-pharmacologic treatments for Tourette syndrome related tics have also been studied.

• #27 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  This agent is FDA approved for the treatment of tics in Tourette syndrome for children as young as 6 years. […] The AAN guidelines identify aripiprazole as probably more likely than placebo to reduce tic severity. […] Overall, risperidone is well tolerated in the treatment of Tourette syndrome related tics. […] The AAN categorizes risperidone as probably more effective than placebo in reduction of tic severity. […] In an effort to suppress tics and reduce risks associated with systemic drug exposure, studies have examined the efficacy of BTX injection. […] The AAN concluded that BTX treatment for Tourette syndrome related tics was probably more effective than placebo in adolescents and adults and stated the PMU might also improve. […] Several non-pharmacologic treatments for Tourette syndrome related tics have also been studied.

• #28 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  This agent is FDA approved for the treatment of tics in Tourette syndrome for children as young as 6 years. […] The AAN guidelines identify aripiprazole as probably more likely than placebo to reduce tic severity. […] Overall, risperidone is well tolerated in the treatment of Tourette syndrome related tics. […] The AAN categorizes risperidone as probably more effective than placebo in reduction of tic severity. […] In an effort to suppress tics and reduce risks associated with systemic drug exposure, studies have examined the efficacy of BTX injection. […] The AAN concluded that BTX treatment for Tourette syndrome related tics was probably more effective than placebo in adolescents and adults and stated the PMU might also improve. […] Several non-pharmacologic treatments for Tourette syndrome related tics have also been studied.

• #29 The Best Medications for Tourette’s Syndrome (Tics) – BuzzRx

  https://www.buzzrx.com/blog/the-best-medications-for-tourette-s-syndrome-tics

  Medications called alpha-2-adrenergic agonists, typically used to treat high blood pressure, can also help control impulses and anger attacks. […] Studies have shown that an epilepsy medication, topiramate (Topamax), may help reduce tics in some people with Tourette syndrome. […] An injection of botulinum toxin (Botox®) into the affected muscle can temporarily improve vocal or simple tics. […] Cognitive behavioral therapy (CBT), habit-reversal therapy, and parent training can be used in addition to medications in children with Tourette syndrome. […] Deep brain stimulation (DBS) may be recommended by pediatric neurology for severe tics with no treatment response to medications and psychotherapy after more than a year. […] Alpha-2-adrenergic agonists like clonidine (Catapres, Kapvay) and guanfacine (Tenex, Intuniv) are usually the first lines of medication treatment for chronic tic disorders like Tourette syndrome.

• #30 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  Clonidine offers a therapeutic option without the risks of drug-induced movement disorders that can be associated with antipsychotic drugs. […] The AAN guidelines list clonidine as probably more effective than placebo, and support that the treatment effect of clonidine appears to be larger in children with comorbid ADHD, with clonidine contributing to an improvement in both tics and ADHD symptoms. […] Guanfacine, another 2 adrenergic agonist, has also been used clinically in Tourette syndrome. […] The current AAN guidelines note that guanfacine is possibly more effective than placebo. […] Two typical antipsychotics, haloperidol and pimozide, have been the traditional pharmacologic treatment for Tourette syndrome related tic suppression. […] The AAN guidelines indicate haloperidol is probably more effective, and pimozide is possibly more effective, than placebo.

• #31 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Clonidine has been used for many years in the treatment of tics and also improves ADHD. […] A newer drug called guanfacine, which works in a similar way to clonidine, is reported to have fewer side effects than clonidine and is now also available in the UK for people under 18 years old. […] Finally, topiramate is a drug for epilepsy and migraine that can reduce tics in some patients and does not act on the dopamine pathway. […] A commonly asked question about the treatment of ADHD in people who also have TS is whether or not the treatment for ADHD makes the tics worse. […] More recent studies and opinion suggest that drugs for ADHD do not generally lead to worsening of tics so then stimulants for ADHD can be used safely in children with tics. […] Atomoxetine is a well-established but newer medication in the treatment of ADHD. […] The group of drugs used to treat depression known as SSRIs (Selective Serotonin Reuptake Inhibitors) are also effective for OCD, sometimes requiring high doses. […] Cognitive behavioural treatment used in combination with SSRIs is most effective.

• #32 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  Clonidine offers a therapeutic option without the risks of drug-induced movement disorders that can be associated with antipsychotic drugs. […] The AAN guidelines list clonidine as probably more effective than placebo, and support that the treatment effect of clonidine appears to be larger in children with comorbid ADHD, with clonidine contributing to an improvement in both tics and ADHD symptoms. […] Guanfacine, another 2 adrenergic agonist, has also been used clinically in Tourette syndrome. […] The current AAN guidelines note that guanfacine is possibly more effective than placebo. […] Two typical antipsychotics, haloperidol and pimozide, have been the traditional pharmacologic treatment for Tourette syndrome related tic suppression. […] The AAN guidelines indicate haloperidol is probably more effective, and pimozide is possibly more effective, than placebo.

• #33 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  Antidepressants. Fluoxetine (Prozac, Sarafem, others) might help control symptoms of sadness, anxiety and OCD. […] Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate (Topamax), which is used to treat epilepsy. […] Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic. […] Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. […] Deep brain stimulation (DBS). For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

• #34 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  There’s no cure for Tourette syndrome. Treatment is aimed at controlling tics that interfere with everyday activities and functioning. When tics aren’t severe, treatment might not be necessary. […] Medications to help control tics or reduce symptoms of related conditions include: […] Medications that block or lessen dopamine. Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap) can help control tics. […] Botulinum (Botox) injections. An injection into the affected muscle might help relieve a simple or vocal tic. […] ADHD medications. Stimulants such as methylphenidate (Metadate CD, Ritalin LA, others) and medications containing dextroamphetamine (Adderall XR, Dexedrine, others) can help increase attention and concentration. […] Central adrenergic inhibitors. Medications such as clonidine (Catapres, Kapvay) and guanfacine (Intuniv) typically prescribed for high blood pressure might help control behavioral symptoms such as impulse control problems and rage attacks.

• #35 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  This agent is FDA approved for the treatment of tics in Tourette syndrome for children as young as 6 years. […] The AAN guidelines identify aripiprazole as probably more likely than placebo to reduce tic severity. […] Overall, risperidone is well tolerated in the treatment of Tourette syndrome related tics. […] The AAN categorizes risperidone as probably more effective than placebo in reduction of tic severity. […] In an effort to suppress tics and reduce risks associated with systemic drug exposure, studies have examined the efficacy of BTX injection. […] The AAN concluded that BTX treatment for Tourette syndrome related tics was probably more effective than placebo in adolescents and adults and stated the PMU might also improve. […] Several non-pharmacologic treatments for Tourette syndrome related tics have also been studied.

• #36 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  There’s no cure for Tourette syndrome. Treatment is aimed at controlling tics that interfere with everyday activities and functioning. When tics aren’t severe, treatment might not be necessary. […] Medications to help control tics or reduce symptoms of related conditions include: […] Medications that block or lessen dopamine. Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap) can help control tics. […] Botulinum (Botox) injections. An injection into the affected muscle might help relieve a simple or vocal tic. […] ADHD medications. Stimulants such as methylphenidate (Metadate CD, Ritalin LA, others) and medications containing dextroamphetamine (Adderall XR, Dexedrine, others) can help increase attention and concentration. […] Central adrenergic inhibitors. Medications such as clonidine (Catapres, Kapvay) and guanfacine (Intuniv) typically prescribed for high blood pressure might help control behavioral symptoms such as impulse control problems and rage attacks.

• #37 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  Antidepressants. Fluoxetine (Prozac, Sarafem, others) might help control symptoms of sadness, anxiety and OCD. […] Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate (Topamax), which is used to treat epilepsy. […] Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic. […] Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. […] Deep brain stimulation (DBS). For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

• #38 Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3899474/

  Several trials have supported efficacy of the alpha-2 adrenergic drugs clonidine and guanfacine. […] Local intramuscular injections of botulinum toxin is a therapeutic option when there are a few particularly bothersome tics. […] In the past few years, deep brain stimulation (DBS) has been used for TS patients with disabling and medication-refractory tics. […] A very important aspect of optimally managing patients with TS is to treat psychiatric comorbidities appropriately. […] Given the fact that many TS patients require treatment for both tics and comorbidities, combination therapy with tic-suppressing, anti-OCD and anti-ADHD medications is commonly employed.

• #39 4 Treatments for Tourette Syndrome | Pediatric Neurology located in The Woodlands, Katy, Sugar Land, Austin, Lakeway, Lake Jackson and San Antonio, TX | THINK Neurology for Kids

  https://www.thinkkids.com/post/5-treatments-for-tourette-syndrome

  We offer comprehensive and compassionate treatment using multimodal therapies to reduce your childs symptoms. These are four possible treatments for Tourette Syndrome: […] If your childs tic is mild and doesnt affect their daily functioning, they may not need medication. When they struggle with moderate or severe symptoms, some medications can help suppress their tics. […] Most patients with Tourette Syndrome develop co-occurring neuropsychiatric conditions. ADHD, which often appears before tics begin, is the most common comorbidity, affecting 60-80% of all children with Tourette Syndrome. […] Each disorder has specific medications that can help treat your childs symptoms. Many children achieve better results when we combine medications with psychotherapy. […] Children with Tourette Syndrome (and other comorbid disorders) often make great strides and experience significant symptom improvement with different types of psychotherapy.

• #40 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Clonidine has been used for many years in the treatment of tics and also improves ADHD. […] A newer drug called guanfacine, which works in a similar way to clonidine, is reported to have fewer side effects than clonidine and is now also available in the UK for people under 18 years old. […] Finally, topiramate is a drug for epilepsy and migraine that can reduce tics in some patients and does not act on the dopamine pathway. […] A commonly asked question about the treatment of ADHD in people who also have TS is whether or not the treatment for ADHD makes the tics worse. […] More recent studies and opinion suggest that drugs for ADHD do not generally lead to worsening of tics so then stimulants for ADHD can be used safely in children with tics. […] Atomoxetine is a well-established but newer medication in the treatment of ADHD. […] The group of drugs used to treat depression known as SSRIs (Selective Serotonin Reuptake Inhibitors) are also effective for OCD, sometimes requiring high doses. […] Cognitive behavioural treatment used in combination with SSRIs is most effective.

• #41 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Clonidine has been used for many years in the treatment of tics and also improves ADHD. […] A newer drug called guanfacine, which works in a similar way to clonidine, is reported to have fewer side effects than clonidine and is now also available in the UK for people under 18 years old. […] Finally, topiramate is a drug for epilepsy and migraine that can reduce tics in some patients and does not act on the dopamine pathway. […] A commonly asked question about the treatment of ADHD in people who also have TS is whether or not the treatment for ADHD makes the tics worse. […] More recent studies and opinion suggest that drugs for ADHD do not generally lead to worsening of tics so then stimulants for ADHD can be used safely in children with tics. […] Atomoxetine is a well-established but newer medication in the treatment of ADHD. […] The group of drugs used to treat depression known as SSRIs (Selective Serotonin Reuptake Inhibitors) are also effective for OCD, sometimes requiring high doses. […] Cognitive behavioural treatment used in combination with SSRIs is most effective.

• #42 Tourette Syndrome and Other Tic Disorders Treatment & Management: Approach Considerations, Treatments for Tics, Treatment for Obsessive-Compulsive Symptoms in Patients With Tics

  https://emedicine.medscape.com/article/1182258-treatment

  Treatments for tics that have not been proven in replicated RCTs include the following: Guanfacine […] Clonidine […] Topiramate […] Botulinum toxin injections and oral baclofen […] SSRIs (eg, clomipramine, fluoxetine) improve tics in some patients, worsen them in others, and have no effect on tics in yet others. […] Initial treatment of OCD in patients with tics usually consists of an SSRI, generally at 3-4 times the antidepressant dose. […] Stimulants such as methylphenidate or dextroamphetamine represent the oldest class of psychotropic drugs still in common use, and have known safety profiles. […] Clonidine has also been proven useful for ADHD in people with TS. […] Stereotactic neurosurgery, either to place deep brain stimulators or to ablate tissue, is indicated only rarely for the treatment of obsessions, compulsions, and possibly tics. […] Some nutraceuticals may possibly improve tic symptoms, but no adequate evidence exists at present. […] Patients should be evaluated at least once by someone with experience treating patients with TS.

• #43 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Clonidine has been used for many years in the treatment of tics and also improves ADHD. […] A newer drug called guanfacine, which works in a similar way to clonidine, is reported to have fewer side effects than clonidine and is now also available in the UK for people under 18 years old. […] Finally, topiramate is a drug for epilepsy and migraine that can reduce tics in some patients and does not act on the dopamine pathway. […] A commonly asked question about the treatment of ADHD in people who also have TS is whether or not the treatment for ADHD makes the tics worse. […] More recent studies and opinion suggest that drugs for ADHD do not generally lead to worsening of tics so then stimulants for ADHD can be used safely in children with tics. […] Atomoxetine is a well-established but newer medication in the treatment of ADHD. […] The group of drugs used to treat depression known as SSRIs (Selective Serotonin Reuptake Inhibitors) are also effective for OCD, sometimes requiring high doses. […] Cognitive behavioural treatment used in combination with SSRIs is most effective.

• #44 Medication for TS

  https://www.tourettes-action.org.uk/70-medication.html

  Clonidine has been used for many years in the treatment of tics and also improves ADHD. […] A newer drug called guanfacine, which works in a similar way to clonidine, is reported to have fewer side effects than clonidine and is now also available in the UK for people under 18 years old. […] Finally, topiramate is a drug for epilepsy and migraine that can reduce tics in some patients and does not act on the dopamine pathway. […] A commonly asked question about the treatment of ADHD in people who also have TS is whether or not the treatment for ADHD makes the tics worse. […] More recent studies and opinion suggest that drugs for ADHD do not generally lead to worsening of tics so then stimulants for ADHD can be used safely in children with tics. […] Atomoxetine is a well-established but newer medication in the treatment of ADHD. […] The group of drugs used to treat depression known as SSRIs (Selective Serotonin Reuptake Inhibitors) are also effective for OCD, sometimes requiring high doses. […] Cognitive behavioural treatment used in combination with SSRIs is most effective.

• #45 Tourette’s Syndrome – Neuromodulation for Movement Disorders & Pain | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/dbs/conditions-treated/tourettes-syndrome

  Whether you or your child has been diagnosed with Tourette’s syndrome, you understand how even subtle tics can affect social and professional interactions. […] The UCLA Neuromodulation for Movement Disorders and Pain Program offers deep brain stimulation for children and adults as a surgical alternative to medication and traditional therapy. […] Behavioral therapy and medicines are the standard treatments for Tourette’s syndrome. At UCLA, we consider a surgical option when medications and behavioral therapy fail. Our UCLA Neuromodulation for Movement Disorders and Pain Program is one of the few centers that performs deep brain stimulation to relieve tics caused by Tourette’s. It is an off-label procedure for treating Tourette’s syndrome. That means it is not yet FDA-approved.

• #46 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  Antidepressants. Fluoxetine (Prozac, Sarafem, others) might help control symptoms of sadness, anxiety and OCD. […] Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate (Topamax), which is used to treat epilepsy. […] Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic. […] Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. […] Deep brain stimulation (DBS). For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

• #47 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  Antidepressants. Fluoxetine (Prozac, Sarafem, others) might help control symptoms of sadness, anxiety and OCD. […] Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate (Topamax), which is used to treat epilepsy. […] Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic. […] Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. […] Deep brain stimulation (DBS). For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

• #48 New Guideline for Tourette Syndrome, Tic Disorders Emphasizes Behavioral Therapy as First-Line Intervention

  https://www.neurologylive.com/view/new-guideline-tourette-syndrome-tic-disorders-emphasizes-behavioral-therapy-firstline-intervention

  The guidelines also include a level C recommendation for the use of botulinum toxin injections for the treatment of tic disorders, including localized and bothersome motor tics and disabling or aggressive vocal tics. […] In patients who don’t respond well to other treatments, clinicians can consider prescribing topiramate at the lowest effective dose. […] For those patients who are refractory to behavioral and pharmaceutical interventions, clinicians may consider deep brain stimulation, though there is limited evidence from randomized trials available. […] Finally, the guideline authors recognize that some patients with tic disorders self-medicate with cannabis in an effort to control their tics and related comorbidities.

• #49 Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Tourette_syndrome

  There is no cure for Tourette’s and no single most effective medication. In most cases, medication for tics is not necessary, and behavioral therapies are the first-line treatment. Education is an important part of any treatment plan, and explanation alone often provides sufficient reassurance that no other treatment is necessary. […] Treatment is focused on identifying the most troubling or impairing symptoms and helping the individual manage them. Because comorbid conditions are often a larger source of impairment than tics, they are a priority in treatment. […] Education, reassurance and psychobehavioral therapy are often sufficient for the majority of cases. […] Behavioral therapies using habit reversal training (HRT) and exposure and response prevention (ERP) are first-line interventions in the management of Tourette syndrome, and have been shown to be effective.

• #50 Tourette Syndrome and Other Tic Disorders | Doctor

  https://patient.info/doctor/tourette-syndrome-and-other-tic-disorders

  Psychoeducation is recommended as an initial intervention regardless of symptom severity. Psychoeducation involves a therapist providing structured and specific information about diagnosis, symptoms, and the methods of treatment used. […] When psychoeducation alone is insufficient, both habit reversal training (HRT)/comprehensive behavioral intervention for tics (CBIT) and exposure and response prevention (ERP) are recommended as first-line interventions for tic disorders. […] Alpha-adrenergic agonists (eg, clonidine) are often recommended as the first line. Tetrabenazine is also an option. […] The next step would be the second-generation, or atypical antipsychotics, with best evidence is for risperidone and weaker evidence for aripiprazole. Another consideration, perhaps preceding the atypicals, would be tetrabenazine.

• #51 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  Antidepressants. Fluoxetine (Prozac, Sarafem, others) might help control symptoms of sadness, anxiety and OCD. […] Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate (Topamax), which is used to treat epilepsy. […] Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic. […] Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. […] Deep brain stimulation (DBS). For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

• #52 Tourette Syndrome and Other Tic Disorders: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/289457-treatment

  Treatments for tics that have demonstrated efficacy in replicated controlled trials include the following: Dopamine D2 receptor antagonist therapy […] Patient education is very important for individuals with Tourette syndrome. Counseling and support including cognitive-behavioral therapy and social skills training should also be considered. […] The Tourette Syndrome Association and its local chapters can be a valuable aid in patient education. […] In a randomized controlled trial of habit reversal therapy (HRT), results differed significantly from those of a control therapy (massed practice; P < .001, analysis of variance). The HRT group had a 97% reduction in tics at 18-month follow-up, with 80% of patients tic-free.

• #53 A Review of the Current Treatment of Tourette Syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337131/

  The primary type of behavioral therapy used is comprehensive behavioral intervention for tics (CBIT). […] According to the AAN guidelines, CBIT is more likely than psychoeducation or supportive therapy to reduce tic severity. […] Overall, CBIT is an understudied treatment for Tourette syndrome, with only 2 available studies of sufficient sample size, limiting reliability. […] The literature supporting definitive treatment of Tourette syndrome related tics is limited. […] Treatment is complicated by the waxing and waning of symptoms, existence of comorbid disorders, and a lack of robust studies identifying treatment with consistent outcomes. […] Overall, the choice of therapy, both non-pharmacologic and pharmacologic, must be individualized based on severity of symptoms, lifestyle, side effects, and response to previous treatment.

• #54 Behaviour therapies in TS

  https://www.tourettes-action.org.uk/71-behavioural-therapies.html

  Behavioural therapies can be useful for most people with tic disorders, although evidence suggests that it is effective for children as young as five years of age and adults. […] The best scientifically validated behavioural treatment is called Habit Reversal Therapy (HRT), which has been researched since the 1970s. […] Another behavioural intervention which has emerging evidence is called Exposure and Response Prevention (ERP). […] Both therapies focus on getting used to the tense or uncomfortable feeling which precedes a tic (called premonitory urge) and tolerating the urge by resisting it or using an action until the urge to tic fades and the individual resists the tic. […] Studies show that most individuals who have a successful response to behavioural treatment typically experience a 30-40% reduction in tics.

• #55 Tourette Syndrome | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/neurosciences/movement-disorders/tourette-syndrome/treatments

  The Northwestern Medicine Parkinson’s Disease and Movement Disorders Center is a Tourette Association of America Center of Excellence. Our goal is to help our patients manage Tourette syndrome and improve their quality of life. We do this with a complete and multidisciplinary approach to care. Experts in neurology, social work and psychiatry work with patients to make a treatment plan for their specific needs. […] Depending on your condition, treatment may include: Medication, Botulinum toxin injections, Supportive therapies, Surgery. […] CBIT is a non-medication treatment. It is highly-structured therapy. Studies show that more than half of patients who do CBIT will have significant reductions in tic severity and improved ability to do daily tasks. CBIT is not a cure for tic disorders. But CBIT can help patients manage their tics and improve their quality of life.

• #56 Treatment options for Tourette syndrome in: Mental Health Clinician Volume 2: Issue 11 | Mental Health Clinician

  https://mhc.kglmeridian.com/view/journals/mhcl/2/11/article-p379.xml

  Guanfacine is a longer-acting α-2 agonist thought to be more selective for receptors in the prefrontal cortex. […] Patients with TS need to be fully assessed prior to beginning a tic suppression therapy. This article has highlighted the medications that are most commonly prescribed for this condition. Due to the more favorable side effect profile of α-2 adrenergic agonists, it would be prudent to begin therapy with either clonidine or guanfacine as a first line treatment. […] However, if tics are more severe, patients do not respond to the above drugs, and side effects are taken into consideration, conventional or second generation antipsychotics may be prescribed. Among the choices of antipsychotics, the one with the most favorable efficacy and safety balance would be risperidone, with special attention to monitoring for weight gain. The ultimate goal for treatment in TS should be to find a balance between tic suppression and minimizing any complications caused by co-morbidities and side effects.

• #57

  https://www.singhealth.com.sg/patient-care/conditions-treatments/tourette-syndrome

  Behavioural therapy can help by teaching patient how to recognise when they are about to have a tic, and what movements they can do to manage it. These techniques are usually taught by a psychologist or psychiatrist. […] Medications are usually not needed unless the tics interfere with activities of daily living (e.g. talking to other people, eating, bathing) […] Some medications can help modify the chemical transmission in the brain, which can then help reduce symptoms. […] Treatment for associated conditions, such as OCD and ADHD. These conditions may be more disruptive than the tics and require different treatments based on the symptoms. […] TS can be a life-long condition. But we know that many people have fewer or less noticeable tics as they grow older. Tics are usually worst between the ages of 7 and 12 years old. Following late adolescence, a lot of children may stop having tics or only get them occasionally. However some adults may need life-long treatment.

• #58

  https://www.singhealth.com.sg/patient-care/conditions-treatments/tourette-syndrome

  Behavioural therapy can help by teaching patient how to recognise when they are about to have a tic, and what movements they can do to manage it. These techniques are usually taught by a psychologist or psychiatrist. […] Medications are usually not needed unless the tics interfere with activities of daily living (e.g. talking to other people, eating, bathing) […] Some medications can help modify the chemical transmission in the brain, which can then help reduce symptoms. […] Treatment for associated conditions, such as OCD and ADHD. These conditions may be more disruptive than the tics and require different treatments based on the symptoms. […] TS can be a life-long condition. But we know that many people have fewer or less noticeable tics as they grow older. Tics are usually worst between the ages of 7 and 12 years old. Following late adolescence, a lot of children may stop having tics or only get them occasionally. However some adults may need life-long treatment.

• #59 Tourette Syndrome | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/tourette-syndrome

  Another approach to the treatment of tics is the use of botulinum toxin injections in the area of the most problematic tic. […] In severe cases of Tourette syndrome which do not respond to other therapies, deep brain stimulation (DBS) may be considered. […] Educating parents, teachers and school administrators as well as healthcare professionals is crucial in early recognition of symptoms, confirming a diagnosis, and initiating appropriate treatment. […] Because of the broad range of neurological and behavioral manifestation and varying severity, therapy of Tourette syndrome must be individualized and tailored specifically to the needs of the patient. […] The most troublesome symptoms, such as tics, OCD, ADHD and impulse control problems, should be targeted first, but many patients may require more than one medication, depending on the complexity and severity of the symptoms.

• #60 Management of Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Management_of_Tourette_syndrome

  Tourette syndrome (abbreviated as Tourette’s or TS) is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of motor and phonic tics. The management of Tourette syndrome has the goal of managing symptoms to achieve optimum functioning, rather than eliminating symptoms; not all persons with Tourette’s require treatment, and there is no cure or universally effective medication. Explanation and reassurance alone are often sufficient treatment; education is an important part of any treatment plan. […] Management of Tourette syndrome can be divided into treatment of tics, and treatment of co-occurring conditions, which, when present, are often a larger source of functional impairment than the tics themselves. There is no cure for Tourette’s. No one medication effectively treats all symptoms, most medications prescribed for tics have not been approved for that use, and no medication is without the risk of significant adverse effects. Treatment is focused on identifying the most troubling or impairing symptoms and helping the individual manage them. Because comorbid conditions are often a larger source of impairment than tics, they are a priority in treatment. The management of Tourette’s is individualized and involves shared decision-making between the clinician, patient, family and caregivers.

• #61 Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Tourette_syndrome

  When medication is used, the goal is not to eliminate symptoms. Instead, the lowest dose that manages symptoms without adverse effects is used, because adverse effects may be more disturbing than the symptoms being treated with medication. […] Complementary and alternative medicine approaches, such as dietary modification, neurofeedback and allergy testing and control have popular appeal, but they have no proven benefit in the management of Tourette syndrome. […] Deep brain stimulation (DBS) has become a valid option for individuals with severe symptoms that do not respond to conventional therapy and management, although it is an experimental treatment.

• #62 Tourette Syndrome | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/neurology/parkinsons-disease-and-movement-disorders/tourette-syndrome

  Another approach to the treatment of tics is the use of botulinum toxin injections in the area of the most problematic tic. […] In severe cases of Tourette syndrome which do not respond to other therapies, deep brain stimulation (DBS) may be considered. […] Educating parents, teachers and school administrators as well as healthcare professionals is crucial in early recognition of symptoms, confirming a diagnosis, and initiating appropriate treatment. […] Because of the broad range of neurological and behavioral manifestation and varying severity, therapy of Tourette syndrome must be individualized and tailored specifically to the needs of the patient. […] The most troublesome symptoms, such as tics, OCD, ADHD and impulse control problems, should be targeted first, but many patients may require more than one medication, depending on the complexity and severity of the symptoms.

• #63 Tourette syndrome: Management – UpToDate

  https://www.uptodate.com/contents/tourette-syndrome-management

  Tourette syndrome (TS) is a neurologic disorder manifested by motor and phonic tics with onset during childhood. This topic will review the management of TS. Other aspects of TS are reviewed separately. […] The management of TS requires a careful assessment of the degree of functional impairment and effect on quality of life caused by tics and comorbid conditions. Education is indicated for all. […] Specific treatment of TS is guided by the need to treat the most troublesome symptoms, including both tics and comorbid conditions such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), behavioral problems, and mood disorders. Therefore, it is important to determine which of these conditions is causing the greatest impairment. Many patients require a combination of therapy to treat tics, ADHD, and OCD.

Zobacz więcej