UNASSIGNED: The authors review the tic phenomenology and TS diagnostic criteria. The bulk of this article focuses on pharmacotherapeutic options for treating tics. They also highlight pharmacotherapies in the research pipeline.
UNASSIGNED: Tic treatment must be tailored to individual needs. Behavioral therapy is the first line of treatment. Most with bothersome tics need pharmacotherapy and rarely, for medication-refractory cases, surgical therapy is indicated. Alpha-2 agonists are considered in patients with mild tics, especially in those with attention deficit with or without hyperactivity. Second-generation antipsychotics like aripiprazole and tiapride may be considered for severe tics. However, prescribers should be mindful of potential side effects, especially drug-induced movement disorders. Botulinum toxin injections may be considered for focal motor tics. Topiramate can be considered when other treatments are ineffective, and its benefits outweigh the risks. The same holds true for vesicular monoamine transporter-2 inhibitors, as they are deemed to be safe and effective in real-world use and open-label trials despite not meeting primary endpoints in placebo-controlled trials. Cannabinoids may be considered in adults if the approaches above do not control tics.
■作者回顾了TIC现象学和TS诊断标准。本文的大部分重点是治疗抽搐的药物治疗选择。他们还强调了研究管道中的药物疗法。
■抽动治疗必须根据个人需求进行调整。行为疗法是治疗的第一线。大多数患有烦躁症的患者需要药物治疗,很少,对于药物难治性病例,手术治疗是指征。轻度抽搐患者考虑α-2激动剂,尤其是那些注意力不足或没有多动的人。第二代抗精神病药物如阿立哌唑和tiapride可考虑用于严重的抽动。然而,开处方的人应该注意潜在的副作用,尤其是药物引起的运动障碍。肉毒杆菌毒素注射可考虑用于局灶性运动痉挛。当其他治疗无效时,可以考虑托吡酯,它的好处大于风险。囊泡单胺转运蛋白-2抑制剂也是如此,尽管在安慰剂对照试验中未达到主要终点,但它们在实际使用和开放标签试验中被认为是安全有效的.如果上述方法不能控制抽搐,则可以在成人中考虑使用大麻素。