The advent of atypical antipsychotics presented psychiatrists with an effective way of treating psychosis without the many side effects associated with conventional agents. Given the superiority of atypical antipsychotics, we examined demographic information and treatment histories of patients currently treated with conventional antipsychotics, especially in regard to treatment with atypical agents. Medication histories and demographic information for 276 patients admitted to an urban hospital were obtained by patient/family interviews and review of medical records. Chi-square and logistic regression tests were used to analyze data for possible predictive factors of which patients within the sample were still receiving conventional antipsychotics for treatment. Seventy-eight (28%) patients were currently being treated with conventional antipsychotics. More than half of them had never received a trial of an atypical agent. African-Americans, who are more likely to suffer adverse effects from conventional antipsychotics, and substance abusers were overrepresented in this group. It is unclear to what extent ethnic or cultural bias played a role in determining medication choice. Because conventional antipsychotics are associated with more side effects and greater medication nonadherence, these patients should be evaluated for appropriateness of a trial with an atypical agent even if they are currently stable with a conventional antipsychotic.
Tourette Syndrome (TS) is a neurodevelopmental disorder characterised by chronic motor and vocal tics, which fluctuate over time. The molecular genetics of TS is supported by genetic epidemiology studies, which strongly suggest the presence of susceptibility genes for TS. Epidemiologic family, segregation and linkage studies, as well as candidate gene studies, have yielded limited specific results to date, however, pathophysiology models that support a molecular genetics approach in TS are emerging. Whole‐genome approaches, including genome‐wide association studies (GWAS) and whole‐genome sequencing, may yield more definitive genomic findings. Uncovering the biological substrate of TS will spur the development of novel, more precisely targeted, treatments for this disabling disorder.
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