A placebo-controlled trial of risperidone in Tourette syndrome

Scahill, Lawrence David; Leckman, James F.; Schultz, Robert T.; Katsovich, Liliya; Peterson, Bradley S.

doi:10.1212/01.wnl.0000055434.39968.67

Cited by 314 publications

(166 citation statements)

References 29 publications

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“…Current evidence supports using risperidone or haloperidol for this sub-population as these medications have proven efficacy for both Tourette syndrome 48,49 and antipsychotic augmentation for treatment refractory OCD.…”

Section: Proportion Of Treatment Drop-outs In Antipsychotic Versus Plmentioning

confidence: 99%

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

Bloch

Landeros-Weisenberger

et al. 2006

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As many as half of obsessive-compulsive disorder (OCD) patients treated with an adequate trial of serotonin reuptake inhibitors (SRIs) fail to fully respond to treatment and continue to exhibit significant symptoms. Many studies have assessed the effectiveness of antipsychotic augmentation in SRI-refractory OCD. In this systematic review, we evaluate the efficacy of antipsychotic augmentation in treatment-refractory OCD. The electronic databases of PubMed, PsychINFO (1967PsychINFO ( -2005, Embase (1974Embase ( -2000 and the Cochrane Central Register of Controlled Trials (CENTRAL, as of 2005, Issue 3) were searched for relevant double-blind trials using keywords 'antipsychotic agents' or 'neuroleptics' and 'obsessive-compulsive disorder'. Search results and analysis were limited to double-blind, randomized control trials involving the adult population. The proportion of subjects designated as treatment responders was defined by a greater than 35% reduction in Yale Brown Obsessive-Compulsive Scale (Y-BOCS) rating during the course of augmentation therapy. Nine studies involving 278 participants were included in the analysis. The meta-analysis of these studies demonstrated a significant absolute risk difference (ARD) in favor of antipsychotic augmentation of 0.22 (95% confidence interval (CI): 0.13, 0.31). The subgroup of OCD patients with comorbid tics have a particularly beneficial response to this intervention, ARD = 0.43 (95% CI: 0.19, 0.68). There was also evidence suggesting OCD patients should be treated with at least 3 months of maximaltolerated therapy of an SRI before initiating antipsychotic augmentation owing to the high rate of treatment response to continued SRI monotherapy (25.6%). Antipsychotic augmentation in SRI-refractory OCD is indicated in patients who have been treated for at least 3 months of maximal-tolerated therapy of an SRI. Unfortunately, only one-third of treatment-refractory OCD patients show a meaningful treatment response to antipsychotic augmentation. There is sufficient evidence in the published literature, demonstrating the efficacy of haloperidol and risperidone, and evidence regarding the efficacy of quetiapine and olanzapine is inconclusive. Patients with comorbid tics are likely to have a differential benefit to antipsychotic augmentation.

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Section: Proportion Of Treatment Drop-outs In Antipsychotic Versus Plmentioning

confidence: 99%

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

Bloch

Landeros-Weisenberger

et al. 2006

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“…A number of studies suggest efficacy and relative safety of risperidone for a host of psychiatric problems in children and adolescents, including tic disorders (Gilbert et al, 2004;Scahill et al, 2003), the psychotic symptoms of schizophrenia (Zalsman et al, 2003), and disruptive behavior in children with low IQ (Turgay et al, 2002) or with pervasive developmental disorders, such as autism (Masi et al, 2003;McCracken et al, 2002). Similar evidence exists for the efficacy of olanzapine in treating disorders in adolescents such as bipolar disorder (Frazier et al, 2001) and schizophrenia (Findling et al, 2003).…”

Section: False Positivesmentioning

confidence: 99%

Prodromal interventions for schizophrenia vulnerability: the risks of being “at risk”

Corcoran

Malaspina

Hercher

2005

Schizophrenia Research

167

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Given the morbidity and difficulty of treating psychotic disorders, including schizophrenia, there has been a move toward identifying and treating adolescents and young adults who appear to be clinically at risk or "prodromal" to psychosis. The field now has greater specificity in identification, with rates of 40-50% conversion to frank psychosis within 1-2 years. There is further evidence that medications and other treatments may have some efficacy for "prodromal" patients, though with variable side effects. However, controversy remains about some of the inherent risks in prodromal research, such as medication exposure and stigma among false-positives. In this paper, we add to this discussion through an analysis of ethics in prodromal research from the more established field of predictive genetic testing. Issues are raised about the effects of information on patients, families, and institutions, as well as future insurability, the limits of confidentiality (as it relies on discretion of patients and families), the autonomy of minors with psychiatric symptoms, and even the risks for the true-positive patient.

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“…3,4 An additional concern for pimozide is the potential for QT prolongation, especially when combined with agents that inhibit the cytochrome P450 3A4 isoenzyme. 5 More recently, atypical antipsychotics, including quetiapine, 6-8 ziprasidone, 9 olanzapine, 10,11 and risperidone, [12][13][14][15][16] have been successfully used to treat Tourette's disorder. Risperidone has been studied the most in this category with 2 double-blind placebo-controlled studies in small numbers of patients.…”

mentioning

confidence: 99%

Brief Report

Padala¹,

Qadri²,

Madaan³

2005

Prim. Care Companion CNS Disord.

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A placebo-controlled trial of risperidone in Tourette syndrome

Abstract: Risperidone appears to be safe and effective for short-term treatment of tics in children or adults with Tourette syndrome. Longer-term studies are needed to evaluate the durability of efficacy and safety over time.

Cited by 314 publications

References 29 publications

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

Prodromal interventions for schizophrenia vulnerability: the risks of being “at risk”

Brief Report

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