Aripiprazole Versus Risperidone for Treating Children and Adolescents with Tic Disorder: A Randomized Double Blind Clinical Trial

Abstract

There are some uncontrolled studies about the efficacy and safety of both aripiprazole and risperidone for treating tic disorder. Moreover, the efficacy of these medications has never been compared. This is the first double blind randomized clinical trial comparing the safety and efficacy of aripiprazole and risperidone for treating patients with tic disorder. Sixty children and adolescents with tic disorder were randomly allocated into one of the two groups to receive either aripiprazole or risperidone for 2 months. The primary outcome measure was the score of Yale Global Tic Severity Scale. In addition, health related quality of life and adverse events were assessed. Both aripiprazole and risperidone decreased the Yale Global Tic Severity Scale score during this trial. Moreover, both medications increased the health related quality of life score. Both aripiprazole and risperidone were tolerated well. Aripiprazole [3.22 (1.9) mg/day] decreased tic score as much as risperidone [0.6 (0.2) mg/day]. Their adverse effects and their effects on health related quality of life were comparable. However, risperidone increased the patients' social functioning more than aripiprazole in short term.

A one year follow up study of persistent motor tic disorder treated with risperidone in a children’s hospital in Sri Lanka

“…The scarcity of follow up studies on persistent motor tic disorder for South Asia makes the comparison of results of this study difficult. But when considering studies from the West there are several conducted on children with all types of tic disorder showing high response rates 14 .…”

“…Despite the study participants were given relatively low doses of risperidone (mean = 1.17 mg/day), a majority (79%) achieved the predefined level of reduction of symptoms. A previous randomized controlled trial comparing risperidone to aripiprazole in children with tics found that risperidone was effective at a mean dose of 0.6 mg/day 14 . It is important to maintain the doses of antipsychotics in children at a minimum effective level as there have been reports of serious adverse effects to antipsychotics in children with neurodevelopmental disorders from Sri Lanka 15 .…”

“…A control group would have allowed assessment of the effectiveness of risperidone compared to other pharmacotherapies and psychotherapies in Sri Lankan children with persistent motor tic disorder. Nevertheless, other recommended pharmacotherapies such as aripiprazole are far more expensive and are not available in the free government health service of the country 14 . Furthermore, habit reversal which is the psychotherapy used for tic disorders requires many hours for an individual child and might not be feasible in the Sri Lankan health setting where the experts to child ratio is low 18 .…”

Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents

“…Only concerning the short term effect, risperidone exceeded aripiprazole, increasing the patient's social functioning. 105 Dosages should also not reach antipsychotic effects and are recommended between 2.5 and 5 mg/day (max. 7.5 mg/day).…”

Comparative Efficacy and Safety of Antipsychotic Drugs for Tic Disorders: A Systematic Review and Bayesian Network Meta-Analysis

“…Antipsychotic drugs are commonly used in the treatment of TDs, including typical antipsychotic drugs (i. e., haloperidol, pimozide) and atypical antipsychotic drugs (i. e., risperidone, aripiprazole, quetiapine) [6,9,10]. A number of randomized controlled trials (RCTs) and systematic reviews evaluating the efficacy of antipsychotic drugs for TDs have been published [11][12][13][14]. In our previous overview including 22 systematic reviews for treating TDs, we found some antipsychotics were efficacious in the reduction of tic severity; however, RCTs directly comparing different pharmacological treatment options for TDs are scarce [15].…”