The efficacy and safety of aripiprazole for tic disorders in children and adolescents: A systematic review and meta-analysis

Wang, Shuai; Wei, Yanzhao; Yang, Jianhong; Yang, Zhou; Cheng, Yu-hang; Yang, Chao; Zheng, Yi

doi:10.1016/j.psychres.2017.04.013

Cited by 15 publications

(36 citation statements)

References 18 publications

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“…In addition, we checked the references since 2011 of other systematic reviews/metaanalyses [5][6][7][8][9], existing guidelines [3,4,[10][11][12], nonsystematic reviews on TS with statements about pharmacological treatment, i.e., dealing with various agents or mentioning treatment in their title . In addition, we had a look into the references of agentspecific reviews and meta-analyses of (in alphabetical order) aripiprazole [65][66][67][68][69][70][71][72], atypical antipsychotics [73], botulinum toxin [74][75][76][77][78][79][80][81][82][83][84][85], cannabis [86][87][88], clonidine [89,90], complementary alternative medicine [91], deutetrabenazine [92], non-dopaminergic agents [93], traditional Chinese medicine [94], and topiramate [95,96]. Moreover, we screened references of reviews on specific aspects of TS if they describe treatment options for coexisting attention deficit hyperactivity disorder (ADHD) [97]…”

Section: Methodology Of Selection Of Agents and Literature Search Strategymentioning

confidence: 99%

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European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

Roessner

Eichele

Stern

et al. 2021

Eur Child Adolesc Psychiatry

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In 2011, the European Society for the Study of Tourette Syndrome (ESSTS) published the first European guidelines for Tourette Syndrome (TS). We now present an update of the part on pharmacological treatment, based on a review of new literature with special attention to other evidence-based guidelines, meta-analyses, and randomized double-blinded studies. Moreover, our revision took into consideration results of a recent survey on treatment preferences conducted among ESSTS experts. The first preference should be given to psychoeducation and to behavioral approaches, as it strengthens the patients’ self-regulatory control and thus his/her autonomy. Because behavioral approaches are not effective, available, or feasible in all patients, in a substantial number of patients pharmacological treatment is indicated, alone or in combination with behavioral therapy. The largest amount of evidence supports the use of dopamine blocking agents, preferably aripiprazole because of a more favorable profile of adverse events than first- and second-generation antipsychotics. Other agents that can be considered include tiapride, risperidone, and especially in case of co-existing attention deficit hyperactivity disorder (ADHD), clonidine and guanfacine. This view is supported by the results of our survey on medication preference among members of ESSTS, in which aripiprazole was indicated as the drug of first choice both in children and adults. In treatment resistant cases, treatment with agents with either a limited evidence base or risk of extrapyramidal adverse effects might be considered, including pimozide, haloperidol, topiramate, cannabis-based agents, and botulinum toxin injections. Overall, treatment of TS should be individualized, and decisions based on the patient’s needs and preferences, presence of co-existing conditions, latest scientific findings as well as on the physician’s preferences, experience, and local regulatory requirements.

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Section: Methodology Of Selection Of Agents and Literature Search Strategymentioning

confidence: 99%

“…In addition, it is a partial 5-HT1A agonist and a 5-HT2A antagonist [131][132][133][134]. Aripiprazole has become a frequently used agent for the treatment of tics due to its good effectiveness on tics and less prominent adverse effects [50,69,72,73,111,135].…”

Section: Aripiprazolementioning

confidence: 99%

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

Roessner

Eichele

Stern

et al. 2021

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

show abstract

“…The second indication explored in meta-analyses concerns tics and Tourette's syndrome. This time, four meta-analyses compared aripiprazole with placebo and another atypical (risperidone) or typical (haloperidol and tiapride) antipsychotic drug or topiramate (Yang et al 2015;Liu et al 2016;Zheng et al 2016;Wang et al 2017). Aripiprazole was found to be superior to placebo in improving tics, but not superior to other antipsychotics.…”

Section: Efficacy Datamentioning

confidence: 99%

Aripiprazole in Children and Adolescents

Coustals

Ménard

Cohen

2021

Journal of Child and Adolescent Psychopharmacology

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Objective: To review the use of aripiprazole in children and adolescents. Methods: Medline and Embase databases were systematically searched using the keywords aripiprazole and child or adolescent over the period from 2000 to 2019. The initial screen yielded 163 publications, from which 99 studies were reviewed. Results: Aripiprazole is one of the most widely prescribed atypical antipsychotics. Like others, its use in children and adolescents is becoming commonplace and occurs in off-label indications. Aripiprazole has proven efficacy for several indications in children and adolescents, including schizophrenia, bipolar disorder, Tourette's syndrome, and behavioral impairments associated with autism and intellectual disability. Adverse effects are more important in children and adolescents than adults, particularly weight gain, drowsiness, extrapyramidal effects, and metabolic effects, even though the latter may appear less important than with other atypical antipsychotics. Severe adverse effects often occur in multiple-prescription settings. At present, postprescription monitoring is very poor. Conclusion: Aripiprazole has proven efficacy for several indications in children and adolescents. However, its use requires clinical and paraclinical monitoring to assess the occurrence of adverse events that may challenge the benefit/risk ratio. In addition, off-label prescriptions should be limited, as they appear to account for a significant proportion of aripiprazole use worldwide.

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“…A meta-analysis of 17 RCTs in the treatment of tic disorders and Tourette syndrome in children and adolescents that comprised 1,305 subjects, found aripiprazole to be as effective as other therapeutics, haloperidol, topiramate, risperidone, or tiapride ( 46 ). According to a recent network meta-analysis of 60 RCTs with antipsychotics for tic disorders, aripiprazole was superior to placebo (SMD = −4.74, 95% CI −8.67, −1.06) and tiapride (SMD = −4.27, 95% CI −8.01, −0.58) ( 47 ).…”

Section: Resultsmentioning

confidence: 99%

Dopamine Receptor Partial Agonists: Do They Differ in Their Clinical Efficacy?

2022

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Dopamine receptor partial agonists (DRPAs; aripiprazole, brexpiprazole, and cariprazine) constitute a novel class of antipsychotics. Although they share a similar mechanism of action, DRPAs differ in their pharmacodynamics, pharmacokinetics, drug interactions, or safety and tolerability. The antipsychotic efficacy of all three drugs was established in several placebo-controlled randomized trials (RCTs) in schizophrenia, both acute phase and relapse prevention. In addition, each of the DRPA agents has been tested in other psychiatric disorders, including bipolar disorder or major depression. However, a few studies have examined their comparative clinical efficacy. There are no head-to-head comparisons between aripiprazole, brexpiprazole, or cariprazine. In two acute schizophrenia RCTs of cariprazine and brexpiprazole, aripiprazole was used as an indirect comparator to control for study sensitivity. To assess potential differences in the efficacy of DRPAs, we reviewed data from controlled trials, systematic reviews, and meta-analyses. Our results showed that the acute antipsychotic effects of DRPAs, as measured by the number needed to treat, are comparable. The three agents were superior to placebo in acute treatment, and cariprazine was found to be effective in the reduction of primary negative symptoms of schizophrenia. In the therapy of bipolar disorder, aripiprazole and cariprazine showed antimanic efficacy, cariprazine was also effective in the management of bipolar depression, and aripiprazole was effective for relapse prevention. The addon administration of aripiprazole or brexpiprazole reduced symptoms of major depression. Aripiprazole can control acute agitation associated with psychosis or bipolar disorder; brexpiprazole showed the potential to manage agitation in dementia patients. Aripiprazole has also established evidence of efficacy in children and adolescents and other conditions: OCD, tic disorders, and autism spectrum disorder. Our review of published data suggests that in terms of clinical efficacy, DRPAs are a heterogeneous group, with each drug possessing its own therapeutic benefits.

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The efficacy and safety of aripiprazole for tic disorders in children and adolescents: A systematic review and meta-analysis

Cited by 15 publications

References 18 publications

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

Aripiprazole in Children and Adolescents

Dopamine Receptor Partial Agonists: Do They Differ in Their Clinical Efficacy?

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