Use of Complementary and Alternative Medicine in Children With Tourette Syndrome

Patel, Himadri; Nguyen, Kieu Hanh; Lehman, Erik; Mainali, Gayatra; Duda, Laura; Byler, Debra; Kumar, Ashutosh

doi:10.1177/0883073820913670

Cited by 14 publications

(11 citation statements)

References 17 publications

(18 reference statements)

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“…Given concerns over treatment side effects, more patients and their families have pursued complementary and alternative medicine (CAM) with the perception that such practices are "natural" and therefore safe [59]. In a survey of 110 TS patients (< 18 years old) and caregivers, 69.1% reported using CAM therapy [59]. The most commonly reported CAM therapies were stress management (44.6%), herbal medicine (18.2%), homeopathy (18.2%), and meditation (9.1%).…”

Section: Alternative Medicationsmentioning

confidence: 99%

Current Management of Tics and Tourette Syndrome: Behavioral, Pharmacologic, and Surgical Treatments

Billnitzer

Jankovic

2020

Neurotherapeutics

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Tourette syndrome is a heterogeneous neurobehavioral disorder manifested by childhood-onset motor and phonic tics, often accompanied by a variety of behavioral comorbidities, including attention deficit and obsessive compulsive disorder. Treatment must be tailored to the needs and goals of the individual patients and their families. All patients should receive education on the condition and, if possible, engage behavioral therapy targeted towards tics and/or comorbidities. Pharmacological therapies, such as alpha agonists, topiramate, and vesicular monoamine transport type 2 inhibitors, are generally used as first-line therapies in patients with troublesome tics that are not controlled by behavioral therapy or when the latter is not available or accessible. Botulinum toxin injections can be used in patients with bothersome focal tics. Second-line therapy includes antipsychotics, such as fluphenazine, aripiprazole, risperidone, and ziprasidone. These medications are generally efficacious but carry the risk of metabolic syndrome, tardive dyskinesia, and other side effects. Much more research is needed before novel therapies such as cannabis-derived products or transcranial magnetic stimulation can be recommended. There is promise in ongoing clinical trials with D1 receptor antagonist ecopipam and other experimental therapeutics. Patients with tics that are refractory to conventional treatments may be candidates for deep brain stimulation, but further studies are needed to determine the optimal target selection. Key Words Tourette syndrome (TS) . Tics . Deep brain stimulation (DBS) . Vesicular monoamine transport inhibitor (VMAT2) . Comprehensive behavioral therapy in tics (CBIT)

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Section: Alternative Medicationsmentioning

confidence: 99%

Current Management of Tics and Tourette Syndrome: Behavioral, Pharmacologic, and Surgical Treatments

Billnitzer

Jankovic

2020

Neurotherapeutics

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“…However, such medication has been shown to treat TS with variable efficacy ratings (3) and can have many side effects, including weight gain, sedation and metabolic disturbances (4). Taken together, caregivers will often seek to explore alternative interventions to treat symptoms of TS with ease of access and minimal to no side effects (5).…”

Section: Introductionmentioning

confidence: 99%

“…One possible reason for the increased reliance on the use of dietary measures in the TS community is the adverse side effects associated with medication which leads to a high proportion of patients discontinuing their medication (18). CAM is increasingly being used in conjunction with medication to help to treat symptoms, showing that caregivers seek to explore nonpharmacologic treatments in addition to the medication that has minimal or no side effects (5). Secondly, self-observations and beliefs that food can influence tic behaviors, for example, deterioration of tics have been related to consumption of refined sugar, caffeine and alcohol (19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Patterns of Nutritional Supplement Use in Children with Tourette Syndrome

Smith

Ludlow

2021

Journal of Dietary Supplements

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Very little is known about the use of nutritional supplements in children with Tourette syndrome. The current study aimed to address the frequency of nutritional supplements and the use of special diets in children with Tourette syndrome and typically developing children. Additional data also sought to address the motivations behind using them, their cost and perceived benefits. A total of 76 responses from an anonymous online survey (Tourette syndrome = 42; typically developing = 34) were completed and analyzed. Fifty-six per cent of children with Tourette syndrome compared to 15% of typically developing children were currently taking nutritional supplements, with the majority take two or more. Thirty-five per cent of the Tourette syndrome compared to 6% typically developing were currently or had previously adopted a special diet. Supplements most used for children with TS included probiotics, omega-3, multivitamins and magnesium. For children with TS, supplementation often began around the age of eight, for a duration on average of 35 months. The average cost was £32.44 a month compared to £8.25 for typically developing children. Seventy-five per cent of supplement users in the Tourette syndrome group noted improvement, mainly in motor and vocal tics, sleep quality and anxiety reduction. Most caregivers learned of supplements through the Internet. In almost 42% of the Tourette syndrome group, their pediatrician was unaware of the supplement use and this rose to 65% for special diets. Given the popularity of nutritional supplements, more research on the effectiveness and safety of such interventions is crucial.

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“…The recent article by Patel and colleagues addresses a relevant topic, that is, the use of complementary and alternative medicine in children and adolescents with Tourette syndrome. 1 The fact that the majority (69.1%) of these patients used complementary and alternative medicine interventions is a significant point to be kept in mind, also considering the positive perception of usefulness frequently reported by interviewed caregivers.…”

mentioning

confidence: 96%