Pharmacotherapeutics of Tourette syndrome and stereotypies in autism.
Author(s): Rajapakse T, Pringsheim T.
Affiliation(s): Department of Clinical Neurosciences and Pediatrics, University of Calgary,
Calgary, Canada.
Publication date & source: 2010, Semin Pediatr Neurol. , 17(4):254-60
Tourette syndrome (TS) and stereotypy in autism spectrum disorders (ASDs) are 2
common movement disorders in childhood. The objective of this review was to
summarize randomized controlled trials published over the past 5 years as an
update of the current pharmacotherapeutic options for the treatment of tics, TS,
and motor stereotypies in children with ASD. We searched MEDLINE (2005-May 2010)
for randomized controlled trials of medications used for the treatment of these
disorders. For the treatment of tics in TS, 2 trials suggest that levetiracetam
is not effective, whereas 1 trial found that topiramate was effective. Single
clinical trials of metoclopramide, atomoxetine, and ondansetron were of limited
quality, preventing conclusions to be made regarding the usefulness of these
treatments for tic disorders. For the treatment of stereotypy in children with
ASD, risperidone has been shown in both a Cochrane review in 2006 and 2
subsequent randomized control trials to be effective. The addition of
pentoxifylline to risperidone may have added benefit. Haloperidol did not improve
stereotypy and was poorly tolerated. There is good evidence that aripiprazole is
effective in the treatment of sterotypies in children with ASD. A large
randomized trial of citalopram did not show any improvement in stereotypy. Single
trials of levetiracetam, guanfacine, and atomoxetine suggest they are not useful
in the reduction of stereotypy in children with ASD.
|