Aripiprazole Improves Associated Comorbid Conditions in Addition to Tics in Adult Patients with Gilles de la Tourette Syndrome
Aripiprazole Improves Associated Comorbid Conditions in Addition to Tics in Adult Patients with Gilles de la Tourette Syndrome
复制标题
阿立哌唑可改善成年抽动秽语综合征患者的抽动和相关合并症
作者：
S. Gerasch;A. S. Kanaan;E. Jakubovski;K. Müller
抽动秽语综合征（GTS）的特征在于运动和发声抽搐，以及相关的共病病症，包括强迫症（OCD）、注意力缺陷/多动障碍（ADHD）、抑郁和焦虑，其存在于大量患者中。虽然包括大量患者的随机对照试验仍然缺失，但阿立哌唑目前被认为是治疗抽搐的首选药物。本研究的目的是进一步研究阿立哌唑在一组无药物成人患者中的疗效和安全性。具体而言，我们研究了阿立哌唑对抽搐严重程度、合并症、先兆冲动（PU）和生活质量（QoL）的影响。此外，我们感兴趣的因素，影响病人的决定，在选择或反对药物治疗。在这项前瞻性、非对照、开放标签研究中，我们纳入了44例患者，并使用许多评定量表评估基线和阿立哌唑治疗期间的抽动严重程度、PU、合并症和QoL。44例患者中有18例决定接受阿立哌唑治疗抽搐，并在4-6周后完成随访评估。我们的主要发现是：（1）阿立哌唑显著减少了抽搐，但不影响PU;（2）阿立哌唑显著改善了强迫症，并显示出改善其他合并症（包括抑郁症、焦虑症和ADHD）的趋势;（3）抽搐的严重程度、PU或QoL均不影响患者决定是否使用阿立哌唑治疗抽搐;相反，患有共病强迫症的患者倾向于决定支持抽动治疗，而患有共病多动症的患者倾向于决定反对抽动治疗;（4）最常报告的不良反应是睡眠问题;（5）患者的生活质量主要受到共病抑郁症的损害。我们的研究结果表明，阿立哌唑可以改善GTS患者除抽搐外的相关共病状况。可以假设这些有益作用与阿立哌唑的适应性药理学特征相关，其对多巴胺能以及许多其他神经递质系统表现出影响。我们的数据第一次提供了证据，证明患者的决定过程是由抽搐严重程度和生活质量以外的其他因素影响的。
Gilles de la Tourette Syndrome (GTS) is characterized by motor and vocal tics, as well as associated comorbid conditions including obsessive-compulsive disorder (OCD), attention deficit/hyperactivity disorder (ADHD), depression, and anxiety which are present in a substantial number of patients. Although randomized controlled trials including a large number of patients are still missing, aripiprazole is currently considered as a first choice drug for the treatment of tics. The aim of this study was to further investigate efficacy and safety of aripiprazole in a group of drug-free, adult patients. Specifically, we investigated the influence of aripiprazole on tic severity, comorbidities, premonitory urge (PU), and quality of life (QoL). Moreover, we were interested in the factors that influence a patient's decision in electing for-or against- pharmacological treatment. In this prospective uncontrolled open-label study, we included 44 patients and used a number of rating scales to assess tic severity, PU, comorbidities, and QoL at baseline and during treatment with aripiprazole. Eighteen out of fortyfour patients decided for undergoing treatment for their tics with aripiprazole and completed follow-up assessments after 4–6 weeks. Our major findings were (1) aripiprazole resulted in significant reduction of tics, but did not affect PU; (2) aripiprazole significantly improved OCD and showed a trend toward improvement of other comorbidities including depression, anxiety, and ADHD; (3) neither severity of tics, nor PU or QoL influenced patients' decisions for or against treatment of tics with aripiprazole; instead patients with comorbid OCD tended to decide in favor of, while patients with comorbid ADHD tended to decide against tic treatment; (4) most frequently reported adverse effects were sleeping problems; (5) patients' QoL was mostly impaired by comorbid depression. Our results suggest that aripiprazole may improve associated comorbid conditions in addition to tics in patients with GTS. It can be hypothesized that these beneficial effects are related to aripiprazole's adaptive pharmacological profile, which exhibits an influence on the dopaminergic as well as a number of other neurotransmitter systems. For the first time, our data provide evidence that patients' decision making process for or against medical treatment is influenced by other factors than tic severity and QoL.
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影响因子：
--
作者：
W. Goodman;L. Price;S. Rasmussen;C. Mazure;Roberta L. Fleischmann;Candy L. Hill;G. Heninger;D. Charne
通讯作者：
W. Goodman;L. Price;S. Rasmussen;C. Mazure;Roberta L. Fleischmann;Candy L. Hill;G. Heninger;D. Charne
DOI：
10.1176/ajp.150.1.98
发表时间：
1993
期刊：
The American journal of psychiatry
影响因子：
--
作者：
J. Leckman;D. E. Walker;D. Cohen
通讯作者：
J. Leckman;D. E. Walker;D. Cohen
影响因子：
5.9
作者：
BECK, AT;BROWN, G;STEER, RA
通讯作者：
STEER, RA
影响因子：
25.8
作者：
Hirschtritt, Matthew E.;Lee, Paul C.;Pauls, David L.;Dion, Yves;Grados, Marco A.;Illmann, Cornelia;King, Robert A.;Sandor, Paul;McMahon, William M.;Lyon, Gholson J.;Cath, Danielle C.;Kurlan, Roger;Robertson, Mary M.;Osiecki, Lisa;Scharf, Jeremiah M.;Mathews, Carol A.
通讯作者：
Mathews, Carol A.
阿立哌唑治疗抽动秽语症儿童和青少年：一项开放标签安全性和耐受性研究。
影响因子：
1.9
作者：
Lyon,GholsonJ;Samar,Stephanie;Jummani,Rahil;Hirsch,Scott;Spirgel,Arie;Goldman,Rachel;Coffey,BarbaraJ
通讯作者：
Coffey,BarbaraJ