Psychiatria pre prax 3/2002

Treatment of tic disorders in praxis

The precise etiology of Tourettes disorder is uncertain but probably has a neurochemical basis and a genetic component. The oldest and still most widely prescribed drug, haloperidol, should now not be considered the first-line agent in children as other agents have superior adverse effects profile. Our firt-line agent for tic suppresion include tiapride, risperidone, clonidine and clonazepam. Shoud these agents be ineffective, we would recommend olanzapine, pimozide or haloperidol. The potential benefit of other agents, such as ziprasidone is encouraging. Obsessive compulsive disorder, when associated with TD, may be treated with either a SSRI in association with dopamine receptor antagonist. Clonidine is a rational first choice where ADHD coexists with TD.

Keywords: Tourettes´syndrome, tics, medication, first-line agents.