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Meta-Analysis
. 2015 Jul 29:15:179.
doi: 10.1186/s12888-015-0504-z.

Aripiprazole for the treatment of tic disorders in children: a systematic review and meta-analysis

Chun-Song Yang  1   2 , Hong Huang  3 , Ling-Li Zhang  4   5 , Cai-Rong Zhu  6 , Qin Guo  7
Affiliations
Meta-Analysis

Aripiprazole for the treatment of tic disorders in children: a systematic review and meta-analysis

Chun-Song Yang et al. BMC Psychiatry. .

Abstract

Background: Tic disorders (TDs) are common neuropsychiatric disorders in children. Typical antipsychotics, such as haloperidol and pimozide have been prescribed to control tic symptoms as first-line agents. However, adverse effects have led to the use of newer atypical antipsychotics. Aripiprazole is one of alternatives. The aim of this study was to evaluate the efficacy and safety of aripiprazole for children with TDs.

Methods: Randomized controlled trials (RCTs), quasi-RCTs and control studies evaluating aripiprazole for children with tic disorders were identified from PubMed, Embase, Cochrane library, Cochrane Central, four Chinese database and relevant reference lists. Quality assessment referred to the Cochrane Handbook for Systematic Reviews of Interventions.

Results: Twelve studies involving 935 participants were included. The general quality of included studies was poor. Only one study used placebo as a control and others used positive drug controls. Participants were aged between 4 and 18 years. The period of treatment ranged from 8 to 12 weeks. Seven studies (N = 600 patients) used the YGTSS scale as the outcome measurement, and there was no significant difference in reduction of the total YGTSS score between the aripiprazole and positive control groups (MD = -0.48, 95 % CI [-6.22, 5.26], P = 0.87, I(2) = 87 %). Meta-analysis of four of the studies (N = 285 patients) that compared aripiprazole with haloperidol showed that there was no significant difference in reduction of the total YGTSS score (MD = 2.50, 95 % CI [-6.93, 11.92], P = 0.60, I(2) = 88 %). Meta-analysis of two studies (N = 255 patients) that compared aripiprazole with tiapride showed that there was no significant difference in reduction of the total YGTSS score (MD = -3.15, 95 % CI [-11.38, 5.09], P = 0.45, I(2) = 86 %). Adverse events (AEs) were reported in 11 studies. Drowsiness (5.1 %-58.1 %), increased appetite (3.2 %-25.8 %), nausea (2 %-18.8 %) and headache (2 %-16.1 %) were common AEs.

Conclusion: In conclusion, aripiprazole appears to be a promising therapy for children with TDs. Further well-conducted RCTs are required to confirm this issue.

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Figures

Fig 1
Fig 1
Flow chart of literature screening and the selection process
Fig 2
Fig 2
Meta-analysis of symptom improvement assessed by YGTSS Total Score
Fig 3
Fig 3
Meta-analysis of symptom improvement assessed by YGTSS Vocal Tics Score
Fig 4
Fig 4
Meta-analysis of symptom improvement assessed by YGTSS Motor Tics Score
Fig 5
Fig 5
Meta-analysis of symptom improvement assessed by YGTSS Total Tics Score
Fig 6
Fig 6
Meta-analysis of symptom improvement assessed by YGTSS Impairment Score
Fig 7
Fig 7
Meta-analysis of tics symptom improvement assessed by tics symptom improvement by author self-defined
Fig 8
Fig 8
Funnel plot asymmetry for the included studies which using YGTSS Scale for efficacy evaluation
See this image and copyright information in PMC

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