Tourette's syndrome (TS) is a neuropsychiatric disorder of childhood onset characterized by multiple motor and phonic
tics that fluctuate over time.
Tic symptoms often improve by late adolescence, but some children and adults with TS may experience significant
tic-related morbidity, including social and family problems, academic difficulties, and
pain. When more conservative interventions are not successful, and when certain psychiatric co-morbidities further complicate the clinical profile, treating TS with an atypical
antipsychotic medication may be a reasonable second-tier approach. However, the evidence supporting efficacy and safety of the atypical
antipsychotics for treatment of
tics is still very limited. The objective of this paper is to provide an updated overview of the role of atypical
antipsychotics for treatment of TS, with evidence-based guidance on their use. Evidence for efficacy of different typical and atypical
antipsychotics for treatment of
tics was examined by conducting a systematic, keyword-related search of 'atypical
antipsychotics' and '
Tourette's syndrome' in PubMed (National Library of Medicine, Washington, DC, USA). Four recent treatment consensus publications were also reviewed. This review focused on literature published from 2000 to 2013 and on available randomized controlled trials in TS. Evidence supporting the use of atypical
antipsychotics for treatment of TS is limited. There are few randomized medication treatment trials in TS (i.e.
risperidone,
aripiprazole,
ziprasidone), which employed varying methodologies, thereby restricting meaningful comparisons among studies. Future collaborations among clinical sites with TS expertise employing high-quality study design may better elucidate the role of atypical
antipsychotics for treatment of TS.