Aripiprazole in the treatment of tic disorders: comparison with other medications and evidence-based therapeutic strategies | Ukrainian Medical Journal

The article analyzes modern approaches to the therapy of tic disorders in children and adolescents, with a focus on the use of aripiprazole. Particular attention is paid to comparing the clinical efficacy and side effect profile of aripiprazole with other antipsychotics, alpha-2-adrenergic agonists, and VMAT2 inhibitors, as well as analyzing the possibilities of their combined use. The features of therapeutic strategies for tic disorders comorbid with attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), recurrent and bipolar depression, and anxiety disorders are examined. It is substantiated that for tic disorders comorbid with ADHD, the combined use of low-dose aripiprazole and alpha-2-agonists is appropriate, as it allows for a synergistic effect with a minimal risk of adverse reactions. Since tic disorders are often exacerbated by stress and anxiety, the use of selective serotonin reuptake inhibitors is a 1st-line treatment for comorbid OCD and depression. The effect of aripiprazole on serotonin neurotransmission helps to stabilize the emotional state of such patients. Further development of therapeutic strategies is linked to the study of selective D1-receptor antagonists (ecopipam), endocannabinoid system modulators, and presynaptic VMAT2 inhibitors (tetrabenazine/deutetrabenazine). Practical significance: modern evidence-based therapeutic strategies have been systematized, which allows for the optimization of the therapeutic process and the improvement of the quality of life for patients with polymorbid tic symptoms.

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