Nyere behandling av Tourettes syndrom : rollen til aripiprazol og dyp hjernestimulering : en litteraturstudie

Abstract

ABSTRACT Several treatment options are available for Tourette’s syndrome. The main purpose of any treatment is to optimise the quality of life of a patient, but there has to be a balance between achieving that, and the many side effects that occur with the various current treatment options. There are certain patients that suffer from therapyresistant, intractable Tourette’s syndrome, often complicated by several comorbid conditions like OCD and ADHD, and there are those who suffer from multiple and serious side effect of todays mediacations. Thus, further research is needed in the field of Tourette’s syndrome. In this literature survey two new treatment options are dicussed. The first one is a pharmacological option aripiprazole, and the other one is deep brain stimulation which is a neurosurgical procedure. A number of open studies with small sample of patients, in addition to multiple case series that have recently been published for the two treatments, show impressive therapeutic outcomes, and also a favorable profile on side effects compared to the current standard treatments. Deep brain stimulation has not been frequently used in children, given the natural waning of symptoms with a patient's age. Aripiprazole has shown beneficial effects when used in both children and adult populations, but there seemed to be a higher incidence of extrapyramidal and metabolic side effects in children. Placebo-controlled randomized trials with a larger sample size and separate groups of adults and children need to be conducted to evaluate the safety and efficacy of both aripiprazole and deep brain stimulation in treating Tourette’s syndrome.