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Quetiapine for tic disorder: a case report
T Chan-Ob1, N Kuntawongse, V Boonyanaruthee
1Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand.
Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|February 21, 2002
Summary
Quetiapine effectively reduced tics in a patient with tic disorder, demonstrating fewer extrapyramidal side effects (EPS). Further trials are needed to establish quetiapine as a first-line tic disorder treatment.
Area of Science:
- Neuroscience
- Pharmacology
- Child Psychiatry
Background:
- Tic disorders affect approximately 20% of children, with limited treatment options.
- Established antipsychotics like haloperidol and pimozide are effective but associated with significant extrapyramidal side effects (EPS).
- Risperidone shows efficacy but can also cause EPS, necessitating exploration of newer agents.
Observation:
- A case report details a 19-year-old female with tic disorder previously treated with haloperidol and risperidone.
- The patient experienced acute dystonia and oculogyric crisis, along with persistent symptoms and EPS.
- Quetiapine was initiated at 50 mg/d without adjunctive benzhexol HCl, with dosage titration based on symptom severity.
Findings:
- Quetiapine treatment led to tic improvement within the first week and complete disappearance for three weeks at 150 mg/d.
- Tics recurred at a lower frequency (20%) necessitating a dose increase to 200 mg/d.
- At 200 mg/d, quetiapine reportedly resolved the patient's tics with minimal reported EPS.
Implications:
- Quetiapine demonstrates potential efficacy and a favorable side effect profile for treating tic disorders.
- The findings suggest quetiapine may be a viable alternative for patients experiencing EPS with other antipsychotics.
- Controlled clinical trials are essential to validate these findings and determine quetiapine's role in tic disorder management.