Psychopharmacology of tic disorders

Tics disorders and Tourette syndrome are commonly encountered in clinical practice. Currently, a vast number of behavioural, pharmacological and surgical treatments are available.

Relevant and recent articles about clinical features, neurobiology and treatment of tic disorders and Tourette syndrome were reviewed and summarized.

Tic disorders and Tourette syndrome are frequently associated with comorbid conditions such as obsessive compulsive symptoms, attention deficit and hyperactivity disorder, anxiety and depression, behavioural disorders and sleep difficulties. Fronto-striatal circuits and the dopaminergic system are believed to be involved in the pathophysiology of TS and tics. Pharmacological options that have been studied for treatment of tic disorders are reviewed. Behavioural therapy such as habit reversal training, and surgical treatment are other options. It is essential to identify and address comorbid conditions such as attention deficit disorder, obsessive-compulsive symptoms, depression, behavioural disorders and sleep disturbances, as they often cause more distress and disability than the tics themselves.

Tic disorders frequently do not require pharmacological treatment, but if required, first line treatment options include dopamine modulators, tetrabenazine, clonidine and behavioural therapy.