Expert consensus on pharmacotherapy for tic disorders in Japan

Area of Science:

• Neurology
• Psychiatry
• Pharmacology

Background:

• Tic disorders are complex neurological conditions often requiring pharmacotherapy.
• Comorbidities such as obsessive-compulsive disorder and attention deficit/hyperactivity disorder are common in patients with tic disorders.
• International guidelines for tic disorder pharmacotherapy exist, but regional expert consensus is crucial.

Purpose of the Study:

• To determine the current status and expert consensus on pharmacotherapy for tic disorders and their comorbidities in Japan.
• To compare Japanese expert opinions with existing international evidence.
• To provide guidance for Japanese physicians in selecting appropriate medications.

Main Methods:

• A two-round Delphi method survey was administered to Japanese experts in tic disorders.
• The survey focused on pharmacotherapy for both tic disorders and common comorbidities.
• A 4-point Likert scale was used to assess expert consensus.

Main Results:

• Initial surveys showed variability in medication preferences and dosages among Japanese experts.
• A significant consensus was achieved in the second survey regarding first- and second-line pharmacotherapy.
• Aripiprazole and risperidone were identified as first- and second-line treatments for tic disorders, respectively.
• Fluvoxamine and atomoxetine were recommended for comorbid obsessive-compulsive disorder and attention deficit/hyperactivity disorder, respectively.
• Agonists of α-2 adrenergic receptors were infrequently prescribed.

Conclusions:

• This study establishes a consensus among Japanese experts on tic disorder pharmacotherapy.
• The findings will aid Japanese physicians in making more informed and judicious medication choices.
• Implementation of this consensus is expected to enhance the quality of pharmacotherapy for tic disorders in Japan.