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Related Experiment Video

Updated: Oct 12, 2025

Generating Acute and Chronic Experimental Models of Motor Tic Expression in Rats

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Published on: May 27, 2021

Treatment failure in persistent tic disorders: an expert clinicians' consensus-based definition.

Davide Martino^1,2,3, Irene Malaty⁴, Kirsten Müller-Vahl⁵

¹Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. davide.martino@ucalgary.ca.

European Child & Adolescent Psychiatry

|November 24, 2021

Summary

A standardized definition for tic treatment failure was developed using an expert consensus approach. This definition guides clinicians on when to consider alternative therapies for chronic tic disorders.

Keywords:

Definition Delphi Refractoriness Tic disorders Tourette syndrome Treatment failure

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Area of Science:

Neurology
Psychiatry
Clinical Psychology

Background:

Lack of a standardized definition for treatment failure in tic disorders hinders optimal patient management.
Existing approaches may lead to prolonged use of ineffective interventions and delayed consideration of advanced treatments like deep brain stimulation.
A clear definition is crucial for consistent clinical decision-making and research.

Purpose of the Study:

To establish an expert consensus-based definition for the failure of medical treatments for tics.
To operationalize this definition for both behavioral and pharmacological interventions.
To provide a framework for identifying when to transition patients to less established therapies.

Main Methods:

A multi-step, multi-round, web-based Delphi approach was employed.
International specialists in tic disorders (neurologists, psychiatrists, psychologists) participated.
A survey was developed, reviewed, and administered to 36 experts from 14 countries over two rounds.

Main Results:

Consensus was reached on 10 statements defining treatment failure in tics.
The definition includes criteria for lack of efficacy, adherence, and tolerability.
Separate operationalizations were established for behavioral and pharmacological treatment failure.

Conclusions:

The developed definition captures the complexity of tic treatment failure.
This consensus definition provides a foundation for consistent clinical practice and future research.
Further studies are needed to assess its clinical feasibility and impact on patient outcomes.