만성 틱장애와 뚜렛 증후군 아동과 청소년에 있어서의 리스페리돈 치료 효과 및 안정성에 관한 연구 : 임상 개방 연구

Abstract

Objective : The purpose of this trial was to investigate the short-term and long-term safety and efficacy of risperidone in the treatment of chronic tic disorders and Tourette's syndrome in children and adolescents. Method : Twenty-seven patients(24males, 3 females/12 Tourette's syndrome, 15 chronic motor or vocal tic disorders) participated a 16 week open-label trial. The ranges of age of patients were from 6 to 18 years. Clinical responses are measured by the Yale Global Tic Severity Scale(YGTSS). The patients were seen at baseline and for three follow up visits(4-week, 8-week, 16-week). Risperidone was started at 0.5mg/day and increased by 0.5mg/day every 5 days until a satisfactory level was reached or the patient complained of intolerable side effect. Results : 1) Clinical response revealed a statistically significant reduction on tic scores ranging from 35.37 to 22.14(37.4%). 2) Statistically significant improvement of tic symptoms appears in 4 weeks. There was statistically significant reduction on YGTSS scores in 8 weeks in comparison with 4 weeks, but there was no statistically significant reduction in 16 weeks in comparison with 8 weeks although there also was clinical improvement. 3) Doses of risperidone at the end of the trial ranged from 1mg to 3mg(mean = 2.02mg/day). 4) The most frequent side effects were sedation(13 cases, 48.1%), easy fatigue(4 cases, 14.8%), dry mouth(2 cases, 7.4%), urinary incontinence(1 case, 3.7%), constipation(1 case, 3.7%) and there was no extrapyramidal side effects. Conclusion : Risperidone, a neuroleptic with both serotonin and dopamine-blocking properties, appears to be effective in reducing tic frequency and intensity. This open clinical trial suggests that low-dose risperidone may be a promising alternative to conventional medications used for treating the symptoms of Tourettes syndrome and chronic tic diisorders in Korean children and adolescents.