Pharmacotherapies to tics: a systematic review
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Zuojie Zhang1,2,3,*, Chunsong Yang1,2,*, Ling-Li Zhang1,2, Qiusha Yi3, Bo Liu1,2, Jing Zeng1,2 and Dan Yu4
1Department of Pharmacy, Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China
2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
3West China School of Pharmacy, Sichuan University, Chengdu, China
4Department of Neurology, West China Second Hospital, Sichuan University, Chengdu, China
*These authors have contributed equally to this work
Ling-Li Zhang, email: [email protected]
Keywords: tics; efficacy; meta-analysis; review; pharmacotherapy
Received: March 24, 2017 Accepted: March 19, 2018 Published: June 15, 2018
The efficacy of all pharmacotherapies for patients suffering from tics were unclear. Literatures were searched from Medline, Embase, The Cochrane Library, and four Chinese databases. The primary efficacy outcome scale was defined as the Yale Global Tic Severity Scale (YGTSS). Overall estimates of pooled weighted mean difference (WMD) with 95% confidence interval (CI) were calculated for each outcome measure. A total of 53 trials were included. Meta-analysis suggested that alpha-2 adrenergic agonist agents and atypical antipsychotic agents were effective in improving tics, which included the maximum number of trials. Typical antipsychotic agents were associated with severer side-effects than alpha-2 adrenergic agonist agents. Besides, Traditional Chinese Medicine showed positive effects in YGTSS (NingDong Granule: WMD=-7.100, 95% CI, -10.430- -3.770; 5-Ling Granule: WMD=-11.300, 95% CI, -14.208- -8.392), while glutamate modulators (D-serine, N-Acetylcysteine and riluzole) might not be working. In summary, alpha-2 adrenergic agonist agents were associated with the optimal weigh between efficacy and safety. However, the significant factor of limited trials and sample sizes discounted these findings. Further better studies are necessary to ascertain them.
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