Aripiprazole for the treatment of tie disorders in children: a systematic review and meta-analysis

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  Background: Tic disorders (TDs) are commonneuropsychiatric disorders in children.Typical antipsychotics, such as haloperidol and pimozidehave been prescribed to control tic symptoms as first-lineagents.However, adverse effectshave led to the use of newer atypical antipsychotics.Aripiprazole is one of alternatives.The aim of this study was to evaluate the efficacy and safety of aripiprazole for children with TDs.Methods: Randomized controlled trials (RCTs), quasi-RCTs and control studiesevaluating aripiprazole for children with tic disorders were identified from PubMed, Embase,Cochrane library, Cochrane Central, four Chinese database and relevant reference lists.Quality assessment referred to the Cochrane Handbook for Systematic Reviews of Interventions.Results:Twelvestudies involving 935participants were included.The general quality of included studies was poor.Only one study used placebo as a control and others used positive drug controls.Participants were aged between 4 and 18 years.The periodof treatment ranged from 8-12 weeks.Sevenstudies (N=600 patients) used the YGTSS scale as the outcome measurement, and there was no significant difference in reduction of the total YGTSS score betweenthe aripiprazole and positive control groups (MD =-0.48,95% CI [-6.22, 5.26], P=0.87, I2=87%).Meta-analysis of four of the studies (N=285 patients) that compared aripiprazole with haloperidol showed that there was no significant difference in reduction of the total YGTSS score (MD =2.50, 95% CI [-6.93, 11.92], P=0.60, I2=88%).Meta-analysis of two studies (N=255 patients) that compared aripiprazole with tiapride showed that there was no significant difference in reduction of the total YGTSS score (MD =-3.15, 95% CI [-11.38, 5.09], P=0.45, I2=86%).Adverse events (AEs) were reported in 1 1studies.Drowsiness (5.1%-58.1%), increased appetite (3.2%-25.8%), nausea (2%-18.8%) and headache (2%-16.1%)were common AEs.Conclusion: In conclusion, aripiprazole appears to be a promising therapy for children with TDs.Further well-conducted RCTs are required to confirm this issue.
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