Haldol Versus Abilify in the Treatment of Childhood Tics

The most common cause of muscular and vocal tics in childhood and adolescence is Tourette syndrome, although other psychological conditions may be responsible. The cause of this disease is still unknown, and those afflicted are virtually powerless to control their spastic movements and noises. Interestingly, most children seem to outgrow the disease by adulthood. Many young people diagnosed with Tourette syndrome also experience other emotional or cognitive issues, such as anxiety, depression, obsessive-compulsive disorder, or attention deficit disorder.

When the symptoms of Tourette syndrome interfere with daily life, effective treatment solutions may include talk therapy and medication. Calming environments have also been shown to help keep tics at a manageable level. Traditionally, when presented with a child who had an extreme case of disruptive tics, antipsychotic drugs like Haldol (haloperidol) were the first choice for physicians. Unfortunately, the side effects of this class of medications make their usage troublesome, especially in younger patients. Weight gain, lethargy, nausea, and headache are all common symptoms of the typical antipsychotic drugs like Haldol.

Recently, a newer class of drugs—the atypical antipsychotics—has received attention from researchers looking for alternatives to treating tics in young people. In a controlled study, Abilify (aripiprazole) was compared with Haldol in terms of both its effectiveness and safety for use with children. The results were mixed but significant. Abilify was not demonstrated to be more effective than Haldol. Children in both study groups showed similar improvement of their symptoms within the same period. The side effects were an entirely different story. Abilify caused relatively few side effects, and these were generally minor. Only 10% of participants discontinued Abilify because of unwanted side effects. The side effects of Haldol, on the other hand, forced nearly a third of study participants to cease their involvement. Four out of five children reported trouble sleeping, while nearly half experienced loss of muscular control—not a desirable outcome when seeking to eliminate tics.

The overall results of this study argue against using Haldol and other typical antipsychotics in the treatment of childhood and adolescent tics. Abilify, a much newer drug, shows equivalent effectiveness with far fewer side effects. In cases where therapy and environmental changes fail to bring improvement, medication may be used as a last resort.

References

  1. MedlinePlus [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Tourette syndrome. Retrieved March 1, 2012. Available from: http://www.nlm.nih.gov/medlineplus/tourettesyndrome.html
  2. Yoo, H., Lee, J., Paik, K., Choi, S., Yoon, S., Kim, J., et al. (2011). Open-label study comparing the efficacy and tolerability of aripiprazole and haloperidol in the treatment of pediatric tic disorders. European Child & Adolescent Psychiatry, 20(3), 127-135.

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