Tourette Syndrome and Other Tic Disorders: Asian Situation

Expert Consensus of Pharmacotherapy for Tic Disorders 

in Japan 

Yu Hamamoto 

Japan 

Introduction: In Japan, medication for Tourette syndrome (TS) and other tic disorders is prescribed based on Western guidelines, and Japanese guideline of pharmacotherapy based on sufficient evidence is strongly desired. We aimed to reach expert consensus of pharmacotherapy for tic disorders by rigorous methodology.

Methods: The first survey about pharmacotherapy for tic disorders by expert physicians was performed from September to November in 2015. Survey form included questions about the first to third preferable medications for tics and comorbid symptoms, initial and maximum doses. Out of 115 physicians who received the form, 54 responded (47.0%). In the second survey, we asked 39 physicians who accepted cooperation for further survey whether they agree or disagree with main findings of the first survey. Four choices (agree, slightly agree, slightly disagree, and disagree) were provided to each question. This survey was performed from June to July in 2016. Out of 39 physicians, 30 responded (76.9%). In the third survey, we repeated the same procedure from September to October in 2016, and out of the 30 physicians, 22 responded (73.3%).
Results: Ninety-two% of the responders of the third survey agreed that aripiprazole is the first line medication, and 87% of them agreed that risperidone is the second line medication. Sixtyf ive% of them agreed that initial dose of aripiprazole is 1.5mg/day, and 96% of them agreed that initial dose of risperidone is 0.5mg/day.
Conclusions: The survey has provided useful information for the guideline including preference of aripiprazole and risperidone as medications for tics in Japan.

Keywords: pharmacotherapy, tic disorders, Japan

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