Otizm ve tourette sendromu birlikteliğinde düşük doz aripiprazol monoterapisinin etkinliği: olgu sunumu

Otizm Spektrum Bozukluğu(OSB) çocukluk döneminde başlangıç gösteren, iletişimde büyük sorunlara yol açan ve bireyin işlevselliğini ve yaşam kalitesini belirgin şekilde etkileyen bir nörogelişimsel rahatsızlıktır. Tik bozuklukları, dikkat eksikliği hiperaktivite bozukluğu gibi birçok psikiyatrik hastalıkla komorbidite gösterebilmektedir. Atipikantipsikotikler OSB olgularında irritabilite ve eşlik eden psikiyatrik rahatsızlıkların tedavisinde sıklıkla kullanılmaktadır. Bu ilaçlardan aripiprazol son yıllarda etki profili nedeniyle oldukça popülerlik kazanmıştır. Psikiyatrik bozuklukların tedavisinde düşük doz aripiprazolünmonoterapi olarak etkinliği dikkat çekicidir. Bu olgu sunumunda ASD ve Tourette Sendromlu otistik çocuğun tedavisinde düşük doz aripiprazolmonoterapisinin etkinliğini sunacağız.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that begins in childhood, causes major problems in communication and significantly affects daily functioning and quality of life of the individual. Many psychiatric disorders such as tic disorders, attention deficit hyperactivity disorder may ve comorbid with ASD. Atypical antipsychotics are frequently using in the treatment of irritability and comorbid psychiatric disorders in individuals with ASD. Aripiprazole popularity has raised in recent years due to its efficacy profile. Effectiveness of low dose aripiprazole as monotherapy in the treatment of psychiatric disorders are remarkable. In this case report, we will present effectiveness of low dose aripiprazole monotheraphy in the treatment of autistic child with ASD and Tourette Syndrome.

___

Stahl, S. M. Stahl'sEssentialPsychopharmacology 4th Edition: NeuroscientificBasisandPractical Applications. Cambridge: Cambridge UniversityPress. 2013.

Robertson, MM. Tourettesyndrome, associatedconditionsandthecomplexities of treatment. Brain 2000; 123(3): 425- 62.

Canitano R, Vivanti G. TicsandT ourettesyndrome in autism spectrumdisorders. Autism 2007;11(1):19-28.

Berenguer-Forner C, Miranda-Casas A, Pastor-Cerezuela G, et al. Comorbidity of autism spectrum disorder and attention deficit with hyperactivity. A review study. Rev Neurol 201560 Suppl 1:S37-43.

Jacob S, Landeros-Weisenberger A, Leckman JF. Autism spectrum and obsessive-compulsive disorders: OC behaviors, phenotypes and genetics. AutismRes 2009;2(6):293- 311.

Marcus RN, Owen R, Kame L, et al. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry 2009; 48: 1110-9.

Ho CS, Chiu NC, Tseng CF, et al. Clinical effectiveness of aripiprazole in short term treatment of tic disorder in children and adolescents: a naturalistic study. Pediatr Neonatol 2014;55(1):48-52.

Stahl SM. Stahl's Essential Psychopharmacology 4th Edition: Neuroscientific Basis and Practical Applications. Cambridge: Cambridge UniversityPress. 2013.

Baron-Cohen S, Scahill VL, Izaguirre J, Hornsey H, Robertson MM. The prevalence of Gilles de la Tourette syndrome in children and adolescents with autism: a large scale study. Psychol Med 1999;29(5):1151-9.

Jones J E, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, Hermann B. Psychiatric comorbidity in children with new onset epilepsy. Developmental Medicine & Child Neurology 2007;49(7): 493-7.

Hartmann A, Worbe Y. Pharmacological treatment of Gilles de la Tourettesyndrome. Neurosci Biobehav Rev 2013; 37(6):1157-61.

Rajapakse T, Pringsheim T. Pharmaco therapeutics of Tourette syndrome and stereotypies in autism. Semin Pediatr Neurol 2010;17(4):254-60.

Gillberg C, Billstedt E. Autism and Asperger syndrome: coexistence with other clinical disorders. Acta Psychiatrica Scandinavica2000; 102(5): 321-30.

Robertson MM. Tourette syndrome, associated conditions and the complexities of treatment. Brain 2000; 123(3): 425- 62.

Glick I D, Murray SR, Vasudevan P, Marder SR, Hu RJ. (2001). Treatment with atypical antipsychotics: new indications and new populations. Journal of Psychiatric Research 2001; 35(3): 187-91.

Kastrup A, Schlotter W, Plewnia C, Bartels M. Treatment of tics in Tourette syndrome with aripiprazole. Journal of clinical psychopharmacology 2005; 25(1): 94-6.

Ghanizadeh A, Haghighi A. Aripiprazole versus risperidone for treating children and adolescents with tic disorder: a randomized double blind clinical trial. Child Psychiatry Human Development 2015; 45(5): 596-603.

Stroup T S, McEvoy JP, Ring KD, Hamer RH, LaVange LM, Swartz MS. Schizophrenia Trials Network. A randomized trial examining the effectiveness of switching from olanzapine, quetiapine, or risperidone to aripiprazole to reduce metabolic risk: comparison of antipsychotics for metabolic problems (CAMP). Am J Psychiatry 2011;168(9):947-56.