Aripiprazol Tedavisine Yanıt Veren Obsesif Kompulsif Bozukluğu Olan Bir Tourette Sendromu Vakası

Tourette bozukluğu (TB) çoğunlukla yineleyen motor vevokal tiklerle karakterize bir hastalıktır. Uzun yıllar tedavisinde haloperidol, trifluoperazin ve pimozid gibi etki gücüyüksek olan klasik antipsikotik ilaçlar kullanılmış, şiddetliolgularda adrenerjik agonist olan klonidin ve guanfasintercih edilmiştir. Son dönemde ise yan etki profilinin dahaiyi olması, vaka sunumları ve kontrollü çalışmalarda etkinliğinin gösterilmesiyle risperidon, ziprasidon, olanzapingibi atipik antipsikotikler yaygın olarak kullanılmaktadır.Biz direnç gösteren obsesif semptomları ve tikleri olanbir vakada mekanizması açısından hem tipiklerden hemde atipiklerden ayrılan aripiprazol kullanımına kısa süredecevap veren bir Tourette bozukluğu olgusunu bildirmeyiamaçladık.

A case of tourette s disorder with obsessive compulsive symptoms which was treated sucessfully with apiprazole

Tourette s disorder (TD) is a disease mostly characterizedwith repeated motor and vocal tics. While highly potentdrugs such as trifluoperazin, pimozide, haloperidol etc.have been used for many years, adrenergic agonists suchas clonidine and guanfacine have been preferred in thetreatment of severe cases. Hence their high potency wasproved in controlled trials and case reports and favourableside effect profiles of these agents, atypical antipsyh- chotics such as risperidon, ziprasidon and olanzapin areused commonly. We aimed to present a case of Tourettedisorder with refractory obsessive symptoms and tics whowas treated succesfully with aripiprazol which differs fromother typical and atypical antipsychotics due to its actionof mechanism.

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1. Toros F, Tot Ş, Avcı A. Çocuk ve ergenlerde Tourette bozukluğu: sosyodemografik, klinik özellikler ve eş tanılar. Türk Psikiyatri Dergisi. 2004;13:187-96.
2. Scahill L, Sukhodolsky DG, Williams SK, Leckman JF. Public health significance of tic disorders in children and adolescents. Adv Neurol. 2005;96:240-8.
3. Khalifa N, von Knorring AL. Prevalence of tic disorders and Tourette syndrome in a Swedish school population. Dev Med Child Neurol. 2003;45:31519.
4. Centers for Disease Control and Prevention (CDC) Prevelance of diagnosed Tourette syndrome in persons aged 6-17 years - United States, 2007.MMWR Morb Mortal Wkly Rep. 2009;58:581-5.
5. Robertson MM. The Gilles de la Tourette Syndrome: the current status. Arch Dis Child Educ Pract Ed. 2012;97:166-75.
6. Kaplan&Sadocks Concise Textbook of Clinical Psychiatry, Benjamin James Sadock, Virginia Alcott Sadock; 557-9.
7. Carter AS, Pauls DL, Leckman JF, Cohen DJ. A prospective longitudinal study of Gilles de la Tourettes syndrome. J Am Acad Child Adolesc Psychiatry. 1994;33:377-85.
8. Jankovic J. Tourettes syndrome. N Engl J Med. 2001;345:1184-92.
9. Bloch MH, Leckman JF. Tic disorders. In Lewiss Child and Adolescent Psychiatry: A Comprensive Textbook, 4th ed. (Eds A Martin, FR Volkmar):569-83. Philadelphia, Lippincott Williams Wilkins, 2007.
10. Braun AR, Stoetter B, Randolph C, Hsiao JK, Vladar K, Gernert J et al. The functional neuroanatomy of Tourettes syndrome: an FDG- PET study. I: regional changes in cerebral glucose metabolism differentiating patients and controls. Neuropsychopharmacology. 1993;9:277-91.
11. Braun AR, Randolph C, Stoetter B, Mohr E, Cox C, Vladar K et al. The functional neuroanatomy of Tourettes syndrome: an FDG- PET study. II: relationships between regional cerebral metabolism and associated behavioral and cognitive features of the illness. Neuropsychopharmacology. 1995;13:151-68.
12. Roessner V, Schoenefeld K, Buse J, Bender S, E Stefan, Münchau A. Pharmacological treatment of tic disorders and Tourette Syndrome. Neuropharmacology. 2013;68:143-9.
13. Bruun RD, Budman CL,. Risperidone as a treatment for Tourettes syndrome. J. Clin. Psychiatry. 1996;57:29-31.
14. Diantoniis MR, Henry KM, Partridge PA, Soucar E. Tics and risperidone. J. Am. Acad. Child Adolesc. Psychiatry. 1996;35:839-40.
15. Lombroso PJ, Scahill L, King RA, Lynch KA, Chappell, PB, Peterson BS, McDougle CJ, Leckman JF. Risperidone treatment of children and adolescents with chronic tic disorders: a preliminary report. J. Am. Acad. Child Adolesc. Psychiatry. 1995;34:1147-52.
16. Shulman LM, Singer C, Weiner WJ., Risperidone in Gilles de la Tourette syndrome. Neurology. 1995;45:14-9.
17. Gaffney GR, Perry PJ, Lund BC, Bever-Stille KA, Arndt S, Kuperman S. Risperidone versus clonidine in the treatment of children and adolescents with Tourettes syndrome. J Am Acad Child Adolesc Psychiatry. 2002;41:330-6.
18. Sallee FR, Gilbert DL, Vinks AA, Miceli JJ, Robarge L, Wilner K. Pharmacodynamics of ziprasidone in children and adolescents: impact on dopamine transmission. J Am Acad Child Adolesc Psychiatry. 2003;42:902-7.
19. Sallee FR, Kurlan R, Goetz CG, Singer H, Scahill L, Law G, Dittman VM, Chappell PB. Ziprasidone treatment of children and adolescents with Tourettes syndrome: a pilot study. J Am Acad Child Adolesc Psychiatry. 2000;39:292-9.
20. Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS. A placebo controlled trial of risperidone in Tourette syndrome. Neurology. 2003;60:1130-5.
21. Dion Y, Annable L, Sandor P, Chouinard G. Risperidone in the treatment of Tourette syndrome: a double-blind, placebocontrolled trial. J Clin Psychopharmacol. 2002;22:31-9.
22. McCracken JT, Suddath R, Chang S, Thakur S, Piacentini J. Effectiveness and tolerability of open label olanzapine in children and adolescents with Tourette Syndrome. J Child Adolesc Psychopharmacol. 2008;18:501-8.
23. Stephens RJ, Bassel C, Sandor P. Olanzapine in the treatment of aggression and tics in children with Tourettes syndrome: a pilot study, J Child Adolesc Psychopharmacol. 2004;14:255-66.
24. Budman CL, Gayer A, Lesser M, Shi Q, Bruun RD. An open-label study of the treatment efficacy of olanzapine for Tourettes disorder, J Clin Psychiatry. 2001;62:290-4.
25. Copur M, Arpaci B, Demir T, Narin H. Clinical effectiveness of quetiapine in children and adolescents with Tourettes syndrome: a retrospective case-note survey. Clin Drug Investig. 2007;27:123-30.
26. Mukaddes NM, Abali O. Quetiapine treatment of children and adolescents with Tourettes disorder. J. Child Adolesc Psychopharmacol. 2003;13;295-9.
27. Roessner V, Plessen KJ, Rothenberger A, Ludolph AG, Rizzo R, Skov L et al. European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment. Eur Child Adolesc Psychiatry. 2011;20:173-96.
28. Neuner I, Nordt C, Schneider F, Kawohl W. Effectiveness of aripiprazole in the treatment of adult Tourette patients up to 56 months. Hum Psychopharmacol. 2012;27:364-9.
29. Wenzel C, Kleimann A, Bokemeyer S, Müller-Vahl KR. Aripiprazole for the treatment of Tourette syndrome: a case series of 100 patients. J Clin Psychopharmacol. 2012;32:548-50.
30. .Lyon GJ, Samar S, Jumanni R, Hirsch S, Spirgel A, Goldman R, Coffey BJ. Aripiprazole in children and adolescents with Tourettes disorder: an open label safety and tolerability study. J Child Adolesc Psychopharmacol. 2009;19:623-33.
31. Bozabalı ÖG, Özbek A, Miral S. Tourette Sendromunda Ketiapin Sağaltımı Çocuk ve Gençlik Ruh Sağlığı Dergisi. 2003;10:22-8.
32. Bozabalı ÖG, Baykara B, Baykara A. Çocuk ve ergenlerde beş farklı psikiyatrik bozuklukta olanzapin kullanımı. Klinik Psikofarmakoloji Bülteni. 2002;12:179-85.
33. Şengül CB, Şengül C. Aripiprazol Tedavisine Yanıt Veren Bir Tourette Bozukluğu Olgusu Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi. 2010;23:66-8.
34. Bozkurt H, Ayaydin H, Abali O. Letter to the Editor. Klinik Psikofarmakoloji Bülteni. 2009;19:447-8.
35. Lieberman JA. Dopamine partial agonists: a new class of antipsychotic. CNS Drugs. 2004;18:251-67.
36. Soygur H. Pharmacokinetic and pharmacodynamic characteristics of aripiprazole. Klinik Psikofarmakoloji Bülteni. 2008:18;81-6.
37. Lawer CP, Prioleau C, Lewis MM, et al. Intercations of the novel antipsychotic aripiprazole (OPC-14597) with dopamine and serotonin receptor subtypes. Neuropsychopharmacology. 1999; 20:612-27.
38. Hounie AG, De Mathis MA, Sampaio AS, Mercadante MT. Aripiprazole and Tourette syndrome. Rev Bras Psiquiatr. 2004;26:213.
39. Travis MJ, Burns T, Dursun S, Fahy T, Frangou S, Gray R, Haddad PM, Hunter R, Taylor DM, Young AH. Aripiprazole in schizophrenia: consensus guidelines. Int J Clin Pract. 2005;59:485- 95.
40. Murphy TK, Bengston MA, Soto O, Edge PJ, Sajid MW, Shapira N, Yang M. Case series on the use of aripiprazole for Tourette syndrome. International Journal of Neuropsychopharmacology. 2005;8:489-90.
41. Winter C, Heinz A, Kupsch A, Ströhle A. Aripiprazole in a Case Presenting With Tourette Syndrome and Obsessive-Compulsive Disorder Journal of Clinical Psychopharmacology. 2008;28:452-4.