SELECTION OF TREATMENT TARGETS FOR PATIENTS WITH TOURETTE SYNDROME

ObjectiveIdentify the primary therapeutic targets selected for a large cohort of patients with Tourette Syndrome.MethodClinical records of 446 patients seen consecutively between 2004–2013 were reviewed. Various features were collated, including clinician-rated severity and treatment outcome at first visit.Results48% of patients had multiple treatment targets. Tics were a target for treatment in 45% of cases (adults: 57%, children 36%). Comorbidities (particularly ADHD, OCD, depression and anxiety) were selected as targets for treatment in 55% of cases. In 18% of adult cases and 30% of children, immediate management did not include any new drug or behavioural intervention – the main outcome was psychoeducation and reassurance. Patients with more severe tics were more likely to have tics selected as the target.ConclusionThese findings emphasise clinicians’ impression of the importance of identification of comorbidities. Children were less likely than adults to have an active management target chosen at first visit, reasons could include a higher threshold for drug prescription, fewer severe cases and the lack of availability of specialised psychology therapies.