Yu Hamamoto1, Miyuki Fujio2, Maiko Nonaka2, Natsumi Matsuda3, Toshiaki Kono4, Yukiko Kano5. 1. Department of Child and Adolescent Psychiatry, Tokyo Metropolitan Children's Medical Center, Japan. 2. Graduate School of Education, The University of Tokyo, Japan. 3. Department of Child Psychiatry, The University of Tokyo Hospital, Japan. 4. Department of Child Psychiatry, The University of Tokyo Hospital, Japan; Department of Neuropsychiatry, The University of Tokyo Hospital, Japan; Department of Forensic Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan. 5. Department of Child Psychiatry, The University of Tokyo Hospital, Japan; Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan. Electronic address: kano-tky@umin.ac.jp.
Abstract
OBJECTIVE: We aimed to clarify the current status of pharmacotherapy for tic disorders and comorbidities in Japan. We used a systematic survey to collate the consensus of Japanese experts and compare it with the recent international evidence. METHODS: We devised a questionnaire on pharmacotherapy for tics and comorbidities and sent it to Japanese experts on tic disorders. Based on the response to the first survey, we revised the questionnaire and conducted a second survey to determine the consensus among the experts on a 4-point Likert scale by the Delphi method. RESULTS: The first survey revealed variability in preferred medications and dosages among the experts in Japan. However, we were able to build a general consensus on pharmacotherapy for tic disorders and comorbidities based on the second survey. Aripiprazole and risperidone were the first- and second-line medication for tic disorders, respectively. Agonists of α-2 adrenergic receptors were seldom prescribed. Fluvoxamine was the first-line medication for comorbid obsessive-compulsive disorder, and atomoxetine for comorbid attention deficit/hyperactivity disorder. CONCLUSIONS: This study will help Japanese physicians choose medications for tic disorders more judiciously and will improve the quality of tic pharmacotherapy in Japan.
OBJECTIVE: We aimed to clarify the current status of pharmacotherapy for tic disorders and comorbidities in Japan. We used a systematic survey to collate the consensus of Japanese experts and compare it with the recent international evidence. METHODS: We devised a questionnaire on pharmacotherapy for tics and comorbidities and sent it to Japanese experts on tic disorders. Based on the response to the first survey, we revised the questionnaire and conducted a second survey to determine the consensus among the experts on a 4-point Likert scale by the Delphi method. RESULTS: The first survey revealed variability in preferred medications and dosages among the experts in Japan. However, we were able to build a general consensus on pharmacotherapy for tic disorders and comorbidities based on the second survey. Aripiprazole and risperidone were the first- and second-line medication for tic disorders, respectively. Agonists of α-2 adrenergic receptors were seldom prescribed. Fluvoxamine was the first-line medication for comorbid obsessive-compulsive disorder, and atomoxetine for comorbid attention deficit/hyperactivity disorder. CONCLUSIONS: This study will help Japanese physicians choose medications for tic disorders more judiciously and will improve the quality of tic pharmacotherapy in Japan.