The Therapeutic Effect And Influencing Factors Of Risperidone In Treating Refractory Tourette's Syndrome

BACKGROUND Refractory Tourette's syndrome (TS) is a new psychiatric concept coming into being in recent years. This kind of disease is a chronic and refractory disorder which is easy to continue to adult and result in deformity for life. It would bring heavy burden to family and society and it is urgent to explore valuable agents and methods. Many studies suggest that risperidone offer superior safety and efficacy in the treatment of TS. It will be of great significance to study the therapeutic effect and influencing factors of risperidone in treating refractory TS. OBJECTIVE The aim of this study was to determine the efficacy and safety of risperidone in the treatment of refractory TS and to explore the key factors affecting the therapeutic effect. METHOD A random-open-controlled study was carried out. 141 patients were entered the study. Subjects were given 8-week risperidone or haloperidol and other typical medication. The efficacy were assessed by YGTSS and CBCL and the safety was assessed by the TESS at baseline and the end of 4th, 8th week of the study. 71 patients of refractory Tourette's syndrom treated with riperidone alone were evaluated at ration and semi-ration on 40 clinical indexes by some standard assessment instruments such as YGTSS, TESS,CBCL, and so on. The data were analyzed with Logistic model. A rate of 30% decrease or above in YGTSS after therapy were "effective". RESULTS 133 subjects completed the study, with 2 in risperidone group and 6 in control group dropped out. Progress was observed in both groups. The efficacy in risperidone group was significantly better than that in control group, with response rates of 56.3% and 32.9% respectively after 4-week treatment(P<0.05), and the YGTSS total score was significantly lower in risperidone group than that in control group(P<0.01). After 8-week treatment, there were more higher response rate (71.8% vs. 51.4%), lower YGTSS total score and CBCL total score, and higher reduction rate of YGTSS score in risperidone group than in control group(all P<0.05 or 0.01). The adverse reactions in risperidone group were milder than that in that in control group at the end of 4-week and 8-week treatment(P<0.01). Single-factor analysis indicated that deficiency in social function, anamnesis, circumstance around home, style of family education, family history, onset age, course of diseases and total score of CBCL on baseline were associated with the effect of risperidone. Deficiency in social function, family history, anamnesis and total score of CBCL on baseline were selected for the regression analysis Through multivariate analysis. CONCLUSION It is an effective and safe new method to treat refractory TS with risperidone. The key factors affecting the therapeutic effect of riperidone in refractory TS are deficiency in social function, family history, anamnesis and total score of CBCL on baseline.