Asunto(s)
Catatonia , Lorazepam/uso terapéutico , Abuso de Marihuana , Trastornos Psicóticos , Adolescente , Catatonia/diagnóstico , Catatonia/tratamiento farmacológico , Humanos , Problema de Conducta/psicología , Servicio de Psiquiatría en Hospital , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/tratamiento farmacológicoAsunto(s)
Antipsicóticos , Aripiprazol , Trastorno Bipolar/tratamiento farmacológico , Distonía/inducido químicamente , Litio/uso terapéutico , Fumarato de Quetiapina/uso terapéutico , Adolescente , Antiparkinsonianos/uso terapéutico , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Aripiprazol/efectos adversos , Aripiprazol/uso terapéutico , Benzotropina/uso terapéutico , Humanos , Masculino , Abuso de Marihuana/psicología , Asunción de RiesgosAsunto(s)
Catatonia/psicología , Trastornos de Ingestión y Alimentación en la Niñez/fisiopatología , Esquizofrenia/complicaciones , Adolescente , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Deluciones/etiología , Trastornos de Ingestión y Alimentación en la Niñez/psicología , Haití , Humanos , Masculino , Abuso de Marihuana , Olanzapina/uso terapéutico , Pérdida de Peso/fisiologíaRESUMEN
OBJECTIVE: Clinical observations have suggested therapeutic effects for ω-3 fatty acids (O3FA) in Tourette's disorder (TD), but no randomized, controlled trials have been reported. In a placebo-controlled trial, we examined the efficacy of O3FA in children and adolescents with TD. METHODS: Thirty-three children and adolescents (ages 6-18) with TD were randomly assigned, double-blind, to O3FA or placebo for 20 weeks. O3FA consisted of combined eicosapentaenoic acid and docosahexaenoic acid. Placebo was olive oil. Groups were compared by using (1) intent-to-treat design, with the last-observation-carried-forward controlling for baseline measures and attention-deficit/hyperactivity disorder via (a) logistic regression, comparing percentage of responders on the primary Yale Global Tic Severity Scale (YGTSS)-Tic and secondary (YGTSS-Global and YGTSS-Impairment) outcome measures and (b) analysis of covariance; and (2) longitudinal mixed-effects models. RESULTS: At end point, subjects treated with O3FA did not have significantly higher response rates or lower mean scores on the YGTSS-Tic (53% vs 38%; 15.6 ± 1.6 vs 17.1 ± 1.6, P > .1). However, significantly more subjects on O3FA were considered responders on the YGTSS-Global measure (53% vs 31%, P = .05) and YGTSS-Impairment measure (59% vs 25%, P < .05), and mean YGTSS-Global scores were significantly lower in the O3FA-treated group than in the placebo group (31.7 ± 2.9 vs 40.9 ± 3.0, P = .04). Obsessive-compulsive, anxiety, and depressive symptoms were not significantly affected by O3FA. Longitudinal analysis did not yield group differences on any of the measures. CONCLUSIONS: O3FA did not reduce tic scores, but it may be beneficial in reduction of tic-related impairment for some children and adolescents with TD. Limitations include the small sample and the possible therapeutic effects of olive oil.