A Prospective Longitudinal Study of Antipsychotic Safety in Children with Tourette Syndrome (P6.016)

Objective: To describe longitudinal outcomes in children with Tourette Syndrome treated with antipsychotics using an evidence-based antipsychotic safety monitoring protocol. Background: Antipsychotics have demonstrated efficacy for the treatment of tics. Due to their association with extrapyramidal, hormonal and metabolic adverse effects, they must be used with caution. An evidence-based antipsychotic safety monitoring protocol (CAMESA) was developed to promote regular screening for adverse effects in children. Design/Methods: A prospective longitudinal study was performed, including all children started on antipsychotics for tics or comorbidities. Children received safety monitoring procedures according to the CAMESA guidelines, involving baseline and follow-up visits at one, two, three, six, nine and twelve months. Monitoring procedures included calculation of body mass index (BMI) percentile, the Extrapyramidal Symptom Rating Scale (ESRS), and laboratory measures of low and high density lipoproteins, triglycerides, glucose, insulin, liver enzymes, and prolactin. Results: 57 children, 27 taking risperidone and 30 taking aripiprazole, were monitored for a mean of 10.11 months. Mean BMI percentile scores were significantly increased compared to baseline at all time points from 3 to 12 months (p th percentile) or obese (BMI over 95 th percentile), and 8 children (14%) had to discontinue treatment due to metabolic adverse effects. Mean ESRS scores were significantly increased at all time points compared to baseline from 3 to 12 months (p Conclusions: Monitoring of antipsychotic medication safety in children with Tourette Syndrome is recommended to weigh the benefits and risks of treatment and inform treatment decisions. Study Supported by: Canadian Institutes of Health Research Disclosure: Dr. Pringsheim has nothing to disclose. Dr. Ho has nothing to disclose. Dr. Sarna has nothing to disclose. Dr. Hammer has nothing to disclose. Dr. Patten has nothing to disclose.