{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T21:36:13Z","timestamp":1772660173075,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Children and adolescents with Tourette syndrome may suffer from comorbid psychological and behavioral difficulties, primarily Attention-Deficit Hyperactivity Disorder-related manifestations including impulsive, aggressive, and disruptive behavior, and Obsessive-Compulsive Disorder-related disturbances. Often, such additional problems represent the major cause of disability, requiring their prioritization above the tic symptomatology. Here, we present six cases of children and adolescents with treatment-resistant Tourette syndrome aged 11\u201317 years, whose symptoms, especially the non-tic symptoms such as aggressive behavior and obsessive symptoms, failed to respond adequately to at least two different antipsychotics and, where deemed appropriate, to a combination with a medication with a different therapeutic indication or chemical class (e.g., antidepressant or anticonvulsant). Such symptomatic manifestations were significantly reduced by the time of the subsequent control visit planned 30 days later, by using lurasidone as an add-on therapy to risperidone or aripiprazole (all p \u2264 0.009). No significant neuromotor or metabolic side effects were reported in all cases in a follow-up period ranging from 4 months to 6 months, supporting the stability of the observed clinical improvement. While still investigational, the preliminary evidence presented here gives reason to hope that lurasidone could possibly be an effective option in Tourette syndrome, warranting further investigation of its potential benefits in neurodevelopmental conditions.<\/jats:p>","DOI":"10.3390\/children8020121","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T23:43:16Z","timestamp":1612914196000},"page":"121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Effectiveness of Lurasidone Add-On for Residual Aggressive Behavior and Obsessive Symptoms in Antipsychotic-Treated Children and Adolescents with Tourette Syndrome: Preliminary Evidence from a Case Series"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6139-1920","authenticated-orcid":false,"given":"Marco","family":"Colizzi","sequence":"first","affiliation":[{"name":"Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy"},{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0125-4112","authenticated-orcid":false,"given":"Riccardo","family":"Bortoletto","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Zoccante","sequence":"additional","affiliation":[{"name":"Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1016\/bs.irn.2017.05.006","article-title":"Tourette syndrome and chronic tic disorders: The clinical spectrum beyond tics","volume":"134","author":"Martino","year":"2017","journal-title":"Int. Rev. Neurobiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/14737175.2018.1413938","article-title":"Tourette syndrome and other chronic tic disorders: An update on clinical management","volume":"18","author":"Martino","year":"2018","journal-title":"Expert Rev. Neurother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/NRL.0000000000000218","article-title":"Progress in pharmacological and surgical management of Tourette syndrome and other chronic tic disorders","volume":"24","author":"Pandey","year":"2019","journal-title":"Neurologist"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.euroneuro.2019.06.008","article-title":"Novel antipsychotics specificity profile: A clinically oriented review of lurasidone, brexpiprazole, cariprazine and lumateperone","volume":"29","author":"Corponi","year":"2019","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"383","DOI":"10.2165\/11587810-000000000-00000","article-title":"Antipsychotic polypharmacy in schizophrenia: Benefits and risks","volume":"25","author":"Barnes","year":"2011","journal-title":"CNS Drugs"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1001\/jamapsychiatry.2018.4320","article-title":"Association of Antipsychotic Polypharmacy vs Monotherapy with Psychiatric Rehospitalization Among Adults with Schizophrenia","volume":"76","author":"Tiihonen","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1017\/S1461145712001320","article-title":"Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment","volume":"17","author":"Toteja","year":"2014","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1002\/phar.1453","article-title":"Antipsychotic polypharmacy in children and adolescents at discharge from psychiatric hospitalization","volume":"34","author":"Keeshin","year":"2014","journal-title":"Pharmacotherapy"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1001\/archpsyc.60.11.1079","article-title":"Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression","volume":"60","author":"Tohen","year":"2003","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1038\/npp.2008.209","article-title":"Divalproex ER combined with olanzapine or risperidone for treatment of acute exacerbations of schizophrenia","volume":"34","author":"Casey","year":"2009","journal-title":"Neuropsychopharmacology"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sohn, M., Burgess, M., and Bazzi, M. (2017). Antipsychotic polypharmacy among children and young adults in office-based or hospital outpatient department settings. Pharmacy, 5.","DOI":"10.3390\/pharmacy5040064"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Colizzi, M., Ciceri, M.L., Di Gennaro, G., Morari, B., Inglese, A., Gandolfi, M., Smania, N., and Zoccante, L. (2020). Investigating gait, movement, and coordination in children with neurodevelopmental disorders: Is there a Role for motor abnormalities in atypical neurodevelopment?. Brain Sci., 10.","DOI":"10.3390\/brainsci10090601"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Colizzi, M., Sironi, E., Antonini, F., Ciceri, M.L., Bovo, C., and Zoccante, L. (2020). Psychosocial and behavioral impact of COVID-19 in autism spectrum disorder: An online parent survey. Brain Sci., 10.","DOI":"10.3390\/brainsci10060341"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1089\/cap.2014.0109","article-title":"Comorbid symptomatology moderates response to risperidone, stimulant, and parent training in children with severe aggression, disruptive behavior disorder, and attention-deficit\/hyperactivity disorder","volume":"25","author":"Farmer","year":"2015","journal-title":"J. Child. Adolesc. Psychopharmacol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.2147\/NDT.S72284","article-title":"Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics","volume":"11","author":"Eapen","year":"2015","journal-title":"Neuropsychiatr. Dis Treat."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology.","DOI":"10.1037\/e591322011-001"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1097\/00005053-198809000-00007","article-title":"Profiles of aggression among psychiatric patients: I. nature and prevalence","volume":"176","author":"Kay","year":"1988","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1097\/00004583-199706000-00023","article-title":"Children\u2019s Yale-Brown Obsessive Compulsive Scale: Reliability and validity","volume":"36","author":"Scahill","year":"1997","journal-title":"J. Am. Acad. Child. Adolesc. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1089\/cap.2018.0037","article-title":"A focused review on the treatment of pediatric patients with atypical antipsychotics","volume":"28","author":"Lee","year":"2018","journal-title":"J. Child. Adolesc. Psychopharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1007\/s10803-015-2628-x","article-title":"Lurasidone for the treatment of irritability associated with autistic disorder","volume":"46","author":"Loebel","year":"2016","journal-title":"J. Autism Dev. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/ijnp\/pyz068","article-title":"Antipsychotic Polypharmacy: A dirty little secret or a fashion?","volume":"23","author":"Lin","year":"2020","journal-title":"Int. J. Neuropsychopharmacol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/2\/121\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:21:46Z","timestamp":1760160106000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/2\/121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,9]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["children8020121"],"URL":"https:\/\/doi.org\/10.3390\/children8020121","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,9]]}}}