Recurrence of Tic disorders in children after medication withdrawal: A cohort study on long-term outcomes

Abstract

Aim

To evaluate the relapse rate in children with tic disorders following medication withdrawal and to identify the risk factors associated with tic recurrence.

Methods

This prospective cohort study enrolled 387 children who had recently discontinued medication and had been tic-free for at least 3 months. Participants were followed monthly for 12 months to monitor tic relapse. The primary outcome was the time from medication discontinuation to tic recurrence, while the secondary outcome was the characteristics of the recurrence. Cox regression models were used to identify prognostic factors associated with relapse.

Results

During the 12-month follow-up, 235 participants (61 %) experienced tic relapse. Among these, 120 participants (51 %) had a recurrence of their original tic symptoms, 75 (32 %) developed new symptoms alongside their original tics, and 39 (17 %) presented with entirely new tic symptoms. Significant prognostic factors for tic recurrence included treatment duration, Yale Global Tic Severity Scale score at the worst-ever phase, average daily screen time, negative emotional stimuli, and snack consumption.

Conclusion

Tic recurrence following medication discontinuation is common in children with tic disorders and is associated with several modifiable prognostic factors. Clinicians should address these predictors to develop more effective prevention strategies and reduce tic recurrence.