Neuroleptics

Neuroleptics used to treat AD-HKD-related symptoms improved behavioural symptoms in fewer than half of the affected children and adolescents, according to a review of earlier studies. (!89) Improvement in cognition was even less apparent. Given the serious risks associated with both acute and long-term use of these drugs (e.g. sedation, dystonic reactions, tardive dyskinesia, and neuroleptic malignant syndrome), the use of antipsychotics for the management of AD-HKD is restricted to extreme cases of patients whose severe symptoms and impairment persist, even after exhaustive investigation of alternative treatments known to be both safer and more effective.

Combinations, augmentation, and subgroup-specific treatment

Treatment of AD-HKD with a single drug is the optimal goal. Occasionally, combinations are considered because of a suboptimal clinical response, side-effects, or the presence of some troubling comorbid condition such as tic and anxiety disorders. Combinations of medications can cause drug interactions. Few combinations have been adequately studied.

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