Objective: To determine whether pediatric patients with tic disorders have an altered risk of atopy when compared with controls, whether this difference in risk is also seen in Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD), and whether commonly used tic medications are associated with different risks of atopy.

Background: Tic disorders are common neuropsychiatric disorders. Previous research suggests ties between tics and atopic disorders such as allergic conjunctivitis, allergic rhinitis, asthma, and atopic dermatitis. Our study aims to expand previous findings by using a more generalizable patient population and examining the effect of medication initiation.

Method: We performed a retrospective cohort study using TriNetX, a global electronic health records network. To assess prevalence of atopy, we used data from patients with tics, ADHD, OCD, or controls ages 5 to 18 seen at Stony Brook Medical Center for a well-child visit between 2019 and 2020. To assess the risk of developing atopy after initiation of tic medication, data from all of TriNetX’s 49 participating healthcare organizations were used. Chi-square tests with Bonferroni correction for multiple comparisons were used.

Results: 14,483 controls, 167 patients with tic disorder only, 1,596 patients with ADHD only, and 41 patients with OCD only were identified for analyses of atopic comorbidity. Atopy was more common in patients with tic disorder or ADHD compared to controls (p < 0.05). Allergic conjunctivitis was more common in tic disorder compared to ADHD (p < 0.05) or controls (p < 0.05). Allergic rhinitis and asthma were more common in ADHD compared to controls (p < 0.05). 54,255 patients with tics, ADHD, and/or OCD taking a single anti-tic medication were identified. There was a significant effect of medication on risk of developing atopy (p < 0.001), with the highest risk in those on clonidine (13.8%) or topiramate (12.4%) and the lowest risk in those on haloperidol (5.3%).

Conclusion: Patients with tics or ADHD exhibited a significantly higher prevalence of allergic comorbidities compared with controls. Allergic conjunctivitis was more common with tics, while allergic rhinitis and asthma were more common with ADHD. Patients on clonidine or topiramate were most likely to develop atopy, while those on haloperidol were least likely. Future prospective studies should further elucidate the link between atopy, tics, and medication use.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-between-tic-disorders-and-atopy/