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November 17, 2023

How should I manage new neck tics in a 27yearold female with moderate intellectual disability, Tourettes history, hypothyroidism, type 2 diabetes, and current medications (quetiapine (Seroquel) 400 mg twice daily, guanfacine 2 mg three times daily, buspirone 15 mg twice daily, hydroxyzine 50 mg twice daily and 25 mg at night, trazodone as needed, levothyroxine, metformin, tirzepatide) after abrupt discontinuation of lowdose aripiprazole (Abilify) that was tapered to 2.5 mg every other day, while trying to avoid additional metabolic burden?

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