SmallMom - absolutely you are bringing up good points. However, there are changes going on to the definition of tourettes - I admit there's no concensus but they are bringing up some changes that may go into the next year's defining of it.
They now believe that many people have it - but it's recessive and not showing up except under duress or taking amphetamines. I don't think I said they cause it - but if that was construed I apologize. I know amphetamines don't cause tics OR tourette's - but may aggravate them as you mention.
I don't think I mentioned - but in rare circumstances amphetamines after long-term use have been known to cause small tics (unrelated to tourettes), or more commonly repetetive grinding of the jaw or other repetitive muscular motions. Rare - but they happen.
Glen,
There's a difference between tic disorder and Tourette's. Here are the DSM-IV criteria for Tourette's:
Diagnostic Criteria for 307.23 Tourette's Disorder
• both multiple motor tics and one or more vocal tics must be present at the same time, although not necessarily concurrently;
• the tics must occur many times a day (usually in bouts) nearly every day or intermittently over more than 1 year, during which time there must not have been a tic-free period of more than 3 consecutive months;
• the age at onset must be less than 18 years;
• the disturbance must not be due to the direct physiological effects of a substance (e.g. stimulants) or a general medical condition (e.g. Huntington's disease or postviral encephalitis) The fact that the poster is 23 years old and just developed tics means he can't possibly have Tourette's. In addition, his "tic" is just motor, not vocal. BTW, our doctors have told us repeatedly that stimulants do not cause tics, but they can exacerbate tics. From what I've been researching - tourettes' syndrome can range from minor with just a small eye tic to the symptoms we've seen portrayed on TV and movies. One specialist talking about it on TV said that the minor variety is so common - up to 20 percent of people out there might have it and never know. It can be brought out stronger with stress, lack of sleep, amphetamines or age even. Just food for thought.Glen,
Interesting. My 12-year-old son has been dx with ADHD, anxiety, migraines and tic disorder (the latter two fueled by anxiety, so say the docs). His tics (nose-bridge wrinkling and mouth opening) began a year ago when we increased his Concerta from 27 mg to 36 mg. He had been on Concerta more than a year when the tics began. Then this February my son wanted off Concerta because he said it made him feel flat and inhibited. Off meds, the tics came and went without rhyme or reason. We did a week-long trial of Adderall XR last spring, and the mouth-opening tic became so bad that kids were asking my son what was wrong with his face. Needless to say, we stopped Adderall. My son is now on Focalin XR, and it appears not to have any noticeable effect on his tics (we see them some days and not others). In fact, my son's neurologist (who treats him for migraines) said she prescribes Focalin to all of her ADHD/Tourette's patients because it is refined Ritalin and appears to cause fewer side effects. My son also started Zoloft for anxiety 2 weeks ago, and our doc says it may quiet his tics. We'll have to wait and see. Our docs have never gotten that worked up about the tics -- they say it's possible they will disappear with adolescence, and there's not that much you can do about them anyway (except add meds with bad side effects, which we're not willing to do). They have never dx him with Tourette's because he doesn't have a vocal tic. But maybe that will change next year . . .
Hey Thanks for answering my post.
I take a 20mg XR at about 8 everymorning as soon as I get up, my classes aren't until 9. I don't start feeling anything until about 11:30 or so. Around 2 I start feeling it wear off, so I pop in another 20mg at 2, and i'm set until I go to bed. So maybe, a higher dosage is just what I really need. I'm massively ADHD by the way, and I was prescribed ritalin as a kid, but I never took it in highschool or undergrad, because I really never needed to. Law School has been the first real challenge in my life, and that is when I decided that I really really need something. I'm 6'2, 200 pounds. I'm not quite sure what to do, because I need something that works in the morning.
The eye twitches could be tics. My 12-year-old son, who has mild tic disorder, had major facial tics on Adderall XR. So bad that we took him off of it after one week. Ask your doctor about the eye twitches, as well.
Take a higher dose, earlier. If classes start at 09:00, but it takes until 11:30 for max effect, take first at 06:00, and drink coffee as an additive. Look at some of the other alternate ingestibles, which may help as well. There's an alt's board in this forum.
A) No way i'm waking up at 6
B) I don't drink coffee :-)
I only have a few more pills left, so i'm going to a doctor next week to get either a refill of Adderall or get on something else. Maybe he'll know what to do for me.
Hey Ryhno,
What time do you take your meds in the morning?
It takes a/b an hour for the initial release to reach noticeable levels, and about 2 hours for full effect. Then there's a continued release throughout the day. However, all these controlled release formulations were designed with midday kiddy meals in mind, so there is also a decline in efficacy during the lunch period.
These XRs and LAs and CRs are designed with an initial release of an outside coating of active ingredient (a.i.), and then a timed release thereafter. Perhaps your initial release is not at the correct dosage. Have you asked your mendicant to up your morning dose?
Another way of doing it is staying on the dose you're on, but ADDing a standard tablet in the morning. In and Out in 4 hours.
Are you taking any other meds, like at night, that may be causing hangovers? Take them earlier.
Let us know what you ended up doing. Adderall is the best of the best. Concerta is a different molecule, more so designed for children and light weights.
I'm 50 yrs old, 100 kg, 1.7 m, and rock on Ritalin LA 60 mg. A middle of the road for ADDer med, but at maximum dose.
I'm a 23 year old law student with massive ADHD and was, about a month ago, put on adderall xr. It works wonders, but it doesn't help me much in class because it doesn't seem to kick in until 1 or 2 in the afternoon...my classes are from 9-12. So it helps me study but doesn't help me much in class.
Also, i've gotten eye twitches for the past two weeks, and i'm wondering if this is a sideeffect of adderall, or maybe it is just all the law books I read.
Also, should I switch to something like Concerta because I would like to have attention in the morning, not just in the afternoon when XR seems to kick in for me.
Thanks for any help?