My 12-year-old son has tic disorder (as well as suspected bipolar, ADHD and anxiety), and while I know Risperdal is supposed to help tics, my son had a med reaction that included an INCREASE in tics. It is called a dystonic reaction, which means involuntary muscle contractions that cause uncontrolled and alarming movements of the face, neck, tongue and back and an uncontrolled rolling of the eyes. Boys are at great risk for dystonic reactions. My son's included incessant mouth opening, lip licking and smacking, and tongue thrusting.
I honestly don't know if tics are common with austism spectrum -- I know they can go hand-in-hand with ADHD -- but if the eye blinking tics started after your son started Risperdal, I would seriously consider asking the pdoc about taking him off of it. We thought my son's tics had just gotten bad on their own, but in reality, Risperdal was making them far worse.
SmallMom38706.6841203704I have a son with PDD-NOS and I think your son DOES sound like he has it, but it could also be Tourettes with it. I'm sure they can co-exist. If I were in your shoes, knowing what I now know, I'd take him both to a Neurologist to check out Tourettes and to a NeuroPsych to verify the PDD-NOS. The spinning, hand flicking that some PDD kids do, the rocking are called "stims" as in stimulations. They may look like ticks, but may not be. Many PDD kids smack their lips, make high pitched sounds, etc. The autistic spectrum kids NEED to do these, and they do tend to kick up under stress. My son doesn't do them much at all anymore, but he did when he was your son's age. My son was tried on ADHD meds because his first wrong diagnosis was ADHD/ODD, but they didn't change anything. Some autistic kids do better on ADHD meds because they are inattentive just like ADHD kids, but many don't. My son is in a special ed class for 1/2 a day and has an aide for science and social studies and goes to art, music, etc. on his own. He is doing very well at 12 years old. Good luck to you and I hope you explore everything. We hadn't even heard of a Neuropsych until Lucas was 11 years old! About Risperdal, when my son was put on it, he also had dystonic reactions. Our pdoc said it was quite serious and took him off of the Risperdal right away. Said that if he continued to have them, then he may have them forever. Needless to say, we didn't want that. He'd never had tics before that though.psm090438706.6846643519
Here is some medical information about the relationship between Tourette's and autism, and about the similarities and differences between tics, stims and stereotypies:
http://tourette-syndrome-now-what.blogspot.com/2005/12/tics- stims-and-stereotypies-tourettes.html
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Tourette Syndrome - Now What?
http://tourettenowwhat.tripod.com
[QUOTE=SmallMom]
but if the eye blinking tics started after your son started Risperdal, I would seriously consider asking the pdoc about taking him off of it.
[/QUOTE]
His eye blinking and the large body movements had already gotten more noticeable, prior to starting the Risperdal, 1 1/2 weeks or so ago. I remember, because my husband asked the psychiatrist about the eye blinking, and after that is when he ended up Rx the Risperdal.
The eye blinking seems even worse now. Not sure about the other. I'm not sure how long I should wait before I decide that either the Risperdal is not working or might even be making things worse. I suppose if things get worse I will call the psych. this week, otherwise, I will give him a call right after Christmas if they get no better.
Does anyone know how long it takes to work? Does it have to build up in the system like an antidepressant or should we see whatever the effects are immediately? I should have asked but forgot. I will try to look on the Net.
Thanks.
Risperdal tends to work fairly quickly if it's at the right dose. You may not see much on a very small dose. (How much is he taking?) Risperdal also made my son extremely restless -- it really was not the med for him.
What looks like tics can also be autistic stims. InABox, I'm not sure you understand these kids, even though I know you say that you work withthem. My son's Special Ed teacher has been with the district for twelve years and did not know what the term PDD-NOS means, so I think often the parents know more than caregivers and teachers. She was a doll about learning about it though. This poster's son has much the same symptoms as mine did and even the same reaction to Risperdal. Your son (InaBox) may have been diagnosed with ADHD, but I've always felt, by the way you described him, that he has some form of autism. One diagnosis can always be wrong, as I've learned. Tourettes and autism can go together, just as any two disorders can, but, again, autistic stims can also be mistaken for tics. She needs to see a NeuroPsych/Neurologist combo to get the big picture.
Smallmom, how weird that they give Risperdal FOR tics when they caused my son to have them! Wow, I just learned something new! That med was horrible for my son. He mostly slept and cried, then the muscles started to ache and the movements began. We're lucky he was taken off of it fast.
psm090438706.8430555556Yes, we thought it was weird, too. Our son's doc didn't believe us when we told him our son's tics were WORSE on Risperdal. Over Thanksgiving vacation, DH and I couldn't stand watching our son's uncontrollable mouth and tongue movements any longer so we took him off Risperdal without asking the doc (and we NEVER do stuff like that). His lip licking was so frequent that it caused a staph infection around his mouth. When we took him into our ped for treatment of the staph infection, our ped said of course the mouth movements were from the Risperdal. Needless to say, our son has a new pdoc (who we think is doing a good job of dxing and treating).
Oh I'm glad. We really have to be cautious with the trust we give in doctors. They're not all up to speed. Good for you!
[QUOTE=psm0904]InABox, I'm not sure you understand these kids, even though I know you say that you work withthem. My son's Special Ed teacher has been with the district for twelve years and did not know what the term PDD-NOS means, so I think often the parents know more than caregivers and teachers.
Your son (InaBox) may have been diagnosed with ADHD, but I've always felt, by the way you described him, that he has some form of autism. One diagnosis can always be wrong, as I've learned. Tourettes and autism can go together, just as any two disorders can, but, again, autistic stims can also be mistaken for tics. She needs to see a NeuroPsych/Neurologist combo to get the big picture.[/QUOTE]
I understand these kids to a point and I'm always learning. I'm sure parents understand them more and I most definitely give them credit. Not only have I worked with them but I've also studied Autism and have done a lot of personal research on the subject matter. Having said that, I don't claim to know everything. :) I'm familiar with PDD-NOS but not all the ins and outs. I havent had to work with anyone with that particular diagnoses.
As for my son, he is going to be tested for ASD. My gut is telling me he's not but it wouldn't hurt to try it. His kindergarten teacher was the one that pointed this out. I think he has ADHD plus SID. Curious, why else do you think he has Autism?
InABox, it's great that you're so interested in autism. Truly, we need all the help we can get (parens and kids). I've spent so much time reading and learning about PDD-NOS that I almost feel like I could teach a class on this. My son is much higher functioning than many kids who have it, but he definitely is ASD. He's improving every year, but is still quite an "odd duck." InABox, ADHD with SID is often undiagnosed high functioning autism. Plus he sounds so much like my son who was misdiagnosed first with ADHD and always had a lot of sensory issues. He was treated for autism, but never had the label until 11, but the interventions REALLY REALLY helped him. Meds DID NOT. I know you don't like meds, and I'm not really crazy about meds, and I'm glad my son doesn't need them. Look, I'm not a professional. The autistic spectrum disorder just comes through to me when you describe your son, but, hey, I'm a layperson. I wish you luck in your testing and hope the interventions work, with or without a diagnosis.
INaBOX,
DH is Dear Husband in cyperspeak.
Tourette's is dx only after both verbal and motor tics are present for a year. Please don't scare wildboys.
TSNW already said autism and tics can be co-morbid.
Risperdal is prescribed to treat tics, but IN SOME KIDS (like my son) tics get worse.
[QUOTE=wildboys]Does your child have any tics or obssessive behaviors? If so, what are they and does your child have a diagnosis? [/QUOTE]
My son has an obsession with clocks/time - "How many more minutes?" He's easily distracted if he sees a clock. He can't stop looking at it, waiting for the hand to move or the number to change. This is a new thing. He's recently been diagones with ADHD - nothing else.
[QUOTE] He is just immature in most areas. He does things like rocks back and forth, has since he was a few months old. We also recently noticed that he turns in circles over and over, says he doesn't want to stop because he likes it - things like that. Like I said, these have seemed to increase lately. He is now in first grade. We are getting his IEP reviewed early based on this new DX of PDDNOS. He was on Buspar and Straterra for a short time, but we discontinued them. He was off of them for 1 1/2 months and then started to have these increased behavioirs. Now, after the increase in these behaviors, we have started a low dose of Risperdal. A very low dose. I just don't know why suddenly, kind of out of the blue he would start more of these repetetive behaviors, unless it is a coping mechanism for the increased stress of 1st grade or us having a new baby (5-6 months ago). The eye blinking is esp. disturbing. He gets upset if I ask him about it and acts like he can not stop. His teacher even called home, because she noticed it. We had noticed this by the last psychiatrist visit and mentioned it, and he referred to them as tics. I wonder if this is common with Autism spectrum disorders? (By the way - DH's brother was suspected of being high functioning autustic - he is deceased - and DH is suspected of it - so there is a family history) [/QUOTE]
I think someone mentioned Tourettes already. That would be my guess as well. As for the spinning, you mentioned he's delayed in most areas. Maybe he's finally able to physically do some of the "Autistic" behaviours he wasn't able to do before - gross motorly speaking. I don't believe tics are associated with Autism. They don't go hand in hand as say.. SID and Autism do. I'm sorry, who's DH? Your son you're speaking of? Also, both Buspar and Risperdal have tics as a negative side-effect. I'm not sure if this has anything to do with this case.
INaBOX38706.8167592593I'm really not trying to scare anyone. I think it was a valid guess. All she can do is talk with her doctor and see what he has to say.
Also, I've been working with children with Autism for 4 years and I've never heard of that before. I've seen only one student with the tics and he was also on Riperdal.
Oh well.
From what I read on the links that TNSW posted, I think they are Stims, not technically "tics". But I am still wondering why they would increase now, before the Risperdal. He has had overall developmental delays, but I doubt so much that he has just now learned to do some of these things. Of course, he may just now have thought about doing them..... hmmm.....
Small Mom is right, part of the reason the Dr. prescribed it was because of the "tics" or whatever. He explained it as... the Risperdal is an anti-psychotic, and it can help ASD children "come out of their little world" so to speak. I am very hesitant about it, though. Those are some dang nasty side effects it can have. So I am going to watch very closely and use a lot of caution if he wants to increase the dose in the future. I just don't think his level of severity is worth any of those side effects.
Also remember that transient tics appear in many children, diagnosed with a disorder or not. 6 or 7 is the prime age for them to begin. Both my boys have tics that started at that age. Only one son is diagnosed adhd/ts. The other may have ts but he doesn't have any issues so I haven't pursued an official diagnosis.TSNW,
Tardive dyskinesia most typically occurs in elderly patients taking traditional (not atypical) antipsychotics for many years. It can happen on atypical antipsychotics, but it is very rare and only occurs after being taken for a while. My son was only on 0.5 Risperdal for 2 weeks. His tongue movements were definitely classified as dystonic reactions and have all but disappeared now that he has been off the med for about 3 weeks.
Oldtimer,
What is your son's official diagnosis?
Funny you say this psm cause my son''s pdd came more obvious when he took Strattera. Noone just wants to be up front and tell us honestly. I would ask them how come when I did his pdd online test and filled out paers when our son was 2 I got 106 score both times. I guess since most think of ASd they think of a loner asd child who rocks in a corner. Today it's been found asd is more than this. Just look up the myths of asd. I looked up what adhd and comorbid disorders it shocked me what all goes with it and can. RNMy son was started on .25 mg.
The tongue movements with risperdal (an atypical neuroleptic) can be worrisome, as neuroleptics can cause tardive dyskinesia ... please make sure the physician has taken that into consideration !! What kind of dosage was he on? I have heard of children on the autism spectrum who were helped with a mere pinch of risperal (way below the usual dosage) ... here are some notes about typical dosage in Tourette's (2.5 - 3.5 mg daily) ... I remember one child on the autism spectrum who benefitted from about 1/2 mg daily, so something very small ...
http://p082.ezboard.com/ftourettesyndromenowwhatfrm5.showMes sage?topicID=80.topic
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Tourette Syndrome - Now What?
http://tourettenowwhat.tripod.com
[QUOTE=oldtimer]Funny you say this psm cause my son''s pdd came more obvious when he took Strattera. Noone just wants to be up front and tell us honestly. I would ask them how come when I did his pdd online test and filled out paers when our son was 2 I got 106 score both times. I guess since most think of ASd they think of a loner asd child who rocks in a corner. Today it's been found asd is more than this. Just look up the myths of asd. I looked up what adhd and comorbid disorders it shocked me what all goes with it and can. RN[/QUOTE] Oldtimer, yes, some professionals haven't updated themselves enough to know about high functioning autism! Most autistic kids are not diagnosed until they are 10 and over, which is scary because so much time is lost and so many drugs can be used that WON'T HELP! You really need to find a professional who understand the new findings on ASD, and recognizes Aspergers and PDD-NOS. THey also need to know which performance tests to give the kids to diagnose them. My son was tested for twelve hours. It's not a fast diagnosis. Many professtionals, however, don't take time with the kids and decide on a diagnosis in one or two sessions of just talking to the parents or listeining to symptoms, without tests or observations or reading all records. Scary to this mom because my son was so misdiagnosed!