Tic & Giving Up Stimulants | ADHD Information

What kind of specialists? I am very open to going to someone else. We did
go to a psychologist before (for anger) but she didn't prescribe meds.
My brother has had tics all his life, so there is a genetic risk. This makes me
concerned. It's ashame, because I really liked Focalin. She ate so well and
had little rebound. But, the blinking had gotten very bad.I forgot to ask...what is Tenex? Isn't it for blood pressure? The ped. didn't
offer that idea. I wonder if it would work.

For starters get a referral from the ped to a good neurologist. The neurologist will do a full neurological evaluation and also do medical testing to rule out other things. It is important that your son be seen by a neurologist because he is getting tics and he will also confirm a diagnosis or deny of ADHD. Sometimes a child could have a tic disorder and be misdiagnosed with ADHD and sometimes the child might have both. The child could also get transient tics while on the med's which do go away when the med's are stopped but again, transient tics could also mean the child is predisposed to tic disorder.

Tenex is a blood pressure med but it is also used sometimes in conjunction with ADHD med's to help alleviate the symptoms of ADHD. The ped wouldn't know this as he's not a specialist and that's why its critical that your son be evaluated by a neurologist.

We went trough the same thing.  Our son developed tics on concerta- so we took him off all stimulants and he had no focus and was a bear to deal with.  He was unhappy a lot- frustrated with himself.  Well after he was off all stimulants he developed a head jerking tic.  Finally our family Dr refered us to a ped. neurologist.  I mentioned clonidine to my Family Dr. and he felt uncomfortable perscribing it cause he had never perscribed it before.  We went to the neurologist and she put him oin clonidine and -thank the Lord-- focalin XR.  She said that the clonidine should help with the tics and that the tics aren't caused from stimulants but stimulants can make them surface in someone who is prone to them in the first place.  She also said that most tics subside before adulthood.  She sees like 3 kids a wk for tics and the adult neurolgist sees way fewer.

 

He has been on clonidine and focalin for about a month and is soo much better.  He still has an occational tic but nothing like before- even on the stimulants they are better than when he was not on them.  Do a google search on clonidine and ritalin and a study from 2002 should come up.  It has some promising information.  He started on clonidine because I requested it because I read this study.  The ped. neurologist was gonna go with tenex.  I think they both will do the same thing.  Clonidine is more sedative but his body has adjusted to it. 

 

If I were you I'd get a referal to a ped. neurologist and see what they say.  There is hope.  If you would have asked me 3 months ago I would have thought there was no hope for us because of the tics.

Please respond if anyone knows anything about this. We finally got DD in
for an EEG (because of blinking tic) and it was ABNORMAL. I am so upset.
We don't see the neuro until about 4 wks. The results were "left temporal
spikes". I have a million questions and now I'm on "red alert"---watching
her like a hawk.
Has anyone else gone through anything similar?   I'm wondering if she has
epilepsy and we didn't know it? THe pediatrician said he usually doesn't see
tics by themself causing abnormal EEG. So, if not just a tic, then tics are
seizure symptoms? Oh boy. THis is confusing and upsetting. I don't know
anyone who I can talk to about this. I am going to bug the doc's office next
week until they know me well, for a quicker appt.
Please Help.

happy2bemom wrote:

 I called the doc and he said sometimes tics can become PERMANENT when stims. are continued with a tic.  He said the only option was Straterra, but it's not ideal.  

 

What type of doctor is treating your son's ADHD? Are the med's being managed by a specialist? As far as tics, they may come out when the child is predisposed to getting tic disorder but tics don't become permanent as a result of taking stimulants. Once you stop the stimulant the tics should go away. Also, there are other options as mentioned in another posts on this thread. You can also try another stimulant to see if your son gets the same reaction. This can be a long, hard journey before the right med and dose is found but parents, pediatricians don't have the knowledge or expertise with these medications so I suggest that a specialist is always sought out to put the child through a trial of med's.

 

My son who just turned 12, also started having problems with tics on focalin after about 3 months of use.   We also experienced rebound on focalin, we disconitued the medication and are currently taking 30 mg of vyvanse, the tics  have decreased but he is so moody and his teacher report that his focus has significantly decreased.  We are waitng to get in to see a ped. neurologist but can't see him untill may.  We are so frustrated with all the different meds he has been on in the past 18 months that I think I'm going to take him off everything for awhile.  We are also considering going to the Amen clinic, has anyone been there?

DD (11 yrs)  has started a blinking tic in the evenings while watching tv.  She is happy and relaxed at the time.  She is on low dose short-acting Focalin.  I called the doc and he said sometimes tics can become PERMANENT when stims. are continued with a tic.  He said the only option was Straterra, but it's not ideal. 
Okay....so we give up on the stimulants that help her so much with focus and even out her personality?  (a.k.a.---help stop that temper).

What about all the studies that unmedicated ADD/ADHDers are more likely to be involved in unwanted activities as teens?  (I can't imagine her driving w/o a stimulant!)
There must be a solution out there.  Of you all that use a psychiatrist for ADD treatment, do you find they're better equipped to deal w/ tics and medicine issues?  He's a terrific pediatrician, but I'm wondering if we should get additional input.
We saw a female psychologists, mainly for anger issues, but I don't think it did a bit of good.  (Except the threat of going back made DD better control her temper).

Isn't it always something with ADD/ADHD kids??  People just don't realize what we got through.

My son who is 10 has been on concerta for 4 years.  At first he had no tics and was on 54 mg..last year he started with tics so bad, the school nurse thought he was having a seizure!  We lowed his dose to 45 mg and added 2 mg of tenex (1 in a.m. and 1 in pm)..he did great on that but the dr. wanted to try getting him off stims so added strattera to the mix.  To shorten this story,  a year later, my son is on 27 mg of concerta, 2 mg of tenex, and 50 mg of strattera...tics are still there, he is so moody on the strattera and I am totally frustrated and not sure where to turn now!  We are trying to wean him off the strattera and then I am not sure what we are going to do!  If anyone has any ideas..please pass along.

Mars

Some people on this site continue using a stimulant when tics surface, but they combine it w/ guanfacine or clonidine, and that seems to stop the tics.  I don't have any personal experience w/ tics, just reporting what I've read some others have done.

My daughter is 12 and takes guanfacine (tenex) in conjunction with Concerta.  We have been doing this combo for about a year.   It has helped reduce her tics - but not totally go away.   It's also helped keep her more even keel - not as wild in the evenings and less anxious.   It's a good combination for her right now.

We use a psychiatric nurse practitioner to manage my daughters medication.  She's been her job for years and is very good.   There three things I really like about working with her - she returns her own phone calls - not talking to a nurse who is relaying a message from a doctor - her appointments are scheduled on the hour - so we have plenty of time to talk - and she actually listens to me and values my input when we are discussing my daughters medications.  
DD has only had the tic for about 4 wks.  The family member that has Tourettes has many obsessive compulsive behaviors.  DD could care less about her environment or rituals.  She is the epitomy of disorganization and lack of routine. 
I keep researching Tourettes and tic disorder looking for connections.  I want answers--yesterday!  I know you all can relate to how I feel about getting answers and solutions.

I take Focalin (of course I am 35) and notice that if I have coffee or other stimulants with it I have difficulty with jitters and blinking, but Focalin is time released and generally does not maintain in the system long if it's low dose as you said, and her coming off in February still having the problem is suspect.

I am glad you are taking her to a neurologist, it's ALWAYS better safe than sorry and you want to make sure all decisions are informed ones.

OCD is not always ritualistic in a fashion that we see on tv, or notice becuase of it being so different than other people.  I have developed OCD behavoir (I'm not OCD but use it to combat my ADHD) and one of them is a strange finger and thumb tapping (think master cylinder from Felix the Cat) as well as blinking my right eye when trying to focus or concentrate.  It's not something I'm aware of when doing it or that I noticed before talking with my psychiatrist for months but in a way it is permanent because I do it unconsiously and it works to keep me balanced. (Or as balanced as I can be).

Keep us posted on how she does.  I'd hate to think it's the Focalin causing the problem or that it's something that can't be corrected, especially with her being in middle school which is just about the cruelist age for kiddos.

It is interesting how every one reacts differently to different medications.   For my daughter Focalin XR made her tics considerably worse.   We only lasted a few days on it.   With Concerta & tenex,  her tics are greatly diminished.

I am so glad to say that after 4 wks, the blinking has greatly decreased.  We are still waiting for our appt. time with neurologist.   I hope it keeps decreasing.   Of course, I realize if this is a tic disorder, it will return in another way eventually.  I would love to know if it's transient or chronic.  Maybe the dr. will know.


I read that if a child has any form of tic for more than 6 months it is considered Tourettes.  The ped neurologist didn't do any tests on our DS. She came in and said matter of factly- he has touretts'- she couldn't beleive we didn;'t know it already.  I strongly suggest you search clonidine and stimulants and also tenex and stimulants.  We have DS on clonidine and before focalin XR but switched to concerta agtan.  Concerta is the culprit for bringing out his tics.  I took hism off concerta after just 3 days cause the tics got worse.  With focolin and clonidine we are happy.  He is doing soooo much better in school.DD's blinking tic has gotten much worse.  (We stopped Focalin first of Feb.)  I am so upset.  She seems unbothered and happy.  I am SO very afraid she is going to get made fun of at school.  Middle School is such a tough time anyway.  I called pediatrician and he is referring us to a neurologist.  I am worried about the kinds of tests they'll do.  I'm afraid for her of what they'll put her through.
I've researched Tourettes and it doesn't fit real well.  I think maybe tics just go along with ADD sometimes?  I have a close relative w/ tics and probably Tourettes.  That has me very upset also.  Would I know by now if she had Tourettes?  There's no OCD in that child at all.
Anyone who's been through anything similar, I would greatly appreciate any advice.  I feel like we're starting down another long road, and I'm fighting to stay optimistic.

ADHD med's do not cause tics but if the child has a propensity towards tic disorder, the med's can make them surface. For all others the tics are called transient tics and go away once the med's are stopped. Seeing a neurologist is the best thing you can do for your child at this point. Tests are non invasive so try not to get all worked up. Write down all of your questions so that when you see the neurologist you won't forget as the more knowledge we have, the less fears we have. Parents are so nervous at the time that we forget what to ask so writing things down always helps.

Right now your overwhelmed which is totally understandable but once you know what your dealing with, there is a sense of relief as a treatment plan can be tailored to your child's needs. ADHD rarely stands alone or sometimes there is a misdiagnosis so seeing a special sit will give you definite answers. Tics don't go along with ADHD but other disorders like tic disorder can co exist. Hang in there and please know we are here for you and no matter how things turn out, these disorders can be effectively treated. Good luck and please keep us posted. Hugs to you