After being on Concerta for 7 months (18mg for 3 months, 27 for 4 months), my son developed a snorting and finger snapping tic. In the past, he has never been on any other ADHD medicine and has never had any tics (although when he was increased to 27 mg. he developed a frequent sniffling sound that disappeared after 2 weeks). Since it was the end of the school year, I decided to take him off Concerta to see if the tics would disappear. Even after 2 weeks of being off the Concerta the tics were still present and at times became more frequent. This was strange because Concerta is supposed to leave the system after 24 hours. The doctor suggested that the tics may not be related to the Concerta. He suggested that my son take Tenex along with the Concerta. I was nervous about giving my child a drug to control the side effects of another drug, so I decided to take him off Concerta completely. The snorting and finger snapping continued until one day I decided that he should try the Tenex (1mg at night). The Tenex (we actually used the generic) made him so tired, but the tics completely disappeared after one dose of Tenex. (The doctor cannot explain why one dosage of the Tenex worked since the Tenex should only work if taken for a number of months.) Since the tics had disappeared , I decided to stop at one dose of Tenex. After 1 week, I decided to try the Concerta 18mg again (He is playing sports this summer and in the past, the Concerta had improved his sports performance.) and sure enough the snorting and finger snapping are back. Today I decided to try 1/2 tablet of Tenex to see if it would work without the tiredness side effect. I'll write back with my observations.
Has anyone else noticed an onset of tics with Concerta? I've read some of the research and have spoken to the manufacturer of Concerta and it is a known side effect in a small percentage of people. What is puzzling to me is why the side effects continue after a discontinuation of Concerta, even though the drug is supposed to leave the system in 24 hours.
I think kids get into habits. Like my daughter used to have this annoying cough, it was just a habit there was no medical reason. And she did it for a year then one day she just stopped it. So most likely there isnt a medical reason just a subtle psychological habit. One dose of the Tenex did a "wipe" of the habit. I'm talking out of my hat here, but I would think something along those lines.How old is your son? Tics can be a side effect of any stimulant. My son tho has tics on and off of stims. Some stims and high doses make the tics more pronounced, but they also have some tics off of all meds.
Both of my sons started their tics at around age 7 1/2. It could be that maybe your son is just beginning nervous tics, and the tenex took away some of the nerves.
arach-have you checked with your Dr about starting and stopping the Tenex? My son has been on Tenex for a year and I was under the impression that it needs to be monitored carefully when starting and stopping!!
Also, check previous postings about Tics-there is a ton of info out there. My son developed tics on any stimulant medication-it does take some time-(for us about a month )for the tics to subside. The Tenex has helped my son stop and think before he reacts and it doesn't exacerbate any tic issues he may have.
Also-make sure the Dr. starts you on a low dose and moves up from there so your son isn't over medicated and too tired. My 80 lb son started on a dose of 1/2 mg for several weeks then went to 1/2 in am 1/2 in pm then 1 year later he is on 1mg in am and 1 in pm.
Here's an update. Concerta 18 and 27mg was causing sniffing (tic) in spring and summer 2005. (My son has never had any tic symptoms before using Concerta). 27 mg worked great for academics, but unfortunately it caused the sniffing side effect.One dose of Tenex completely stopped the sniffing for a day or two, but once I started him back on Concerta and the Tenex regularly, the Tenex did not seem to help the sniffing. It must have been a fluke the first time. The sniffing was unbearable (although my son didn't notice it), so I took him off of everything for the summer and decided to try again with a clean slate in the fall. Surprisingly, while off all medicines, it took about 2-3 weeks for the sniffling to completely disappear.
The week before school, I started him on the Tenex. He was very tired the first day, but after that was fine. The next 2 weeks I gave him 18 mg (some slight clearing of the throat, but progressively becoming more consistent) and then gave him 27mg the following week. At that point, the clearing of the throat became consistent and I decided to take him off of everything again. How frustrating! The 18mg was causing sniffing/clearing of the throat and academically was not making a difference. The 27mg dosage was working academically and unfortunately the side effect outweighed the benefit.
The doctor has now suggested Stratterra because it is a nonstimulant and may not cause the sniffing (tic). I know Straterra has been in the news and now has a new warning label about possible liver damage. It has not been around as long as the ingredient in Concerta and I am not sure about using it. I read so many negative posts about Straterra and now I am absolutely scared to give it to my child (interrupted sleep, sexual dysfuction etc.) I'm not sure whether there is someone out there that is using a variety of Usernames to "slam" Straterra or whether the posts are honest.
Any thoughts?
Here are my thoughts based on our experience with our 12-year-old son, who has been dx with ADHD, anxiety, tic disorder and migraines.
Our doc has told us that tic disorder frequently goes hand-in-hand with ADHD (both are neurological disorders). We have also been told that stimulants can exacerbate tics, but meds do not cause tics. Anxiety can also fuel tics. My son's tics developed when he was on Concerta last September. We lowered the dose, and the tics lessened but did not completely disappear. In February my son said he no longer wanted to be on Concerta because it made him feel flat and inhibited. He then did a trial of Adderall, and the tics became so pronounced that kids were asking him what was wrong with his face (he told them it was chapped lips -- LOL!). Needless to say, we stopped the Adderall. (We also tried Strattera, but he got 2 severe migraines in 3 days so we stopped.) He then went to short-acting Focalin last spring, but was off meds all summer. During the summer he had a pronounced 4 day episode of severe tics with no med on board at all. It was actually good that we saw this because we now know from first-hand experience that in my son's case the tics do exist regardless of stimulants. This fall he went on Focalin XR, which has been a good med for my son. I see the tics come and go, but not anywhere near the extreme that they were when he was on Adderall. My son's neurologist (who treats him for migraines) told us that she gives Focalin to all her patients with Tourettes Symdrome (a severe form of tic disorder) because it is a refined version of Ritalin that is supposed to cause fewer side effects.
Just my two cents: Have your son evaluated by a neurologist and ask about trying Focalin. Good luck!
Hello everyone! My daughter just started Concerta and I'm wondering how much of the tics is normal? She's started having them after a few sessions of biofeedback and now with Concerta... I got worried because in the info that came with the medicine it says that you should not take concerta if you have tics...I just called one of the doctors that look after my daughter and he said that I should not be worried, but to take close attention tot he tics and see if they become worse...I just wish I knew more, because all I want is to help my daughter. Her tics only happen at night, do you think that I should be worrried a lot about it? Thanks.
My thoughts are posted above. Tics are not "normal"; they are a separate neurological disorder that can go hand-in-hand with ADHD. Our doctor feels that taking stimulants with tic disorder is fine as long as the tics don't become so noticeable that the other kids are talking about it. Because the tics started before she took Concerta, your daughter's tics are not medication-induced; however, stimulants can make tics worse. You do need to watch, as your doctor suggested. If you're not satisfied with the reponse your doctor gave you, seek out a second opinion.
"I'm not sure whether there is someone out there that is using a variety of Usernames to "slam" Straterra or whether the posts are honest. "
THE POSTS ARE HONEST !!!! .... AND THEY'RE NOT FROM JUST ONE POSTER.
My son still had tics while on Focalin XR. I think if you're predisposed to them, then you're going to get them. Previous posts have people even developing tics after using Strattera, when that's not supposed to happen since it's not a stimulant. Go figure.I'm so glad this is being discussed!
Tourettes can NOT be caused by meds - only made more noticable! It's a genetic disorder - and if you have no family history of Tourette's it's highly unlikely you have it now. It's not a recessive trait - you got it - ya got it!! Most people who have it never notice - they blink their eyes rapidly when stressed, cluck their tongue - all sorts of manifestations.
There's good indications that Tourette's comes from the same part of the brain as ADHD - so there's no reason to think that ADHD and Tourettes shouldn't show up as a pair of comorbids.
If the meds work but cause a slight tic - I'd say your child getting a good education and making headway in this hard world is a great thing and worth it!! Looking back at the last 35 years or so of my ADHD - I'd trade a limb if I could go way back and nip it in elementary school. Yes, it makes us as kids suffer THAT much when it's a severe type!
Glad to see this dialogue - I'm very impressed!
Here's an update on my son that had sniffing and clearing of the throat tics on Concerta. He's now trying Focalin XR 10 mg. Although he still has very infrequent sniffing (still left over from his reation to the Concerta, I couldn't wait anymore to start another drug), the Focalin has not exaserbated the problem and I am keeping my fingers crossed. I also have been giving him his medicine with milk. I'm not sure if that has anything to do with not having a tic reaction to the Focalin, but I thought I would mention it.Small Mom,
Thank you for your detailed response. I'm going to ask the doctor about focalin.
my granddaughter who is 10 now,,,has tourettes,,,before she started getting them she was not on meds. then she started retalin,,,then they started,,,the snorting,,clearing of throat,,body movements,,,and it drove her crazy,,,,,i went to the doc,,,and they saw her,and took her off of retalin,,,,we also went to children's hospital,,,ticks are not cause by adhd,,,but it is a hang on,,,,and the doc said that it uncovered the tics,,,they said that there are alot of people in this world that have tics,,fbut just don't know it,,,stimulates bring it out more,,,,well it has been about 5 yr now,,,and she still has them,,,but5 not as bad right now,,,because as we say they are sleeping,,,,and they could sleep for about a yr,,,keeping fingers crossed,,,it can also be gennic,,,so teach your child not to be embarrassed,,,how to relax and never never,,,get on them for having tics,,,,,it is a form of release,,,,,
[QUOTE=SmallMom]My thoughts are posted above. Tics are not "normal"; they are a separate neurological disorder that can go hand-in-hand with ADHD. Our doctor feels that taking stimulants with tic disorder is fine as long as the tics don't become so noticeable that the other kids are talking about it. [/QUOTE]
Yes, this is correct.
The combination of Ritalin and Clonidine (Patch) works very well for kids who are comorbid with tics and ADHD. The following article discusses a recent study...
http://www.ninds.nih.gov/news_and_events/news_articles/news_ article_adhd.htm
Well, after being on 10mg of Focalin XR for about 3-4 weeks, my son now has the clearing of the throat tic again. It occurs every 3 seconds or so, and I therefore have no choice but to take him off of it. Not sure what I'm going to do next. I'm really frustrated because the medicine really helps him track when he reads and spell carefully when he writes. The first day that he took the Focalin XR pill with milk for breakfast, the tic left over from the Concerta completely disappeared! So, I thought maybe he needed to drink milk with the pill. I was giving him OJ with Concerta. (I know the type of drink is not supposed to matter, but it's just my observation.) While on Focalin XR, he did develop a very quiet sniff, but I thought of it as a trade off for the benefit of Focalin. Now that he is clearing his throat, and not quietly sniffing every once in a while, I tried to think of what has recently changed. I'm sure they're just coincidences, but I wish I could figure out the trigger!
Here are the changes:
One week ago, we switched from two 5mg capsules (taken at the same time), to one 10mg capsule. (At first he was on a trial, so 5mg capsules were used to build up the dosage.)
This past weekend we didn't give him medicine for two days.
Two days ago he didn't take his every day mulitple vitamin with dinner so we gave it to him in the morning with the Focalin.
Any thoughts?
my grandson is taking concerta,,,,and the pharmacist said that with the med that he was not to take vitamins or any acid fruits or juice,,,or red dye in food,,,that for some reason it can get the med to work the oppisite,,,more hyper and so i will not stop him from having it but i do let him have it around bed time,,,He said it has some effect on stimulante meds,,,,