ADHD and Tourette Syndrome | ADHD Information
No my son is not under the care of a psycologist or psychiatrist right now. He was assessed but there really has been no follow-up. Mostly we have been left on our own to deal with it. Our options have been laid out before us as "deal wih it with medication" or "deal with it without medication." "thank you - good bye"
And what is a "bad case" of adhd? We live in a fairly rural community and there are no support groups etc. here for me to see how other parents deal with this and how their kids are effected as compared to mine.
My son is sweet, and kind and caring and wanting love and affection. He has good days and he has bad days. He is emotional much of the time and is always moving even when he doesn't know it. He says things that are inapropriate and doesn't even notice it. He does things that are wrong by anyone's standards and doesn't understand why he gets into trouble over it. He at times is lost himself as to why he does certain things. I know he knows better and when we examine it together afterwards he knows he knows better and he gets very frustrated himself with the things he does.
Those are the reasons that after dealing with this for 4 years now I am finally willing to try medication. But the tourette/tic thing scares me. I don't want to bring on (by introducing medication) a ticcing period that is out of control and will not wain.
bman, do you have tourette's or a transient tic disorder or are your tics just as a result of the medication? What has your doctor told you? If you go off the meds, do the tics go away? What medication are you on?
It seems like everyone has a different experience with meds and the tics they can or do not enduce. I guess we just have to try and see what works for us.
I guess the big question in my head is that Brent (my son) is in a waining period right now with his tourette's. He hasn't tic'd for about 3 months (he still has tics, like licking his lips and humming, but others don't think it "strange" like the other jerking type tics he has had). I'm worried that if I start the meds I will bring on another bout of tics that may have otherwise not reared their heads for another couple of months or so.
I know that no one can answer this question for me, but I have to prepare myself for what ever happens. And try and prepare him too.
Smallmom
The dr. has perscribed dexedrine. I haven't filled the script yet, but that is what we are going to try first.
Tater,
What alternative route have you taken and is it working for you child?
Hi,
I`M new here,but just wanted to let you know i have a son 6 who has adhd and ts i started him on strattera the end of May and saw results the first week and so didn`t his teachers.He is able to forcus alot better,even asked to practice school work at home,now enjoys crafts and other activities as before he would not stay with things for more then a few minutes. His tics have decreased alot.I also have him in karate,and he is going to camp this summer and having a great time The only things that i have to watch is that is appitiete had decreased and he is skinny as is, and he also has allways had a problem with constipation,which this med can cause. His self essteim had gone way down,but he is doing alot better now.I know every child is different,but i thought i`d let you know it has work for my son.
Go visit our alternative board....there's lots of great things you could try.
Does your son see a therapist? Perhaps one that specializes on ADHD? I am an adult who has ADHD by the way.
MARCI.... I have had a nervous "tick" for a long time..not bad at all.......but it is on and off... an my adderall sometimes does kick it up.... But im no Medical Doctor by all means....Ask your Doc....
It does say on the side effects label that it can worsen tourettes. But if he has a bad case of ADHD then the tourettes could be triggerd by the chem inbalance.
Hi there,
I'm new to this so take it easy on me please.
I am a parent of an ADHD child who also has tourette syndrome. My ADHD son is now 9 years old, and until this point, I have not considered medication for him. But after this past school year and over the last couple of months I have come to realize that if I don't do something to help a part of our family will break. Not sure if it will be him, me or my relationship with my husband, but something needs to change.
I am now looking into medications to help even out my son's temperment and impulsiveness. However, I have read and been told that medication used for the treatment of ADHD can increase the frequency and severity of Tourette tics and medication for tourette's can increase the severity of adhd.
Right now my son has been in about a 6 month waining period with his tics and I don't want to "anger" the beast.
Does anyone have any comments or suggestions.
I just came across this study online-thought you might want to read. . . ADHD and tic disorders in children corrected with guanfacine, Yale researchers find Children with attention deficit hyperactivity disorder (ADHD) and tic disorders showed a 37 percent improvement when they took the medication guanfacine, an alternative to drugs like Ritalin, which can worsen tics, Yale researchers found in a new study published in the July issue of American Journal of Psychiatry."Guanfacine appears to be a safe and effective treatment for children with tic disorders and ADHD," said first author Lawrence Scahill, associate professor in the Yale Child Study Center at Yale School of Medicine.
Scahill said this is the first controlled study of guanfacine in children with ADHD. The researchers looked at 34 boys and girls diagnosed with ADHD and a tic disorder. They reported that guanfacine was associated with an average improvement of 37 percent in total score on the ADHD Rating Scale, compared to 8 percent improvement for the placebo. Guanfacine also improved tics and performance on tests of attention and impulse control.
ADHD causes learning and behavioral problems in mostly male children and some adults. The disorder has been treated effectively with Ritalin, methylphenidate and d-amphetamine, but these drugs can have side effects. Over 20 years ago, Donald J. Cohen, M.D., director of the Yale Child Study Center, found that another drug called clonidine could lessen tics and improve ADHD symptoms, but clonidine wears off quickly and can have serious side effects.
Guanfacine was identified as a superior drug to clonidine in the Yale laboratory of Amy F. T. Arnsten, associate professor of neurobiology. Arnsten's team found guanfacine has fewer side effects in animals and strengthens functioning in the brain's prefrontal cortex, which is known to malfunction in ADHD patients.
"This research represents an excellent example of how clinical and basic researchers, collaborating together, can discover new treatments for neuro-psychiatric disorders," said Arnsten.
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In addition to Scahill, Cohen and Arnsten, the study authors at Yale include Phillip B. Chappell, M.D., Young S. Kim, M.D., Robert T. Schulz, Lily Katsovich, Elizabeth Shepherd and James F. Leckman, M.D.
The study was supported in part by grants from the Children's Clinical Research Center, Mental Health Research Center and the Tourette Syndrome Association
Marci,I've had TS since at least age 5...although I wasn't dx' until I was in my 50s, as well as for AD/HD.
How fortunate your son is (and you) to at least know his tics/jerks have a name and that it's more than just being a hyper, nervous child. And that he can talk with you about it. No one ever spoke of my jerks to me, except for "stop that!" "Don't do that!" In the 1950s the thought of a neurological disorder wasn't even thought of, just like very little was know of ADHD. I just lived with embarrassment and teasing. 
Incidentally, TS can be controlled (at least by adults) to an extent...I control it when I'm face to face talking with someone. But if I think no one is watching, boy, oh boy! Also, TS does not have to involve vocal tics, no matter what you are told.
Anyway, I take Paxil (for anxiety as well) and it does seem to help some, since Paxil is also rx'd for OCD, which Tourettes definitely is...very obsessive, compulsive. And I agree, if possible, to see a neurologist about his possible Tourettes.
Good luck!
Marci,
What med does your doctor want your son on? Just curious . . .
Both Ritilain and Strattera made my son's tics worse....he is now med free and doing the alternative/natural thing.
My son also has adhd/ts, and he is able to take most of the ritalin based stims with no noticable increase in his tics. Adderall definitely made them worse. And just recently I stopped the stims b/c a high dose of metadate cd aggrevated the tics.
My son's tics disappeared immediately after stopping the stims (most of them, that is). He still has some tho, but they are definitely not caused by the stims.
If your life is really in turmoil due to the adhd, I would say try the ritalin based products. They work quick and are out of the system quick. It was a lifesaver for me for many years. Then if you notice an unacceptable increase in the tics, stop the meds. The problem with using a med like strattera is that it can take up to 6 weeks to begin working. The stims work immediately at the right dose. And you can stop immediately too.
Best of luck to you.
I will have to check to see if Tenex is available in Canada. Thanks for the tip.Hi Marci-My son has ADHD and a tic disorder. We did not know this when he started his med trials. All of the usual front line medications for ADHD exacerbated my sons tics(to an extreme degree). Finally, we met with a psych who specialiazed in co-morbid ADHD. He prescribed Tenex(guanfacine) which is considered a front line med for ADHD children who have Tic isssues or Tourette's. You may want to research it or ask your doctor about it. I feel it took a long time for my sons tics to disappear after being removed from the other stimulant based medications. The bottom line is there are other options for children with Tics that not alot of people or Doctors know about-but if you choose to medicate be aware that there are choices that will work well for your son without making his Tourettes worse and may even help. Keep us posted on how things go.
Thanks for the info. My dr. is recommending dx right now. The trouble is that we live in a very remote community and the closest dr's that are not gp's are 6 hrs away. I am planning a couple trips this summer (around my work) to take my son in to see the psychiatrist at the Tourette Clinic so I hope he can give me some guidance.
Right now I have to perscription for dx but have not brought myself to fill-it. Still feels weird in my hand.
Marci,
In your shoes, I would see a neurologist and ask about medication for an ADHD/Tourette's kid. My son (dx with ADHD, anxiety and tic disorder) sees a neurologist for migraines and occasionally we run all his meds by her to see what her reaction is from a neurological standpoint. She did tell us that she treats all her Tourette's kids with Focalin, a fairly new refined version of Ritalin that is supposed to cause fewer side effects than the other stimulants. Focalin is available in a short-acting (3 to 4 hours) version and a just-introduced long-acting form called Focalin XR. My son has tried regular Focalin and we did not notice any appreciable increase in his tics. (Of course, every kid is different and meds are a trial-and-error process.) My son is currently on no ADHD meds and his tics tend to come and go. Adderall XR did make his tics noticeably worse to the point that other kids were asking my son what was wrong with his mouth.
Please post again if you have other questions.
Hi, Marci.
Here is a summary of all of the most recent research on the use of stimulants in persons with or predisposed to tic disorders:
http://tourettenowwhat.tripod.com/tics_and_stimulants.htm
Here is an explanation from Roger Freeman, MD, previous member of TSA's Medical Advisory Board, on the origin of the myth about tics and stimulants:
http://www.tourette-confusion.blogspot.com/
And here is more research information about tics and stimulants:
http://p082.ezboard.com/ftourettesyndromenowwhatfrm5.showM essage?topicID=74.topic
Most physicians knowledgeable in the treatment of TS now acknowledge that stimulants can be cautiously used in the presence of tic disorders.
Here is a controlled study of clonidine and methylphenidate (Ritalin) for the treatment of ADHD when tics are also present.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=pubmed&dopt=Abstract&list_uids=11865128& query_hl=1
I know it's a tough decision -- I hope the research results will be of some encouragement. Best of luck to you and your son!
My son is about to try Clonidine in combination with Concerta because he gets an eye tic on any stimulants. I hope it helps with few side effects if any.Marci, im sorry i didnt get back to you earlier... but My Tic isnt the result of this Med.... i have always had it. They called it a physical tic.... a habit is a habit, but a tic can come and go with no reason.... and thats what i have. I do know that when im on adderall that sometimes its either not there at all... usually when im focusing on work or something.... but when im not doin much and just sittin around and not doin anything ill feel my littl tic commin around.