View Full Version : Does ADD medication improve tourettes?


mildadhd
02-07-13, 12:14 AM
Please excuse my ignorance.

I was wondering if symptoms of Tourettes decrease when a person with Tourettes takes ADD medication,

and vice versa,

do Tourettes symptoms increase when the ADD medication wares off?


Also what other kinds of medication do people use to treat Tourettes?



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namazu
02-07-13, 01:05 AM
I was wondering if symptoms of Tourettes decrease when a person with Tourettes takes ADD medication,
and vice versa,
do Tourettes symptoms increase when the ADD medication wares off?
Also what other kinds of medication do people use to treat Tourettes?

It varies from person to person.

For some people, stimulants can actually make tics and other repetitive behaviors (and OCD) worse.
Some people may have no change, or even some improvement in their tics.
It can sometimes be difficult to tell if it's really caused by the medication, though,
because tics naturally wax and wane over time.
For other people, the extra self-awareness that stimulants help provide
may help them manage their tics better.

The alpha-2a-agonists (non-stimulants),
clonidine (Kapvay) and guanfacine (Intuniv),
which are now approved for treating ADHD,
are also sometimes used to help reduce tic severity.
They can make some people tired, though,
and they lower blood pressure
(which can be good or bad, depending on what their blood pressure is to begin with).

(Me, I take a stimulant plus clonidine.
I don't have a Tourette's diagnosis,
but I have a related condition in addition to the ADHD,
and this combo helps me manage the symptoms.)

Some people with Tourette's take newer antipsychotics,
but usually only if the tics are very severe,
or if they also have problems with rage or aggression
or comorbid psychotic disorders.
These medications tend to have more frequent and more serious side effects
than stimulants or alpha-2a-agonists.

Many people with milder symptoms don't take any meds to treat their Tourette's at all,
though if they have comorbid OCD or ADHD, they may treat those with meds.

There is also a behavior modification technique
called "Habit Reversal Training" or "Habit Reversal Therapy" (HRT),
which is quite effective for some people.
It basically consists of recognizing an oncoming tic
and redirecting the body to do something else instead.
For example, if a person has a tic where they jerk their arm up,
they might instead clasp their hands until the urge passes.
Similarly, someone who has bothersome vocal tics
might practice substituting a less-disruptive sound or breathing pattern.
The goal of HRT is not to eliminate tics altogether,
though it can reduce them quite a bit,
but mostly it is to reduce the frequency of physically-injurious
or socially-stigmatizing or educationally-disruptive
or otherwise very bothersome tics
by substituting a less disruptive behavior
and learning to tolerate physical urges to tic better.

Maggie Sugar
06-11-13, 02:38 PM
Namazu, you gave a great overview of the meds in these issues.

My husband, and two of my children have TS. My dh and my oldest child also have ADHD. One of our children without TS has ADD without H and our youngest child has TS, Asperger's, Migraine, Chronic Pain and no ADHD or ADD.

Our oldest has fairly severe TS symptoms as well as ADHD with rage. She was started on Orap, and Nifidpine, these didn't work well, so Adderall (a stimulant used for ADHD) was added when she was about 11 or 12. It was like the skies parted. Our Neurolgist told us "the rule of thirds" when it comes to TS and stimulants: a third of patients' tics will get worse, they have to come off the stimulants, an other third of patients tics stay the same, they can stay on them if it helps the ADHD, a third of patients' tics actually get better. Our oldest child was among the last group; it made all the difference in the world for her.

Sadly, after she turned 21, she was getting more and more resistance from doctors who didn't want to prescribe the Adderal. They seemed to think that "people outgrow ADHD" (which we knew was not true) and while living on her own, she went through cold turkey withdrawal of the Adderall without saying anything to her father or myself. I was livid when I found out. The Neuro who originally treated her, and was the best Neuro we have ever had for these issues had died and the adult Neuro she was seeing was not familiar with either TS or ADHD.

We were lucky that she was able to be treated during the years she was in school, she didn't finish her Bachelor's Degree because she couldn't concentrate without the Adderall, and we've been upset about that for years.

We were glad that the stimulants really helped both her ADHD and her TS when she needed them the most.

Your mileage may vary.