View Full Version : 12 Year old ADHD boy now with tics


JimmyJim
08-18-15, 12:32 PM
Hello:

My son has been diagnosed with ADHD for quite some time now, and for the past year had been doing really great in school for the 1st. time finally, and was getting very good grades. He would love to read and write and was always very active in sports.

For the past 2 months over the summer he started opening and closing his drawers before going to bed and started to tic at night. Occasionally he would talk out loud as well. He no longer reads or writes and seems to be depressed. Even with sports he is completely different now. He used to be very involved with the game and would act as team captain helping the soccer team play. Now he doesn't, and just looks bummed. When I ask how the practice went, he would just say fine. He never ever tells us how he feels. He's a completely different kid-in a very short amount of time.

Doctor says he should try Intunive and it may help. We're on day 2 and he seems even more tired than ever. I don't want to put him on this medication, but I've seen him tic while biking and it's scary....he turns his head for some time and is not looking where he is going. He just had 2 accidents, so I thought I'd give this a try. I'm so scared for him. Anyone else had the same thing? Recommendations?

Thanks-

busymomonli
08-18-15, 04:11 PM
You don't mention if he was on medication already when he started the tics? Tics can be a side effect of some meds, and changing or lowering the dose may help. If the Intuniv is causing him to withrdraw, I would call the doctor and ask to switch.

I have a 12 year old son as well. We have decided to forgo all meds because they caused depression in him. We went through so many, and every one had the same effect. He would withdraw, not talk, and lose interest in things he loved. He even said a few times he would rather be dead. That was it for us, and we decided it wasn't worth it. Now we are trying to teach him to manage his symptoms on his own. It's been hard, but he's maturing somewhat and that has helped.

JimmyJim
08-18-15, 05:09 PM
Thanks for the reply. He was on Ritalin LA, but we stopped during the summer. We just give it to him for school.

Does your son have tics?

I just can't believe how fast this happened. From doing great to this. It seemed to start after a large growth spurt.

busymomonli
08-18-15, 05:16 PM
My son never had tics, but did develop some strange habits while on medicine. He would pick his fingers and his lips endlessly, which is something he never did before. He also chewed on anything and everything. He still does this, but when he was on medication he would chew the oddest things. It was so bad the school called because the teacher was worried he would choke on something, and when he couldn't find something he would chew his shirt collar or sleeve and it was always wet.

My experience with medication is that they often need to be changed as they grow a resistance to them. My son was on Concerta and it worked magically for a year, then suddenly stopped. But I guess their growth could explain that.

namazu
08-18-15, 07:45 PM
Several thoughts on this...

1. There are valid reasons to consider not giving meds during the summer -- catching up on growth if it suppresses your son's appetite, perhaps less need because there's more activity and less focused work in the summer, etc. That said, ADHD doesn't take summers off. Could your son be experiencing social difficulties, having trouble with sports due to distractibility, or other potentially ADHD-related problems that are frustrating him? Kids with ADHD are prone to accidents due to not paying attention or doing things impulsively.

2. Tics and ADHD are common "playmates", if you will. Especially if you have a family history of tics or OCD (but even sometimes without), late childhood is a common time for tics to appear or worsen. Stimulant meds can make tics worse for some people, better for some people, and make no difference for others. Tics themselves (unless directly caused/exacerbated by meds -- which doesn't sound like the case since they have mostly occurred in the summer when he's off meds) tend to wax and wane over time -- becoming worse or better, or changing form, without a whole lot of obvious rhyme or reason. Stress can exacerbate them. Having attention called to them can exacerbate them. There are effective strategies that can be taught to reduce them, or to channel them into less bothersome or dangerous forms. But it may just be something that will run its course.

3. The opening and closing drawers thing would make me a little concerned, especially if he feels like he "has" to do it and isn't just, say, absent-mindedly looking for pajamas or playing around for the fun of it. ADHD and tics (especially tics) frequently coexist with obsessive-compulsive disorder.

OCD involves obsessions, which are persistent/recurring/intrusive ideas or images of something extremely distressing or terrifying, and compulsions, which are actions taken to try to prevent or check that the awful thing won't happen/hasn't happened. The nature of the obsessions and compulsions varies by person. People may sometimes recognize rationally that their obsessions are unrealistic (though they feel very real and can't be shaken easily). The compulsions may have very little to do, logically, with the obsessions (at least, from an outside perspective), but they serve to counter the anxiety -- though at the same time, reinforce the connections. And sometimes, especially when tics are also present, sometimes compulsions are done just to feel "right".

Given that your son has been seeming glum lately and opening/closing drawers -- for which there could be many explanations, admittedly! -- it might be worth inquiring in this direction to rule out OCD. (If present, OCD can be treated with both specific types of therapy and medication.) Because the obsessions can be both extremely disturbing and also sound ridiculous (even if they feel very real), sometimes people may be reluctant to divulge what it is that's bothering them.

4. Your son's a pre-teen. Puberty, junior-high-age social shenanigans, etc., can all be factors. Plus at this age it's pretty common for kids to start wanting their parents to leave them alone, quit pestering them with (well-intentioned) questions, etc. Some of this might play into it.

5. Depression also frequently coexists with ADHD/tics, and puberty-ish is one of the more common times when it can rear its ugly head. If your son's sleep habits or eating habits have changed noticeably, these can be signs of depression, in addition to mood and behavior changes. (Excluding the kind of wolfing-down-everything-in-sight that's common during a growth spurt!)

6. Intuniv tends to be more helpful with impulsivity and physical hyperactivity and sometimes tics than with other aspects of ADHD. The same ingredient that's in Intuniv, guanfacine, has also been used to lower blood pressure and help with sleep. Tiredness is a very common side effect of the medication, though it may diminish with time. It's usually worst at the beginning. I agree with busymomonli that if he's seeming withdrawn after starting the medication, it would be worth talking to the doctor. Ditto if the tiredness doesn't go away, or if he complains of light-headedness (which can be a result of reduced blood pressure) or other side effects.

So I guess my advice would be to try -- and I know it may not be easy if he's in the one-syllable grunted answer phase! -- to get a sense from him of what's going on.

Tell him you've noticed that he doesn't seem to be doing some of the things he seemed to enjoy before -- reading and writing, getting excited about sports -- and you're wondering if everything's OK with him. He may tell you everything's fine, or maybe he'll tell you that it's summer, so duh, he's not going to waste it reading and writing, or there's some bully on his team, or he keeps spacing out and missing the ball, or he has a crush on someone who maybe hasn't returned the interest, or who knows what.

You could ask him what he's doing when he's opening and closing drawers -- and if there's something he's looking for, or if there's something on his mind or something bothering him. Again, for various reasons, he might be reticent, but if you ask gently and lovingly and without cornering him, he might give you some insight.

And certainly you should mention your concerns to his doctor regarding the meds, tics, behavior/mood changes, etc., especially if things don't improve by the start of the school year.

Best wishes to your family!

sarahsweets
08-19-15, 03:49 AM
my son had a brief period where he developed a throat clearing tic. He was prescribed clonidine when this happened and it cleared up. He has never had an issue with it since and he is no longer medicated.

LynneC
08-19-15, 10:25 AM
Thanks for the reply. He was on Ritalin LA, but we stopped during the summer. We just give it to him for school.



I just can't believe how fast this happened. From doing great to this. It seemed to start after a large growth spurt.
I wonder if much of this has to do with puberty and the changes that are happening within his body?
What has been doing for the summer? Has his social life changed recently?

JimmyJim
08-19-15, 02:40 PM
Thank-you Namazu for all of that great information! The doctor is supposed to call back today. We're also going to contact a psychologist for help as well. Of course, none are covered by our insurance.

LynneC, I sure hope this is just something to do with puberty and he will be his old crazy run around self again.

His social life hasn't changed, other than the fact it's summer so he has less friend interaction on a daily basis.

Thanks all for your help!!

zette93
08-19-15, 08:18 PM
It takes about 3 days to adjust to Intuniv, then the tiredness should lift. The first time we put my son on it, on the 3rd day he fell asleep so deeply at school that they called me to come get him, because they couldn't fully wake him. It scared me, so we took him off and tried again during the school break. We had several times of trying different dosages, and each time he went up or down, it took 3 days to stabilize at the new dose.

It turned out not to be an effective med for my son -- 1mg didn't do much for him, and 2mg made him really spacey. Also watch out for severe constipation -- my son had take a maintenance dose of Miralax for months when he was on 2mg. Hopefully you have a better experience.

JimmyJim
08-20-15, 09:16 AM
More great info. thanks zette93!

My son is looking better on his 4th day on Intuniv. He's talking and making fun of me like he used to. He's on 1mg btw. We're going to give this at least a week and see how we're doing...he's going to sleep a lot better than he was. He had a good playdate last night and he was his old obnoxious self..I was so happy to see that. He's quite funny, and quick with his humor. It's not that easy to get him playdates sometimes. It amazes me how many people will cancel playdates at the last minute.

My wife spoke to the doctor yesterday, but only for a little bit...he said if after the week has past, and if he's still sleepy during the day, there was a short acting option to Intuniv. Nice that we at least have options. Now I'm wondering if adding his Ritalin LA (or short acting) would be a good idea or not. I guess I'll get to that when the week has passed.

JimmyJim
09-27-15, 09:29 AM
Update. He's better after seeing a psychologist specializing in tics and ocd. Evidently he's very busy and said he's really not taking on any more patients, but he said he would meet my son. The psychologist knew my son was very against going and told him that if he thought he could control his ocd, he would not have to see him. After that ONE visit, his tics remain, but his ocd seems to have slowed for the time being anyway. I'll just occasionally see him touch his body in the same pattern a couple of times. He's also less sluggish and more like himself. I have to wonder if it's also the social interaction he gets from school that might be helping him. When he's home his favorite activity is unfortunately XBOX if we can't get a playdate together.

The amount of Intuniv we're giving him is so low, we're considering taking him completely off. It does seem to have a side effect of making him pee himself, and unfortunately he doesn't seem to mind and will just continue whatever he's doing instead of changing his clothes. Ugh....

My son saw Mazerunner last night with some friends and came home terrified. I had to sleep with him and noticed some tics as he was trying to sleep, but they only lasted about 10 min. Wish I knew about that movie beforehand.

OLSD2015
10-23-15, 07:50 AM
Jimmy - I saw your post. I think you can help me with mine. Here it is: http://www.addforums.com/forums/showthread.php?t=172638

Anything you can share would be appreciated. Thank you.