View Full Version : Tics. Again.


ADHDKylee
05-26-09, 04:23 PM
When I first started on about 18mg of Concerta, I developed a tic in my right eye. Soon it started in my left eye as well. When my dose was raised to 36mg, I started to get a tic where I had to wriggle my nose like a rabbit. I switched to Strattera, and they all stopped. However, Strattera was not a good enough medication for me so I had to go back to Concerta. My dose was raised to 72mg, and I recently started to get a tic where I have to wave and wriggle my hands around, and another where I have to jerk my body to the one side or shrug my shoulders. It's like a pain or feeling of pins and needles until I do it. I try to hold onto my wrists or just scratch where I can feel the tic to surpress it, but it doesn't work. Is there a solution? Because right now, I am about ready to just throw my medication out. I have kids and even teachers staring at me all day as if I'm crazy, and I have no idea what to do because I know stimulant medication only makes tics worse.

Amaryste
05-27-09, 12:43 AM
Increasing the methylphenidate dosage can intensify the tics experienced on the lower milligrams. I would recommend lowering the dosage (ex: 54 mg) until they subside into a tolerable state. If this doesn't work, then try switching stimulant families or to other non-stimulants. There may be medications that counter this side-effect, so try asking your doctor.

ADHDKylee
05-27-09, 08:20 AM
We're in the middle of switching doctors, so I can't really ask anyone for now.. If I lower the dose the medicine won't work for what I need it for. We can't really afford to add in another medicine, and all the others seem kind of expensive too. I was hoping maybe the tics went away by themselves..

γ-quantum
05-27-09, 09:02 AM
i initally had some 'nervous tics' on ritalin as well, but didnt think much of it, as they only occured when i was among people. it was just around the mouth (jittering), and blinking eyes / twitching cheek occasionally.
but, i am always extremely tensed around people, as i dont know how to walk or move or where to put my hands and stuff, so i appear like a robot, anyway... the tics never happened when i was at home / alone and relaxed.
however, they did go away after a few weeks of taking ritalin, same as the tiredness side-effect went away, too. i am on the quick-release 10mg pill 3x daily though, not on concerta... yet.

Amaryste
05-27-09, 02:53 PM
If the adverse side-effects heavily impacts your day-to-day functioning, then it would be much better to take a lower dose that offers slightly less AD(H)D relief and side-effects. Of course, you won't be as focused, but you can accomplish more sans the frequent interruptions.

----------------------------------------
Example:

Higher Dose
75% Benefit - 55% Side-Effects = 25% Benefit

Lower Dose
58% Benefit - 20% Side-Effects = 38% Benefit

Which one would you prefer?
----------------------------------------

The main key here is to allow your body to adapt to the medication before titrating to a higher dose. Once the titration is complete, you'll be able to reap the benefits of your ideal mg without having other issues undo them. This should only take a few weeks at most like Y-quantum, though it is often reported one week is sufficient enough. (The only exception: If your tics are as mild as YQ's, I'd say stick to the 72 mg.)

ADHDKylee
05-27-09, 04:12 PM
The hand flapping/wriggling one only bothers me because my wrists get sore after a while.. I can't go down to 54mg though, I would have to go back down to 36mg, because I take two 36mg pills to make the 72mg. I find they get worse when I have some kind of stress. For example the first set started during first semester final exams, and this set has started during second semester final exams..

Amaryste
05-27-09, 05:16 PM
Hmmm, you have five options:

1.) Get a 7-day prescription for 54 mg.

2.) Or 27 mg (to add to the 36) to equal 63 mg.

It's like a pain or feeling of pins and needles until I do it. [...]

Because right now, I am about ready to just throw my medication out.3.) Stay on the 72: endure the tics and hope you make it. Try to ease stressful situations by preparing for them ahead of time.

There is no way to prevent motor or vocal tics unless the tic was brought on by the use of stimulant drugs, in which case stopping the drug may get rid of the tic.

http://www.everydayhealth.com/health-information/tics-prevention.aspx4.) Try a new medication. (Wellbutrin, Amphetamines, etc.)

5.) At your doctor's decision only: Try mixing Straterra with Concerta. (Straterra = level out the side-effects; Concerta = ADHD relief)

ADHDKylee
05-27-09, 11:30 PM
Thank you.. I don't have the Strattera anymore. That worked very well with the two together, but Strattera was way too expensive. Thank you for your help though

Amaryste
05-28-09, 12:43 AM
Yeah, unfortunately, I don't know any non-medical way to treat the tics aside from wishing luck.

That said, you can take a look at these articles. They're technically for TS, but it might be useful for you stimulant-induced tics.

http://www.ich.ucl.ac.uk/gosh_families/information_sheets/tourette_syndrome_non_medicine/tourette_syndrome_non_medicine_children.html

http://www.cincinnatichildrens.org/health/info/mental/diagnose/tics-ts-meds.htm