ADHD Meds & tics?

[Anonymous]

OOPs-quotes were backwards above!!! top should have been quoted.

[Anonymous]

Anonymous wrote:

OP, if your child really needs medication, tics are not your primary problem. Seriously. Since I'm a research scientist, I read all the primary research literature on ADHD meds. The take-away is that stimulants are the safest and most effective psychiatric drug there is. Side effects include appetite loss, possible moodiness and difficulty sleeping, tics, etc, but like all side-effects, not everyone will display these symptoms. My child never showed moodiness, for ex, and no difficulty sleeping. He has always had a small appetite and is very small for his age, so the appetite suppressing effect is serious for us, but we monitor it and he eats most in the evening, when the meds have worn off. The tics are hardly visible, or only to me.

The psychiatrist should start your child on the lowest dose, keep him on it for at least a couple of weeks, and incrementally increase the dose until either the side-effects become too serious, or the optimal effect is reached. The two weeks minimum (up to a month) are useful because at first the body reacts strongly to each new dose, and after a week or so the body adjusts and the effect of the stimulant diminishes slightly. This is the standard of care, and anything else is suspect.

So don't be scared. Keep a record and report every observation to the psychiatrist.

I am not the OP but am in a similar boat as OP and appreciate PP's response and have a followup question. Based on your reading, do you have a sense of what the effect on tics is of using a stimulant when the child already exhibits some tics (mostly eye/head movements)? We are at the point with DS where I think it's worth a try with meds. Aside from the inattentiveness, focus, and impulse control, he is also mindlessly eating food, just inhaling food, particularly when he has a difficult task to do (not difficult in terms of the work itself, but difficult for him to get and stay focused). He has gained a lot of weight this year, and was not small to begin with. I think if the medicine could help him focus and decrease his appetite, it's worth a shot. I just worry about the tics. It's so frustrating to face multiple symptoms and not know which to treat first and how the other symptoms will react!

If you think he really needs meds, go ahead and try. The tics may start to increase, and you'll have to wait a few weeks to see if they stabilize, then decrease, which is what we would expect. If they don't, you may have to try a different stimulant.
Finding the right meds is a long and very thorough process - rushing will not help. It's better to work with a reputable psychiatrist, not a general pediatrician who has little knowledge of these drugs.

For the mindless eating issue, I'm not sure how out of the norm that is. Many adults have difficulty with portion control, especially when they are distracted by TV or other activities. The solution is to only eat at the table, for meals. Snacking at all hours is bad for one's health because it makes it harder for the body to feel full, plus snack food is often non-nutritious or downright unhealthy. In my opinion, children should not have free access to food if they don't know the rules of eating, or if they can't stop when they feel full. When snack time comes around after school, my kids serve themselves a bowl of whatever or an individual yogurt in the kitchen, put the rest back, and eat at the table while talking about their day - it's also a break from work. Then they do their homework in their room or in the living room, without food.

[Anonymous]

Does anyone have a psychiatrist they recommend in the close in Maryland/DC area who can work with DS who has a history of tics in prescribing ADHD meds. DS is in middle school and having the tics come back is real concern at his age so I’d like to find someone who has experience dealing with both issues if possible. Will ask his pediatrician as well, but wanted to see if DCUM had any recommendations. Thanks!

[Anonymous]

Anonymous wrote:Does anyone have a psychiatrist they recommend in the close in Maryland/DC area who can work with DS who has a history of tics in prescribing ADHD meds. DS is in middle school and having the tics come back is real concern at his age so I’d like to find someone who has experience dealing with both issues if possible. Will ask his pediatrician as well, but wanted to see if DCUM had any recommendations. Thanks!

Yes! Azin Bekhrad at Ross Center. I have 2 kids with tics who see her. One was able to tolerate ADHD meds and one wasn’t. She is very good.

[Anonymous]

Thanks, pp!

[Anonymous]

My son has always had intermittent tics. Like every few years, he'll develop a tic that will last a few months and then go away on his own.

He started taking ritalin about three months ago and developed a tic... or readopted an old tic. It did seem related to the medication in that it was worse during the hours the medication was at its most effective. after a couple of months, though, the tic went away.

It seemed to me that the medication triggered the tic but certainly didn't cause it. When my son's body got used to the medication, the tic went away (as they always have).

[Anonymous]

Anonymous wrote:I have posted serveral times about my son's new inattentive type adhd diagnosis. I'm researching medications and see that most list tics as a side effect. Can someone tell me how common this is? Do the tics only last while the medication is in the system or does it always stay?

DC took the lowest dose of Datrana patch and within two weeks developed blinking and oral tics as well as hives. The hives went away after a week, the tics stayed and diminished over time but still rear up under times of heavy stress- even 10+ years later. He has taken Straterra since and has tolerated that well- but is can have very sever side effects too- you have to watch carefully in the beginning.