ADHD Meds & tics?

[Anonymous]

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?

[Anonymous]

my DS had tics on Adderall and they stopped as soon as he went off the med.

[Anonymous]

Thanks. Can you tell me what kind of tics? Did they start immediately after you started the meds?

Sorry for all the questions. Everyone has been so helpful.

[Anonymous]

Interesting. I thought my son has developed more tics on Focalin XR than before meds (these are the only meds we have tried), but after 3 months, they have abated significantly.

This goes for all other side effects, as well as the intended primary effect - they all tend to decrease after the body has got used to the medication.

[Anonymous]

14:37 here. My son always had a tendency to rub his fingers together. This increased sharply when he started meds, and now has decreased to his previous "baseline". If your son already has certain habits, I would expect those to increase, not to suddenly see completely new habits.

[Anonymous]

Forgot to add he compresses his lips as well. Those are his two tics.

[Anonymous]

But not all kids develop or show tics, right?

I'm a mess researching meds. I'm starting to get scared.

[Anonymous]

It happens with asthma meds too. You just have to decide which is worse.

[Anonymous]

First, most kids do not develop tics at all. It is not a frequent side effect.

For kids who do develop tics, if they are minor, the research shows that most tics will go away by the 6 week mark.

For my DS, who had tics before we ever started meds, most of them clearly made the tics worse and we stopped the med (think a transition from a small throat-clearing tic to complex facial grimaces). The exception was Ritalin, so that's what he takes.

[Anonymous]

The stimulant medications do not cause tics. But if there's an underlying pre-disposition for tics, they can bring them out. That's what happened to us. DS1 developed a tic on stimulant meds, DS2 did not. We discontinued stimulants with DS1 and they went away but re-emerged prior to puberty.

[Anonymous]

Anonymous wrote:The stimulant medications do not cause tics. But if there's an underlying pre-disposition for tics, they can bring them out. That's what happened to us. DS1 developed a tic on stimulant meds, DS2 did not. We discontinued stimulants with DS1 and they went away but re-emerged prior to puberty.

This is what our neurologist says. DS developed his first tics within a few weeks of starting concerta in 3rd grade. He was eventually diagnosed with Tourettes. By 5th grade the tics were very severe and there was talk of adding some pretty strong meds to control them. In the spring of 5th grade we decided to trial off Concerta. It took a few weeks but eventually the tics decreased to a very mild level.

[Anonymous]

Anonymous wrote:But not all kids develop or show tics, right?

I'm a mess researching meds. I'm starting to get scared.

I posted earlier at 14:37.

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.

[Anonymous]

I feel he is very mild. For him it's just a focus problem. He sits still, doesn't have impulse control issues. Tomorrow is the meeting with the dr., so I'll know more. This is not an easy process and there are a million questions that come to mind. Thanks to everyone for answering.

[Anonymous]

My dd takes a stimulant for ADHD and has no tics. She acts exactly the same, her side effects are a smaller appetite and when she first started, some difficulty getting to sleep. The sleep issue resolved after a few weeks, and now she sleeps fine. Still eats a small lunch at school and a bigger dinner when she gets home.

[Anonymous]

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!