Doctor for tics?

[Brenda]

I've not been posting for awhile because things have been so hectic but I need some info.What type of doctor treats tic disorders?We have been seeing a behavior pediatrician for over a year and he's not helping.My daughter now has motor tics and a vocal tic since increasing her Ritalin LA from 10 mg to 20 mg.Her ADHD is under control but the tics are getting bad.All the stimulants(and Strattera) have caused motor tics but this is the first vocal tic.She is grunting.I'm afraid they'll become permanent.Should I carry her to a child psychiatrist or a neurologist?

[Mayleng]

Brenda, bring her to a neurologist. Reduce or stop her ritalin now and take her to see the neurologist.

[Brenda]

Thanks Mayleng.That is what I thought.I'm only going to give her 10 mg tomorrow and call her ped for a referral.I really want to stop the ritalin but she has to have something.Maybe I should stop the ritalin because the tics look worse than the adhd.I just don't know what to do.We increased the ritalin last week and her teacher said she's seen a huge difference but I hate the tics.

[Mayleng]

s*rry Brenda that you and Steph are going thru this. I think you should see a Neurologist as soon as possible. See what the Neuro says. If it becomes tourettes it is more of a problem and the side effects of meds for tourettes is much worse than ADHD.

[ilovemyboys]

Meds are not a cause of Tourette's (T/S). Tourette's is inherited and you either have it or you don't. Stimulants can bring on Tics, but not Tourette's.

I was lucky b/c my son had tic's prior to meds, and was diagnosed with T/S and adhd before stims. Stims have helped him and not effected his tics. This is not the case for everyone. If I had started stims prior to his tics developing, I would have said that the stims caused the tics.

I agree that she should see a neurologist. Its possible that your daughter will have Tics with or without stims. You should discontinue the stimulants and see what it does to the tics. Then you can decide whether or not the stims are worth the tics. Different stims affect tics differently, also, so they are not definitely ruled out with tics or T/S.

My son is fine on ritalin based meds but Adderall was terrible for his tics.

Good luck. You also may want to research T/S. There are some good websites out there.

[Mayleng]

ilovemyboys, just a bit of background.

Stephanie does not get tics when off stimulants, but this is the first time she has had vocal tics on stimulants.
(right Brenda?)

She tried alot of stims as well as strattera and they all made her tic. So does she have tourettes, I don't know. But can stims trigger tourettes if she is susceptible to it?

[Brenda]

Right Mayleng.She only gets tics on stimulants.They always stop after she discontinues the stimulants after a few days.She never had any tics before meds.She's been on Adderall,Concerta,Metadate,Ritalin La,and Strattera.All caused tics.

ilovemyboys,my brother and three of my cousins have different motor tics.None of them have vocal tics.They are not ADHD but they have done drugs in the past.They have not been diagnosed as TS.I figured their tics are from doing drugs.Can you have TS without vocal tics?I thought if the tics stop when you stop the ritalin it was not TS.

I called her dr and he talked with a neurologist and he wants her to start haldol.I am scared of that.I called some neurologists and asked about the tics and they said if the tics are caused by the stimulants then she should see a Child Psychiatrist to help with her ADHD meds.

[ilovemyboys]

According to my neurologist, the definition for diagnosing T/S is 3 different tics (both motor and vocal) in a period of 1 year.

If she doesn't tic off meds, then i would assume it is not T/S. The interesting thing is that T/S is inherited, and its interesting that tics appear elsewhere in the family.

I personally would take her off the stims if the tics were severe (or even bothersome). I don't know if they will make the tics permanent, but I wouldn't risk it. I would investigate other adhd alternatives.

I have a wonderful neurologist that has a large adhd practice. I've heard stories tho that other neuro's don't like to treat adhd anymore, and leave it to the child psychiatrists. I think you should just find a very experienced doctor of any kind who can help treat your daughters adhd. Best wishes. I truly feel for you ...
I'm sure it is upsetting. I'm not sure what I would do if my son couldn't take stims. They help him so much...

[Mayleng]

Brenda said:

Right Mayleng.She only gets tics on stimulants.They always stop after she discontinues the stimulants after a few days.She never had any tics before meds.She's been on Adderall,Concerta,Metadate,Ritalin La,and Strattera.All caused tics.

ilovemyboys,my brother and three of my cousins have different motor tics.None of them have vocal tics.They are not ADHD but they have done drugs in the past.They have not been diagnosed as TS.I figured their tics are from doing drugs.Can you have TS without vocal tics?I thought if the tics stop when you stop the ritalin it was not TS.

I called her dr and he talked with a neurologist and he wants her to start haldol.I am scared of that.I called some neurologists and asked about the tics and they said if the tics are caused by the stimulants then she should see a Child Psychiatrist to help with her ADHD meds.

Brenda, I would not put her on haldol just yet. See if the tics stop when you stop the ritalin first. Also if you can't find a Neuro who is willing to take on a adhd child, then you might have to see a child psych - but make sure they know what they are doing. I am surprised the doctor mentioned haldol without first seeing your child. That would not be the neuro I would want my child to see. Or if it was your peds who want to put her on haldol, then I would be concerned about this peds too. I can tell you that most neuros would resist putting a TS child on this type of meds unless their tics are interfering so much with their daily life that the side effects of the meds outweigh the tics.

[mrsheartbuzz]

Hello!

My son is 11 and has been on every medication under the sun for his ADHD. We see a developmental specialist at a neurologist practice. She is wonderful! She has listened to my concerns and has voiced her opinions and together we came up with the best solution for my son. at this time, he is taking strattera/concerta combo. Low doses of each. Just enough to help him without the "tics" being too bad.(this combo gives him lip-licking ) We've been through much worse. She would rather him not be on stimulants, but strattera alone didn't work and strattera and anti depressants were a lethal combo for him(very high heart rate). He unfortunately needs SOME kind of pharmaceutical help. He is also taking clonidine ,which is supposed to help the tics.(and I think it does lessen the severity). What I have learned is every child reacts differently to different medications. Find what works best for you. Change it up when you need to. Pick the lesser of the evils and most of all,talk to your child about it. My son knows he needs meds and would rather take them than not. Good luck!

mrsheartbuzz (just counting the days until summer and NO MEDS!)

[theirmom]

You might want to check out a neurologist that specializes in movement disorders regarding tics.