https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/the-tic-service/medication-for-tics-and-tourette-syndrome/
Medication for Tics and Tourette Syndrome
Tics are often managed first with psychoeducation and behavioural intervention. Behavioural intervention can be as effective as medication for a lot of children. For some children, medication is also an option. Medication is considered when tics are severe and interfere with everyday functioning and cause pain and injury.
Types of medication
The Tic Service advise medicines recommended by the European clinical guidelines for Tourette syndrome and other tic disorders. There are two different classes of medication for tics.
Centrally acting alpha agonists
These medications work by acting on specific receptors in the brain called alpha-adrenoreceptors and reduce the effect of noradrenaline in the brain. They are mainly used to treat tics and Attention Deficit Hyperactivity Disorder. They are also sometimes used to treat high blood pressure (hypertension). These medications are not addictive, but it is unwise to stop taking them suddenly. This is because the medication can reduce blood pressure and stopping suddenly can lead to blood pressure going up quickly. Two medications in this class are Clonidine and Guanfacine. Clonidine is usually given in two to three divided doses daily to reduce the risk of side effects. Guanfacine is usually given as one dose at night. Your child’s heart rate and blood pressure will be monitored.
Anti-dopamine medications
These medications work by blocking the dopamine receptors within the pathways in the brain, reducing the effect of dopamine in the brain. They are used to treat tics and are also used to treat psychosis. Examples of medications in this class include Aripiprazole and Risperidone. These medications require a blood test and sometimes an ECG (heart tracing) before your child starts taking them.
Tic medications and other conditions
Children with tic disorders commonly have other co-occurring conditions such as Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Disorder. We advise that the condition that is most troublesome is treated first. Your doctor will advise you about medication which is suitable for children with tics and another condition. It is good to know that stimulant medication for Attention Deficit Hyperactivity Disorder is often used for children with tics. The evidence shows that for most children stimulant medication does not increase tics.
Which medication is right for my child?
For children with tics and Tourette syndrome, medication may help to reduce the severity and frequency of tics. All medications can have side effects. Further reliable information about individual medications, including side effects, can be found at: Further reliable information about individual medications, including side effects, can be found on www.medicinesforchildren.org.uk/
The decision to take a medication will always be made in discussion with a doctor. If you want further information on medication for tics and Tourette syndrome, speak to your doctor at your local CAMHS or Community Paediatrics service who may also consult with the Tic Disorder Service.