children s health issues
Tourette Syndrome and Other Tic Disorders in Children and Adolescents
Treatment of Tic Disorders
Reassurance and support Comprehensive Behavioral Intervention for Tics Medications If symptoms are mild, reassurance is often best, with as little attention paid to the tic as possible until it disappears on its own. Treatment can often be avoided if the family understands the disorder and if the disorder is explained to and understood by the child's teachers and schoolmates. CBIT is a type of behavioral therapy. It may help some older children manage their tics. CBIT includes the following: Cognitive-behavioral techniques (such as habit reversal training) Education about tics Relaxation techniques Habit reversal training involves teaching children new behaviors to substitute for the tics. For example, if the tic involves shrugging their shoulders, they may be taught to stretch out their arms until the urge to shrug passes. Education may involve teaching children (and their parents) to identify situations in which tics occur or become worse. Medications to stop tics are recommended only if tics persist and are interfering with the child's activities or self-image. The lowest dose needed to make tics tolerable is used, and doses are decreased as tics lessen. Formild tics,clonidineandguanfacineare medications that help. They can also help control anxiety and ADHD, which may accompany a tic disorder. However,clonidinecan cause drowsiness, which may interfere with the child's daytime activities. Althoughclonidineis also used to treat high blood pressure, it rarely causes low blood pressure in children. However, after children have takenclonidinefor a while, suddenly stoppingclonidinemay cause blood pressure to increase temporarily. Antipsychotic drugs may be effective even though psychosis is not the cause of tics. Effective medications include Children who have tics and who are struggling in school should be evaluated for learning disorders and provided with support as needed. If obsessive or compulsive traits are bothersome, a medication such as a selective serotonin reuptake inhibitor (SSRI), which is an antidepressant, may be useful. Treatment can be difficult to treat because the stimulant medications typically used to treat it may worsen tics. Sometimes low doses of these medications can effectively treat ADHD without making tics worse. Or a medication that is not a stimulant can be used to treat ADHD. 