ADHD w/ Tourette's

My son has had Tourette Syndrome, OCD and ADHD since he was 3 yrs old. In first grade we started him on Clonidine, another medication that was originally for high blood pressure, just as Tenex was. It served him well for several years. and not only helped his ADHD but also helped is tics and his frustration level. I believe that if this medication is begun at a very low dose and upped carefully to the lowest effective dose, it is well worth running the slight risk of undesireable side effects. No parent wants to medicate but we really have to recognize the need for help and resort to what medicine has to offer our children when they are not able to function. All parents must educate themselves as well as they can about the medications and then decide if the child needs to try one. That decision is a team decision: Doctor, Parent and child. Good luck with your son. He is lucky to have you as his DaD!

Thank you so very much for your reply. That has helped me out alot. Im not sure how long it will take effect, but today was a very good day for him. I have sat him down and talked to him about his medication and he understands. I think it is important to explain to the children about their meds. He actually came home and said that he thinks it is helping. He understands his problem and he wants nothing else except to correct it. Maybe today was just a coincidence but I really hope that it works out. How long has your child been on Tenex?
Please anyone else with an opinion, please reply….Thank you

Kev

YOu are very welcome. One does feel quite isolated with these problems. You are correct in talking with your son about he medication and his condition. I explained my son’s chemical imbalance by comparing the making of a lemonade to his brain chemical production. Sometimes a little bit of this, or a little bit of that is what is needed to make it “just right”. Kids know that something is not quite right and have a right to know, in their own language and on their own level, just what the problem is and even take part in the solutions, including modifications and medications. They are the first to WANT to be successful and we can help them by empowering them, to a certain extent, to do so. My son is now 14 and took his clonidine until he was 13. He went med free for a while and had to go back to meds a few months ago. He is on Adderall along with Prozac for his ADHD and OCD. It is a trial and we must see how his tics react with this combination. “Different Meds for Different Heads”, a friend says and she is so correct. Good luck with the Tenex.

Kevin,

The latest medical thinking is that stimulant medications can be used with kids who have tic disorders, including Tourette’s. For those whose tics are exacerbated to an intolerable degree, another medication, such as Tenex or clonodine or others, the names of which I cannot recall, can be prescribed along with the stimulant. You may not want to use multiple medications with your child, or there may be other reasons why stimulants are not appropriate for him, but I thought the information might be helpful. My son has tics (not Tourette’s) and takes adderall without any exacerbation. Before we started meds I did some research on stimulant use and tic disorders and the information related above is essentially what I found out.

Andrea

Andrea, we are also using Adderal and haven’t experienced an exacerbation of tics. Each child is different and the results of use of stimulants in children with TS or any of the other tic disorders are varied and depends on the individual. Studies have shown that the “danger” of tic exacerbation isn’t as bad as was first thought. It is most common for stimulants to be used with clonidine or Tenex to counteract the effects of the stimulant on the tics. Whatever the choice of medications it is a trial and error affair to be worked out carefully with the pediatric neurologist. Good feedback from the school and family is crucial. Thank you for the stimulant/tic information. although Adderall is a bit different from the usual stimulants such as Ritalin or Dexetrine, I hadn’t made that clear in my former post, although it is the reason I posted. (Not quite used to this format/medium)
BJ Maya

I was actually posting in response to Kevin’s message, but I certainly agree with what you have posted. Adderall is thought to be a good choice when tics are present because it has a slower, smoother onset than other stimulant meds and wears off more subtly as well.

Andrea

BJ, You said earlier the Clonidin helped your son’s ADHD, in addition to the tics. Then this post you said your son was also on Adderall. Did he go on the Adderall because the Clonidin, while helpful for attention, was not helpful enough? My TS son has inattentive ADD. The doctor has been treating the TS with SSRI’s for two and a half years. His tics disappeared for nearly a year and then came back with a vengeance 14 months ago following a strep infection. We’ve been upping the SSRIs (first Prozac, now Luvox) with absolutely no improvement. I think the doctor went the SSRI route because there may be a slight OCD factor (but over time I’ve come to believe it really is just TS) and because SSRIs have fewer side effects. He started taking Adderall a year and a half ago (four months before the tics came back)—big improvement in attention. We see the doctor mid-April—my thought is to demand we end the SSRI and switch to Tenex or Clonidin. My hope was that, depending on the results, we could also stop the Adderall. But I don’t want him to lose the attention. Any views on this? Has your son experienced any adverse side effects from Clonidin? Thanks.

Hello, anon,
My son was doing so well and had been on meds for so long that we just decided to wean him off of the clonidine. A few months ago a new dr. wanted to try the Adderall with his Prozac for the ADHD. It has helped him. The clonidine did help him when he used it for so many years. I think the next med to try after this would be Tofranil if he has any problems with this one, that is. We are just in the first two months of the Adderall so time will tell.

Im getting alot of info from all these postings. I guess for the past couple of days since he has been on Tenex, my son’s impulstivity has decreased but I can see the hyperactivity still exists. As for the ADD, it is hard to tell since it is spring break. I will find out about his ADD when they start back up. But my question is we are going to the Dr. in 2 weeks. If I don’t see improvement with his symptoms, should I request a stimulant, ie. Concerta, Adderal, with Tenex? I know that Concerta is time released and has done WONDERS for my nephew (45 days of “A’s” in conduct and “A’s and B’s” in school work). I hear that time released meds are the best way. Im just really scared to the tics. His tics has decreased over the years from head jerking and now to sporadic twitch (maybe 5 times in a day depending on his activity). His head jerking was so bad it actually put him in pain. It is gone now and I don’t want to put him on a med that will bring it back.

Kevin

KEVIN,
I know it is hard to be patient but Tenex or Clonidine need a bit more time of trial period than the stimulants to see the optimum result that is going to be seen. I would try it at least 6 to 8 weeks before I made any decisions about trying something different. Specially since you are seeing some positive results already. The stimulants DO HAVE more of a probability of exacerbating tics so you might as well give the Tenex a while to work.
Good luck with it!
BJMaya

Kevin, Since my son hasn’t tried clonidine or tenex, I would go with BJ’s advice and give it a little more time. She reported (as have others I’ve seen who have posted elsewhere) that these medications often also help attention. The usual wisdom on stimulants for kids with tics is to try Adderall—it kicks in more smoothly than Ritalin and seems to have fewer reports of tic side effects. Concerta has the advantage of timed release but our experience on it was dreadful. We didn’t see any increase of tics with adderall. There is a good forum on TS and you might try posting there. They make you register first, which is a bit of a hassle, but the excellent webmaster was forced to do it to avoid spam.
Try http://neuro-mancer.mgh.harvard.edu/cgi-bin/forumdisplay. (Sorry I don’t know how to hyperlink.)