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Tics Due to Attention Disorder, Not Drug Treatment (Medscape - dead link)

QUOTES:

But a growing body of research demonstrates that tics can arise in children with ADHD whether or not they take medication. For example, a recent study found that 5% of non-medicated children with ADHD also had tic disorders, and were 60 times more likely than their peers without the attention disorder to have Tourette's syndrome.

In an interview with Reuters Health, Dr. Roger Kurlan of the University of Rochester in New York, who reviewed the findings from Dr. Turgay and his team, agreed that medications are not likely to blame when children with ADHD develop tics. Rather, he explained, patients often develop tics within 1 year or 2 after they have been diagnosed with ADHD, whether or not they receive treatment.

"Study after study after study is showing that medication is not part of the [tic] disorders," he said. "It's just part of the natural course of ADHD."

Also available at mkadhd.org

Thanks, KBurra !

Tourette Syndrome: Current Controversies and the Battlefield Landscape,
Neal R Swerdlow MD PhD
Department of Psychiatry, UCSD School of Medicine
Current Neurology and Neuroscience Reports 2005, 5:329-331

"Another controversy in TS treatment surrounds the use of stimulants, once disfavored based on reports of tic exacerbations. More recent prospective, longitudinal studies now support the safety and efficacy of stimulants in patients with comorbid TS plus ADHD, with some evidence for a reduction in tic severity in these patients. Nonetheless, based on residual lore and non-data-based concerns, stimulants may still be underused in TS patients."

TSNW - Tics and Stimulants

TSA Statement on methylphenidate (Ritalin) and clonidine (Catapres)

Roger Freeman MD on how the tics/stimulants myth came about:

Tourette Syndrome: Minimizing Confusion:
"Why Do Books Say That You Should Never Give a Stimulant Drug to Someone With Tics/TS? There was an observation on a few cases over 25 years ago that some children with ADHD, given a stimulant like Ritalin or Dexedrine, developed tics. This seemed to confirm some animal research showing that high doses of these drugs brought out stereotyped behaviour. For years after this publication, no one had the nerve to continue treating a person who developed tics, to see what would happen. Then drug companies were sued in the US, claiming that the childrens' TS was caused by the drug. The Scientologists picked this up and (through their "Citizens Commission on Human Rights") started warning people that if their child takes Ritalin, he/she will develop TS. To this day, the warning remains in the US and Canadian drug books, despite much clinical experience and research that shows this is not usually so. A recent study showed that roughly 22% of children taking any drug (including Ritalin) had an increase of tics temporarily. ADHD normally starts in very early childhood, so when TS followed, it was assumed that the drug was the cause; at that time TS was thought to be very rare, so something external had to be causing it. We use stimulants for concurrent ADHD fairly often, regardless of whether the child has TS, and have been doing so for years. But don't expect to see the warning removed from books any time soon!"