Attention deficit hyperactivity disorder, tics and Tourette’s syndrome: the relationship and treatment implications. A commentary
Abstract
Tourette's Syndrome (TS) is now recognised to be a common childhood onset neurodevelopmental disorder. Attention deficit hyperactivity disorder (ADHD) is also a common childhood disorder. There are many cases in which the two disorders are comorbid. The reasons for this are unclear, but the comorbidity does not necessarily point to one genetic cause. Sleep is also often disturbed in individuals with TS and ADHD. The treatment implications of ADHD in the setting of tics or TS are important. Clonidine is suggested as a first line treatment. It was once thought that stimulants were contraindicated in the treatment of ADHD in the setting of TS, whereas it is suggested that they may be safe, but should be used judiciously. In addition, it was once thought that the combination of stimulants and clonidine was contraindicated, but from a large study the combination does appear to be safe. A relatively new medication for ADHD is atomoxetine, and although not documented widely in the setting of tics and TS, it may prove useful in this setting; further research is required. This commentary briefly discusses the comorbidity between TS and ADHD and offers treatment suggestions.
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For clonidine, there exists some evidence that it may reduce tics in frequency and severity, as well as improve ADHD symptoms; but worsening of tics may be seen in about a quarter of cases.
“For clonidine, which is only occasionally used in Europe to treat TD and/or ADHD, but recommended by some authors (especially where TD is the predominant disorder) [116], there exists some evidence that it may reduce tics in frequency and severity, as well as improve ADHD symptoms; but on the other hand, worsening of tics may be seen in about a quarter of cases [3].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [116]
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- Authors
- M. Robertson*, M.
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2006-02
- Volume
- 15
- Issue
- 1
- Pages
- 1-11
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- OpenAlex
- W1963644974
- Cited by
- 143
- References
- 91
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 10 · 2020: 15 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 10 · 2015: 5 · 2014: 5 · 2013: 11 · 2012: 8
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Stuttering Research and Treatment
- Keywords
- attention deficit hyperactivity disorder, Tourette syndrome, tics, comorbidities, pediatric neurodevelopmental disorders, sleep disorders, clonidine, stimulants, atomoxetine, combination therapy, therapeutic implications
- MeSH terms
- Atomoxetine Hydrochloride, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Tourette Syndrome, Humans, Methylphenidate, Propylamines, Adrenergic Uptake Inhibitors, Tics
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