First-onset tics in patients with attention-deficit–hyperactivity disorder: impact of stimulants

Roessner, Veit; Robatzek, Monika; Knapp, Guido; Banaschewski, Tobias; Rothenberger, Aribert

doi:10.1017/s0012162206001290

Cited by 70Attention Deficit Hyperactivity DisorderObsessive-Compulsive Spectrum DisordersStuttering Research and Treatment

First-onset tics in patients with attention-deficit–hyperactivity disorder: impact of stimulants

Roessner, Veit, Robatzek, Monika, Knapp, Guido, Banaschewski, Tobias, Rothenberger, Aribert·2006·Developmental Medicine & Child Neurology

DOI 10.1017/s0012162206001290

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Abstract

First-onset tics during stimulant treatment of attention-deficit-hyperactivity disorder (ADHD) are clinically relevant and remain a matter of scientific debate. Because there are limited clinical trials analyzing the risk of first-onset tics in stimulant-treated ADHD, a comprehensive evaluation is required for evidence-based clinical recommendations. An analysis of studies with high methodological quality (i.e. double-blind placebo-controlled) on first-onset tics during stimulant treatment of ADHD revealed that there seems to be no elevated risk of first-onset tics in children undergoing this treatment. Although a close temporal relationship might be seen in a few patients, the role of treatment duration, dose of stimulant, genetic vulnerability, and developmental aspects need to be further explored to clarify possible pathophysiological mechanisms of tic emergence under stimulant treatment. The results of high quality studies, in addition to specialized studies with methodological limitations, suggest that stimulants are the criterion standard for the safe and successful treatment of ADHD.

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Several recent reviews indicate that stimulants are adequately safe in patients with both ADHD and tic disorders and should not be disregarded when planning treatment for ADHD in these individuals.
“Several recent reviews [24, 119, 124] indicate that stimulants are adequately safe in patients with both ADHD and TD and should not be disregarded when planning treatment for ADHD in these individuals.”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [119]
The precipitation of first-onset tics during treatment with methylphenidate was found not to be different from placebo (range 0-20%), according to a review that examined predominantly short-term studies but included up to 4 years' duration of monitoring.
“The precipitation of first-onset tics during treatment with methylphenidate was found not to be different from placebo (range 0–20%), according to a review that examined predominantly short-term studies, but included up to 4 years’ duration of monitoring [119].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [119]

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Authors: Roessner, V., Robatzek, M., Knapp, G., Banaschewski, T., & Rothenberger, A.
Affiliations: University of Göttingen (DE)
TU Dortmund University (DE)
ORCID: Roessner, Veit
Banaschewski, Tobias
Rothenberger, Aribert
Venue: Developmental Medicine & Child Neurology
Publisher: Wiley
Published: 2006-06-19
Volume: 48
Issue: 07
Pages: 616
ISSN: 0012-1622 (ISSN-L)
1469-8749
DOI: 10.1017/s0012162206001290
OpenAlex: W1997290932
Cited by: 70
References: 63
Citations by year: 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 2 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 8 · 2013: 5 · 2012: 4
FWCI: 4.46
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm, 3361 d)
Locations: Developmental Medicine & Child Neurology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Social Sciences › Psychology › Clinical Psychology › Stuttering Research and Treatment
Keywords: attention deficit hyperactivity disorder, stimulant medication, children, treatment safety, genetic susceptibility, treatment duration
MeSH terms: Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Dose-Response Relationship, Drug, Humans, Risk Factors, Tic Disorders, Tics

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First-onset tics in patients with attention-deficit–hyperactivity disorder: impact of stimulants

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