Drug and non-drug treatments of children with ADHD and tic disorders.
OBJECTIVE
To review the treatment of ADHD in children with chronic tic disorders.


BACKGROUND
Tic disorders are relatively common in school-age children and range from mild to severe. Children with mild tics may not require medication for the treatment of tics. The co-occurrence of attention deficit hyperactivity disorder (ADHD) and disruptive behavior are common in children with tic disorders and may be associated with significant morbidity.


METHODS
We conducted a literature search to identify reports of tics as an adverse effect to stimulant medication, the treatment of children with ADHD and tics as well as novel treatments that have been proposed for the treatment of ADHD in children with tic disorders.


RESULTS
The preponderance of evidence suggests that stimulant medications are safe and effective in the treatment of children with ADHD and tic disorders. A minority of children with tic disorders may show a worsening of tics or not tolerate stimulants for other reasons. The growing list of non-stimulants provides options for clinicians and parents of these children.


CONCLUSIONS
Treatment planning for children with ADHD and tic disorders involves careful discussion with parents on choosing the best course of action. Stimulants should be part of this discussion. More study is needed on non-pharmacological approaches to the treatment of tics and ADHD in this population.
Child Study Center, Yale University, P.O. Box 207900, New Haven, CT, 06520, USA.
Yann
Y
Poncin
Denis G
DG
Sukhodolsky
Joseph
J
McGuire
Lawrence
L
Scahill
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013981:Tic Disorders / Q000139:chemically induced / Q000188:drug therapy* / Q000453:epidemiology
D000316:Adrenergic alpha-Agonists; D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants; D017367:Selective Serotonin Reuptake Inhibitors