Hello All
It’s been three weeks since my son developed severe vocal tics, and one week since starting new ADHD medication (Aptensio).
Fastforward to today, and the tics are the same, some days worse. Also, his occupational therapist reported that on the last two visits, she’s noticed worsening in his implulse control, and heightened energy, “different type”. Not hyperactive/inattentive.
I’m so worried for my little one. I feel emotionally exhausted
How old is your son? Does he have a history of tics? What time of day are you seeing them?
Passing tics, both motor or vocal, are more common than most people realize, especially in boys ages 4-12. They frequently go away in their own. My son’s tics ramp up after Spring Break w/ end of school year stress / excitement, then they disappear in the summer.
If he is ticcing, that could explain the extra energy the OT is seeing. My son can have a nervous energy about him when tics flare up.
If this is the first time you’ve seen your son have a tic, I would just make a note of it, and keep a log of any future tics you also see. It wouldn’t hurt to contact your pediatrician as well.
If your son has a history of tics, I would write down when & what all you remember and bring it your pediatrician. They can refer you to a neurologist if the tics are becoming problematic.
Since the tics started before the stimulant medication, you are probably alright to continue with the medication- but keep your prescribing physician aware of the tics. My son's tics flared up the first 1-2 weeks on a stimulant, but once his body got use to it, they went back to normal. They are even a little better, as the stimulant medication gives him a better ability to control the tics.
Finally, kids with tics do tend to flare up more at home, especially after a school day. They spend all day trying to hold tics in and focus and all the million things they need to learn, that when they get home they sometimes just need to let it all out at a safe place.
Hopefully some of this helpful to you - let me know if you have any questions!
Thank you for sharing . He is having tics throughout the day, but I’ve noticed that they “flare up” at times. I’m assuming anxiety, excitement or overstimulation . It is affecting his self esteem , and he keeps his hands in his mouth . I’ve had to apply anti-biotic cream on them, as they were getting red and “ rough” . If things are not better by next week, I will request a neurology referall .
That sounds like a wise choice.
Depending on his age, a neurologist may recommend medication like guanfacine (which actually works pretty well with stimulants - some people take it to alleviate stimulant side effects &/or give an evening boost for ADHD treatment.) If your son is older, Habit Reversal Therapy is a behavioral therapy that is also effective for treating tics.
Praying for healing & answers for your son!
Thank you. He was prescribed Intuniv, and we tied it once, but he was very tired the next day. I’m scared to give it to him again 
I’m with you being emotionally exhausting. My 11 yr old son has been having a motor tic since December by rolling his head. He has been on stimulant methyalphanadate for 6 yrs. The Med works great with impulse control, attentiveness, and calming his energy.
He does have verbal tics too by saying a phrase repeatedly but I’m thinking it’s OCD.
We went to pediatrician and neurologist. The methylphenidate has a side effect causing tics. The neurologist prescribed Clonidine but didn’t stop tics. About a week ago went off methylphenidate and started Strattera with the Clonidine. It will take 2 weeks for Med to work. I’ve neen praying and looking for a counselor to learn coping strategies.
I’m hoping this new medication will work. We are on week two of Aptensio, and so far the tic have “improved” some. But he had also had two episodes of agrresio/irritability. It’s so hard trying to figure out what works and what doesn’t . I’m going to try an ADHD parent coach to teach me better skills to best help my son.
That sounds like a great plan. Though medication is typically the biggest / quickest improvement, ADHD also seems benefits from very specific parenting strategies.
Has the aggression been in the evening? Though my son doesn’t have huge crashes when his meds wear off, he does sometimes struggle with disappointment during those times.
Fingers crossed!
My daughter also gets tics, and we've learned that they are going to come and go, ebb and flow, and that they may be a different tic the next time. She's on a stimulant and the meds doc has said that the research is increasingly showing that tics are not caused by stim meds. My daughter did go on guanfacine, prescribed by a neurologist. It is safe to use with the stim meds. It does help anxiety and tics somewhat but she still does get tics. One other thing I heard from other parents whose kids have tics: don't draw attention to it, don't show you are nervous about it. They'll go away eventually but yes, may last longer than we want. Good luck!
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ADHD support
