My 8 year old son has been on Concerta for about a year. He developed a tic for the first time about 6 months ago. It stayed for about two weeks, while gradually changing, then went away. He’s developed another tic about two weeks ago and it also has gradually changed over the two week period. I point it out to him to try and get him to notice, and I know he can’t control it. I’m wondering if it’s due to the medication. Does anyone have experience with tics? Can you shed some light on how I can help him? I have never been a fan of putting him on the meds, but it does help him to calm down. Off meds, he’s restless and screaming like a wild animal all day. I’m worried the tics will go noticed at school (when he eventually goes back) and be made fun of by his peers. Thank you for your replies!
Tics on Concerta?: My 8 year old son... - CHADD's ADHD Pare...
Tics on Concerta?
Hello! My son has Tourette Syndrome along with ADHD (and so do 2 of my adult cousins), so hopefully I can help a bit.
Occasional tics in children are actually fairly common, especially in boys as they near puberty. They tend to wax and wane throughout the year, though you can usually find patterns (holidays, start & end of school year are common times to flare up.)
Based on scientific data, the current medical opinion is that ADHD and it’s treatments do not cause tics, though it may unmask tics in children already prone to them. Methylphenidate (such as Concerta) are usually well tolerated by children prone to tics.
My son is 8 and also on a methylphenidate (Metadate CD). He was diagnosed with ADHD on his 6th birthday, TS about 3 months later, and we started stimulant medication @ his 7th birthday (and are still using it.) What we noticed on the medication was that it did not seem to make his tics worse - in fact, he was better able to control them - however, they also don’t seem to fade in the summer like they did before medication. We currently do not treat his tics, as they don’t bother him and no one really notices them but me.
My advice would be to keep a log of when & what tics you see, and to let your prescribing physician know about the tics, along with your pediatrician if they are not the one treating the ADHD.
What tics are you seeing? If the tics are subtle and not bothering him, I’d recommend ignoring them, as pointing them out & trying to stop them can make them worse. If his tics are bothering him or if other children start teasing, then there are a variety of treatment options, though best to be guided by a medical professional. My son’s neurologist also recommended practicing deep breath techniques, using apps like Calm, and to try redirecting the more problematic tics.
Hopefully this CHADD article can also answer some of your questions.
My son had a tic as well. We did the same as you and pointed it out in hope he could better control it. His neurologist actually told us that makes it worse. Best to ignore it. Often they are associated with anxiety as well as stimulants. He added Guanfacine 1mg which allowed us to lower the stimulant dose. Tic went away. Guanfacine isn’t a stimulant and helps with tics, focus and anxiety. My son was a little zombie for the first 3 days on it but within a week he adjusted and was back to normal. Tic went away within 3 weeks. You just need to start on .5 mg and dose up to 1mg over several days. We split it in half and give .5mg morning and night in a spoonful of chocolate pudding. Hopefully this helps. Meds are all different for everyone but it may be worth a try!
We've had the same experience with Ritalin. My 8 year old started on it last summer and within a short time we started noticing tics. Her doctor didn't seem too concerned and said childhood tics eventually go away. We've changed her to Focalin and they continue. We stopped giving her meds when school closed because we wanted to see if they would get better. They have not.
She's basically gone through several tics over the year. One will stop and another will start. The motions are very noticeable at home, but her teacher told us she hadn't noticed them which makes me wonder if my daughter is aware enough to stifle them during school to avoid her peers noticing. We try not to point out when it's happening so as not to make her self conscious and stressed which seems to make it worse. I'd say when your son goes back to school, ask his teacher to take note of how often and how severe his tics are in class and then you can evaluate if it's likely to cause social struggles. Wishing you the best!
It is common for kids with tics to stifle them at school, which leads to explosion of them when they finally get home. It’s like having to pee - you can learn to hold it for awhile, but eventually it’s gotta come out - the more so the longer you’ve held it.
And teachers are great at spotting tics. I thought my son just had a vocal tic, then my husband mentioned finger-flicking and his teacher spotted finger sniffing. Which is when we went started seeing a neurologist.
Hi, I can relate to what your child is going thru. When my daughter was on concerta I never noticed the tics until now but she is on Vyvanse. I try to point it out too but I don't think they realize they are doing it. I told her Dr and prescribed another medicine to go with the Vyvanse to stop the tics but I'm scared to give it too her. They say to cut in half and take like that but said it had side effects like high blood pressure so idk if I want to give to her. I wish it was something out that there. I just don't want my child taking this medicine to control this and another to control the side effect of that medicine, it's just too much for a 9 year🤦
first line tic medications (Guanfacine, Clonidine) were initially developed to be blood pressure meds - but did a poor job of effecting blood pressure. They are also secondary choices for treating ADHD. They typically aren’t as effective as stimulants, but can be better tolerated in children who aren’t having success / too many side effects with stimulants.
It’s very common to combine them with stimulants though for ADHD. Even for children without tics, as the non-stimulant can balance out some of the stimulant side effects.
If tics are related to Concerta, they show up within a few weeks of starting or increasing the medication and don't go away until the medication is stopped. Your history doesn't suggest an association. Rather, he may be one of the 10% or so of children with ADHD who ultimately develop tics. Our son had them for a while and then they faded. We did not change his stimulant medication.
thank you for that information.
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