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.