Questions posted in the Child Behavioral Health Forum have been answered by
Dr. Kevin Kennedy of Harvard Vanguard Medical Associates.


Question Title: Add + Tics

Forum: The Child Behavioral Health Forum
Topic: Other Behavioral Topics

I dont know if this is the right forum for this, but atleast I can post one here..
My question is if a ADD patient with has TICS (a sideeffect of it) can get rid of it?
I now use rytalin (suppose to take 20MG a day.. I do 60.. works way better) ....

thank u..



Dear Wss,

Use of stimulant medications (Ritalin, Dexedrine, Cylert) in treatment of ADHD may result in the appearance of tics, or in the worsening of already-existing tics, particularly in patients who are at genetic risk. There is some controversy about how to approach this matter. Some say that the appearance of a tic should indicate cessation of the medication or, at the very least, a reduction in dose. Others say that the physician should balance the impairment brought on by the tic with that occasioned by the ADHD symptoms themselves. In any case, it is true that a medication-induced tic may not disappear if the medication is stopped - there is no guarantee.
You mention in your note that you are "supposed to take 20 mg/day", but that you are actually taking 60 mg/day. You are at the maximum recommended dose of Ritalin. Have you decided on your own to take this dose, without the guidance of your physician? If so, this is very unwise. Always consult your physician about your medication regimen, including the overall daily dose, how it should be divided and when during the day you should take the medicine. The particular regimen can have important implications re: possible side effects, such as insomnia, anorexia.
Your physician may also want to monitor your blood pressure. Two groups of patients are particularly vulnerable to elevated blood pressure on stimulant medications: African American male teens and children who have comorbid anxiety.

This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options that pertain to your particular medical condition or situation.

*Keyword: ADHD, Tics




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Kevin Kennedy, Ph.D.
Harvard Vanguard Medical Associates
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