Medicine is generally not needed for Tourette's disorder (TD). Usually doctors first work with parents and other caregivers (such as teachers) to educate them about the condition. Behavioral training, such as habit reversal training, creating an appropriate home and school environment, and helping build your child's self-esteem are often tried first.
Sometimes medicines are added to a treatment program when tics are severe or are causing your child a lot of physical, mental, or emotional problems. The goal of using medicine for tics is to improve a child's overall functioning, not to make the tics go away completely.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body. Dystonia affects about 1% of the population, and women are more prone to it than men.
An overall program that includes medicine may ease a child's general frustration and make him or her more comfortable around other people. Medicine sometimes helps a child with TD feel better mentally and function better at school and at home.
It is important to find out whether a child with TD also has symptoms of other conditions, such as behavior problems or mood disorders. Often problems such as depression or anxiety need to be treated first.
In the United States, treating tics with medicine is often an unlabeled use. This means that the U.S. Food and Drug Administration (FDA) has not approved the medicine specifically for treating tics or has not approved it for use in children. If a doctor suggests that your child take medicine to control tics, ask for an explanation of the benefits and risks. Ask how the medicine works, how long your child can take it, and whether there are any short-term or long-term side effects.
It is sometimes difficult to know whether medicine is helping to control tics. This is because the tics in Tourette's disorder can come and go. Also, tics may return or seem worse when medicine is stopped. Always work with a doctor when you want your child to start or stop taking medicine.
Clonidine (Catapres), which has been shown to reduce tics by 25% to 35% over 8 to 12 weeks.1 Known side effects include drowsiness and low blood pressure. It's important to check your child's blood pressure and pulse both at the start of treatment and during it. People who have heart conditions should talk with a doctor about whether they can take clonidine.
Pimozide (Orap) and haloperidol (only available in generic form), which reduce tic frequency and severity in up to 80 out of 100 people.2 Because of the side effects, these medicines are rarely the first ones used to treat tics. These side effects may include uncontrolled movements of the jaw, mouth, tongue, cheek, legs, and arms; heart problems; allergies; and drowsiness.