Diagnosing Tics and Tourette’s Disorder
A comprehensive evaluation is an essential starting point, both for establishing a diagnosis and ruling out other neurological or medical conditions. The doctor will ask about the patient’s early development, educational or occupational history, social development, medical conditions, and previous treatments. Additional evaluations, including a physical exam and testing such as MRI, CT scan, EEG, or blood tests may be recommended. Neuropsychological testing may also be indicated in some cases to facilitate educational planning.
Treatments for Tics and Tourette’s Disorder
Education is the first step in treatment, and learning about TS is an important part of managing the condition. In addition to the information our Program’s staff provides, the Tourette Syndrome Association is a helpful resource for patients, families, educators, and other clinicians.
Following evaluation, our clinical team will recommend a comprehensive treatment plan tailored specifically to the needs of each individual patient. Recommendations will include state-of-the-art, scientifically-based treatments, such as Cognitive Behavioral Therapy and/or medication. Consultation to referring clinicians and schools is also provided.
- Behavior therapy can help people with TS substitute other, more-acceptable movements or sounds for their tics
- Cognitive Behavioral Therapy can help reduce obsessive-compulsive symptoms
- Psychotherapy can help people with TS and their families cope with the disorder
- Several medications are used to reduce tics:
- Alpha adrenergic agonists (which are high blood pressure medications) such as guanfacine (Tenex) and clonidine (Catapres) can be used off-label for tics
- Newer neuroleptic medications, such as aripiprazole (Abilify) and ziprasidone (Geodon)
- Pimozide (Orap) and haloperidol (Haldol), which are the only formally-approved medications for TS
- Obsessive-compulsive symptoms may be treated with:
- Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), or other medications in this class
- Attention Deficit Hyperactivity Disorder (ADHD) symptoms may be treated with:
- Stimulants, such as methylphenidate (Ritalin)
- Alpha adrenergic agonists as above; longer acting versions (Intuniv) are indicated for treatment of ADHD
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