Effective treatment for children with ADHD and chronic tic disorders

ST. PAUL, MN Research has recently revealed an effective drug therapy for children who have chronic tic disorders (including Tourettes syndrome) concurrent with attention deficit hyperactivity disorder (ADHD). As many as nine in 10 children with tic disorders also have ADHD. Previously, the use of medications most commonly prescribed to treat children with ADHD had been discouraged for those who also had tic disorders, either because their benefits had not been clinically established or had been associated with a worsening of tics.

The stimulant methylphenidate (MPH), also known as Ritalin, has long been the mainstay of treatment for ADHD, with clonidine as the most commonly prescribed alternative. A new study, published in Neurology, the scientific journal of the American Academy of Neurology, has demonstrated that both MPH and clonidine, especially when used together, are effective in treating these children, with minimal side effects.

The most effective treatment for ADHD in our trial was the combination of clonidine and MPH, according to study author Roger Kurlan, MD, of the University of Rochester Medical Center in New York. Improvements related to MPH were observed in the areas of on task behavior and attentiveness, while improvements related to clonidine included reduced occurrence of crying, frustration, restlessness, excitability and impulsiveness.

The 136 study participants, ages seven 14, were divided into four groups and were administered: MPH alone; clonidine alone; MPH and clonidine; and placebo. The placebo group was included as no medication had been previously established to be effective or well-tolerated for treatment of ADHD coupled with chronic tic disorders.

Participants responses were measured using ten rating scales, including teacher and parent observation and task and functioning testing, at baseline and every four weeks of the 16-week study. Not only did tics not worsen during treatment with MPH, the

Contact: Cheryl Alementi
American Academy of Neurology

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