Medication for tics and Tourette's syndrome

Strong evidence – there is lots of high-quality evidence that some young people find this treatment option helpful.

Your professional might offer you medication as a second treatment option if behavioural therapy wasn’t available, you didn’t want to try behavioural therapies or you didn’t find behavioural therapy helpful.

Medication won’t completely stop all your tics, but can help your tics to happen less frequently or be less intense. It can be difficult to tell whether medication is helping because tics can come and go, so it’s not always clear why you might be experiencing fewer tics.

If you start taking medication then your professional should suggest that you start taking a low dose and keep track of both how well the medication is working and any side effects.

There are two types of medication that are usually used to help with Tourette’s syndrome:

  • Antipsychotic medication
  • Noradrenergic medication

Antipsychotic medication

There are several different types of antipsychotic medications used to manage tics in Tourette’s syndrome. They are called antipsychotic medications because they were developed to treat psychosis, but they can be helpful for Tourette’s syndrome too. Your professional is most likely to offer you a medication called aripiprazole, but in some circumstances they might suggest that you take a different type of antipsychotic medication.

Noradrenergic medication (clonidine and guanfacine)

Clonidine and guanfacine are types of noradrenergic medications (which means they act on a chemical messenger in the body called noradrenaline). They were originally developed as blood pressure medication but are also effective for ADHD and to treat tics.

Research has shown that noradrenergic medications can be as effective as antipsychotic medication to reduce tics for some children and young people. These medications do still have side effects including feeling drowsy, headaches and a drop in blood pressure. Because of this, your blood pressure will need to be monitored while you take noradrenergic medication and your professional will explain that stopping taking the medication suddenly can cause a rise in blood pressure.

What type of medication will I be prescribed?

Choosing the right medication will be different for each person because Tourette’s syndrome can involve a wide range and severity of symptoms. Any other mental or physical health conditions that you might have (such as ADHD, obsessive compulsive disorder or depression) can also affect which medication might work best for you.

Your professional will work with you to decide whether taking medication is the best option for you. This might depend on:

  • the severity of your tics
  • how much distress they cause you
  • how much they interfere with your life
  • whether the medication would help with your tics or another mental health condition such as ADHD or OCD
  • whether you might need a combination of medications to treat your different symptoms

If you decide to take medication then your professional is most likely to suggest an antipsychotic medication called aripiprazole. However, if you also have ADHD then your professional might recommend guanfacine or clonidine instead.

If you don’t find aripiprazole helpful or you can’t take it then your professional might suggest another type of medication. This might be another type of antipsychotic medication such as risperidone or a noradrenergic drug such as guanfacine or clonidine.

You might need to try several different medications before you find one that suits you. As tics can naturally come and go, it can be hard to figure out which type of medication has worked best. To help with this, it can be useful to keep a diary of how you feel while taking each type and dose of medication. This means that you can look back and work out which medication worked best for you with the fewest side-effects.

Occasionally, your professional might suggest that you try a combination of medications. For example, your professional might recommend this option if your tics are very severe, they are causing you problems in everyday life and single medications haven’t helped very much.

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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