Tics |
- Neurology referral is not required for clearance before treatment with stimulants.
- A referral to neurology may be indicated if the provider is not clear if movements of concern are tics, or management is complex.
- Tics emerge at similar age at which stimulants are prescribed, do not assume tics are secondary to stimulant.
- Not a contraindication for using stimulant medication for treatment of ADHD:
- Naturally wax and wane; emergence of tics with starting/changing ADHD medications may be coincidental. Likely tics will wane without discontinuation of ADHD medication.
- Frequency and severity can change with ADHD medications, but are not caused by the medication.
- Comorbid tics and ADHD may benefit from alpha-agonist medications.
- e.g., guanfacine and clonidine
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