Pharmacologic Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Tourette and Tic Disorders. 2022

Robert J Jaffe, and Barbara J Coffey
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA. Electronic address: robert.jaffe@mountsinai.org.

A complete and comprehensive medical and psychiatric evaluation is necessary to delineate tic symptoms from attention-deficit/hyperactivity disorder, and to prioritize the most problematic symptoms for intervention. Stimulants are the recommended first-line pharmacotherapy to treat attention-deficit/hyperactivity disorder symptoms in patients with tic disorders. Comprehensive behavioral intervention for tics is an effective behavioral therapy that is generally considered the first-line treatment of persistent tic disorders. α-Agonists can be added to stimulants if tics increase or be used as monotherapy to target attention-deficit/hyperactivity disorder and tics. Atomoxetine is also an excellent option to treat attention-deficit/hyperactivity disorder and tics.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069445 Atomoxetine Hydrochloride A propylamine derivative and selective ADRENERGIC UPTAKE INHIBITOR that is used in the treatment of ATTENTION DEFICIT HYPERACTIVITY DISORDER. Atomoxetine,Atomoxetine HCl,LY 139603,N-methyl-gamma-(2-methylphenoxy)benzenepropanamine hydrochloride,Strattera,Tomoxetine,Tomoxetine Hydrochloride, (+)-isomer - T351671,Tomoxetine Hydrochloride, (+-)-isomer,Tomoxetine Hydrochloride, (-)-isomer,139603, LY,HCl, Atomoxetine,Hydrochloride, Atomoxetine
D000697 Central Nervous System Stimulants A loosely defined group of drugs that tend to increase behavioral alertness, agitation, or excitation. They work by a variety of mechanisms, but usually not by direct excitation of neurons. The many drugs that have such actions as side effects to their main therapeutic use are not included here. Analeptic,Analeptic Agent,Analeptic Drug,Analeptics,CNS Stimulant,CNS Stimulants,Central Nervous System Stimulant,Central Stimulant,Analeptic Agents,Analeptic Drugs,Central Stimulants,Agent, Analeptic,Agents, Analeptic,Drug, Analeptic,Drugs, Analeptic,Stimulant, CNS,Stimulant, Central,Stimulants, CNS,Stimulants, Central
D001289 Attention Deficit Disorder with Hyperactivity A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-V) ADHD,Attention Deficit Disorder,Attention Deficit Hyperactivity Disorder,Brain Dysfunction, Minimal,Hyperkinetic Syndrome,Minimal Brain Dysfunction,ADDH,Attention Deficit Disorders with Hyperactivity,Attention Deficit Hyperactivity Disorders,Attention Deficit-Hyperactivity Disorder,Attention Deficit Disorders,Attention Deficit-Hyperactivity Disorders,Deficit Disorder, Attention,Deficit Disorders, Attention,Deficit-Hyperactivity Disorder, Attention,Deficit-Hyperactivity Disorders, Attention,Disorder, Attention Deficit,Disorder, Attention Deficit-Hyperactivity,Disorders, Attention Deficit,Disorders, Attention Deficit-Hyperactivity,Dysfunction, Minimal Brain,Syndromes, Hyperkinetic
D013981 Tic Disorders Disorders characterized by recurrent TICS that may interfere with speech and other activities. Tics are sudden, rapid, nonrhythmic, stereotyped motor movements or vocalizations which may be exacerbated by stress and are generally attenuated during absorbing activities. Tic disorders are distinguished from conditions which feature other types of abnormal movements that may accompany another another condition. (From DSM-IV, 1994) Post-Traumatic Tic Disorder,Tic Disorder, Chronic Motor or Vocal,Tic Disorder, Post-Traumatic,Tic Disorder, Transient,Tic Disorders, Vocal,Vocal Tic Disorders,Childhood Tic Disorders,Chronic Motor or Vocal Tic Disorder,Motor Tic Disorders,Motor or Vocal Tic Disorder, Chronic,Tic Disorders, Childhood,Tic Disorders, Motor,Transient Tic Disorder,Childhood Tic Disorder,Motor Tic Disorder,Post Traumatic Tic Disorder,Post-Traumatic Tic Disorders,Tic Disorder,Tic Disorder, Childhood,Tic Disorder, Motor,Tic Disorder, Post Traumatic,Tic Disorder, Vocal,Tic Disorders, Post-Traumatic,Tic Disorders, Transient,Transient Tic Disorders,Vocal Tic Disorder
D015897 Comorbidity The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
D020323 Tics Habitual, repeated, rapid contraction of certain muscles, resulting in stereotyped individualized actions that can be voluntarily suppressed for only brief periods. They often involve the face, vocal cords, neck, and less often the extremities. Examples include repetitive throat clearing, vocalizations, sniffing, pursing the lips, and excessive blinking. Tics tend to be aggravated by emotional stress. When frequent they may interfere with speech and INTERPERSONAL RELATIONS. Conditions which feature frequent and prominent tics as a primary manifestation of disease are referred to as TIC DISORDERS. (From Adams et al., Principles of Neurology, 6th ed, pp109-10) Habit Spasm,Tic, Motor,Tic, Vocal,Habit Chorea,Habituation Spasm,Tic,Tic, Gestural,Tic, Transient,Chorea, Habit,Choreas, Habit,Gestural Tic,Gestural Tics,Habit Choreas,Habit Spasms,Habituation Spasms,Motor Tic,Motor Tics,Spasm, Habit,Spasm, Habituation,Spasms, Habit,Spasms, Habituation,Tics, Gestural,Tics, Motor,Tics, Transient,Tics, Vocal,Transient Tic,Transient Tics,Vocal Tic,Vocal Tics

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