ADHD Symptoms The Link Between Tic Disorders and ADHD By Keath Low Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. Learn about our editorial process Updated on February 06, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Carol Yepes / Getty Images Table of Contents View All Table of Contents Understanding the Connection Related Conditions Tics and ADHD Medication Treatment Coping With ADHD and Tics Tics are characterized by repeated, sudden, jerky, involuntary movements of one’s face, shoulders, hands, legs or other body parts. Tics can also be vocal and may involve throat-clearing, sniffing or snorting, grunting, dry coughs, clicking, hissing, barking, or even words or phrases. These movements and/or vocalizations may occur frequently throughout the day or they may occur only occasionally. They tend to increase under excitement, physical or social stress, anxiety, or if the individual is very tired. Some medications are also believed to exacerbate tics. Tics occur in about 20% of school-age children. Approximately one in five children aged 6-17 years old may develop a tic, but may sometimes start as early as two years of age. Tics can sometimes occur alongside ADHD, which may lead some people to wonder if the two conditions might be related. This article discusses how the two conditions are related, other conditions that may commonly co-occur, and how tics can be treated. The Connection Between ADHD and Tics A 2016 study found that 35–90% of children with Tourettes also had ADHD. Research has found that chronic tic disorders, Tourette syndrome, and obsessive-compulsive disorder may share some underlying genetic and neurological origins, and an individual with any of these conditions is also quite likely to have ADHD. In children who develop tic disorders and ADHD, ADHD usually develops two to three years before tics. Related Conditions Tic disorders do appear to have a genetic link, as they tend to run in families, and have also been linked to environmental factors. They also tend to co-occur with certain conditions, which may be due to shared underlying genetic factors. Chronic tic disorders affect about one percent of children and may indicate a more serious disorder called Tourette syndrome (TS). Tourette Syndrome Tourette syndrome is a genetic, neurological disorder whose primary manifestations are the presence of motor and vocal tics. Tourettes is commonly associated with ADHD, obsessive-compulsive disorder, behavior problems, and learning disabilities. The National Institute of Neurological Disorders and Stroke reports that approximately 200,000 Americans have the most severe form of Tourettes, while as many as one in 100 display Tourette syndrome and other chronic tic disorders. Though Tourettes is a lifelong condition, symptoms tend to peak during the early teenage years with improvement in later adolescence and adulthood. Tourettes affect men approximately three to four times more often than women. Autism Autistic people sometimes experience tics or Tourette syndrome. This can cause uncontrollable body movements and vocalizations. According to one study, an estimated 9% to 12% of autistic people have tics. Another 2017 study found that between 3% and 20% of autistic people have Tourette syndrome. Tics and ADHD Medication There has been some controversy over whether stimulants, the most common form of medication therapy for ADHD, worsen or even cause tics. Studies indicate that most children with co-occurring tics and ADHD do not experience an increase in tic severity while on low to moderate doses of stimulants. However, there does appear to be a small proportion of children for whom this is a problem. It is not clear if the stimulants actually cause the tic or if the stimulants trigger tics that were already pre-existing, but not yet obvious. It is also possible that tic disorders may look similar to ADHD in their early stages. So the tic may have developed whether or not the child had been treated with stimulants. If your child with ADHD develops tics, report it to your child’s doctor. Together you will weigh the risks and potential benefits of different medications, as well as explore alternative medicines to stimulants. Treatment for ADHD and Tics There are treatments that can help people with ADHD manage symptoms of tics. Interventions to manage ADHD differ from treatments for tics, so it is important to get the right treatment for each condition. ADHD Treatments Characteristics of ADHD are typically managed through the use of medication and behavior interventions. These can help people function more effectively in their environments. Stimulant medications are often prescribed, but non-stimulant options are also available. Tic Treatments There are a few different treatment options that can help people manage tics. Comprehensive behavioral intervention for tics (CBIT) is a treatment that includes psychoeducation, relaxation techniques, and identifying triggers. Habit reversal therapy (HR) and exposure and response prevention (ERP) can also be helpful. Medications may also be helpful for managing tics. The older "typical" neuroleptics such as pimozide and Haldol are often used to reduce tics, in addition to the newer "atypical" neuroleptics/antipsychotics such as risperidone. Clonidine and guanfacine, types of anti-hypertensive agents, may also be used for mild to moderate tics and may be better tolerated than the neuroleptics. Coping With ADHD and Tics Tics are sometimes temporary and may be induced by stress or a recent illness. But if you are experiencing persistent tics, there are some things that you can do to cope: Talk to your doctor: First and foremost, talk to your doctor about your symptoms. They can assess your condition and better determine what might be causing your symptoms. Get enough sleep: Make sure that you are getting plenty of rest since a lack of sleep can sometimes worsen tics Consider treatments: Medications can be helpful in some cases, but you might also consider behavioral interventions that target tics. Manage stress: Stress can worsen tics, so it is important to find ways to deal with feelings of stress and anxiety. Relaxation strategies such as deep breathing, meditation, and yoga can be helpful. A Word From Verywell ADHD does not cause tics, but the two can co-occur. It is not uncommon for people with ADHD to have tic disorders such as Tourette syndrome. Other conditions, including autism and OCD, also often occur with tic or tic-like behaviors. In some cases, ADHD medications appear to play a role in the onset of tic symptoms, although further research is needed to explore the connection. If you are experiencing symptoms of ADHD or tics, talk to your doctor. They can evaluate your symptoms and recommend treatments that can help you manage your symptoms more effectively. 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Madruga-garrido M, Mir P. Tics and other stereotyped movements as side effects of pharmacological treatment. Int Rev Neurobiol. 2013;112:481-94. doi:10.1016/B978-0-12-411546-0.00016-0 Cavanna A, Coffman K, Cowley H. Tourette Association of America. The Spectrum of Tourette Syndrome and Tic Disorders: A Consensus by Scientific Advisors of the Tourette Association of America. Oluwabusi OO, Parke S, Ambrosini PJ. Tourette syndrome associated with attention deficit hyperactivity disorder: The impact of tics and psychopharmacological treatment options. World J Clin Pediatr. 2016;5(1):128–135. doi:10.5409/wjcp.v5.i1.128 Coffey BJ. Complexities for assessment and treatment of co-occurring adhd and tics. Curr Dev Disord Rep. 2015;2(4):293-299. doi:10.1007/s40474-015-0061-7 National Institute of Neurological Disorders and Stroke. Tourette syndrome fact sheet. 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Neurol Clin Pract. 2017;7(2):148-156. doi:10.1212/CPJ.0000000000000348 Nissen JB, Kaergaard M, Laursen L, Parner E, Thomsen PH. Combined habit reversal training and exposure response prevention in a group setting compared to individual training: a randomized controlled clinical trial. Eur Child Adolesc Psychiatry. 2019;28(1):57-68. doi:10.1007/s00787-018-1187-z Jones KS, Saylam E, Ramphul K. Tourette Syndrome And Other Tic Disorders. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. By Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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