Tic Disorders
There are two main types of tics. Motor tics are involuntary movements that can be simple, such as head jerking or eye blinking; or complex, like twirling or jumping. Vocal tics are involuntary sounds that can be simple, like grunting or clearing the throat; or complex, such as repeating words or swearing (coprolalia). The tics are sudden, rapid, recurrent, and nonrhythmic. Many people report what is called a premonitory urge, an uncomfortable feeling or sensation that occurs prior to the occurrence of the tic, that is relieved after the tic occurs.
If a person has either single or multiple motor tics or vocal tics that have persisted for more than a year since the first tic occurred, this is called a chronic motor or vocal tic disorder. Onset must be before age 18. If the motor or vocal tics have occurred for less than a year, it is called a provisional tic disorder.
Both multiple motor and one or more vocal tics characterize Tourette’s disorder (TD). Onset occurs before age 18 and the tics have continued for more than a year since the tics began. TD often occurs with attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) or other behavioral problems.
There is no cure for tic disorders, but there are medications and behavioral treatments that can alleviate symptoms. Research supports the effectiveness of habit-reversal training and comprehensive behavioral intervention for tics (CBIT) in producing improvement of symptoms.
The Tourette Association of America reports on their website that Haloperidol (Haldol), pimozide (Orap), and aripiprazole (Abilify) are currently the only medications approved by the U.S. Food and Drug Administration (FDA) to treat tics. However, guanfacine or clonidine, both of which are alpha- adrenergic agonist medications that are approved for use in the treatment of high blood pressure, are used off label for treatment of tics.
