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Re: Development of tics in taking Ritalin.

Posted by SLS on September 25, 2000, at 12:41:40

In reply to Development of tics in taking Ritalin., posted by Dalewhee on September 24, 2000, at 13:47:28

Cylert (pemoline) is another stimulant used for ADD. It is chosen less often now, probably because of its potential to infrequently produce liver abnormalities. Your doctor will be able to council you on the degree to which this represents a risk. However, it does work to improve attention and cognitive performance. Like many other medical decisions, I guess the potential benefits must be weighed against the potential risks. I have not seen tics mentioned as often with its use on Medline, possibly because it is not used as frequently. But Cylert is very different from both amphetamine and Ritalin, and might not produce the tics that the latter two have.

Noa's suggestion of using Wellbutrin (bupropion), an antidepressant, is a good one. There are some studies that conclude it to be effective, but I would look to the real-life experiences of a doctor to give an idea of how useful it is. Wellbutrin, too, has been shown to be capable of producing tics and exacerbating Tourette's. The properties all of these drugs have in common is that they act to stimulate nerves that use dopamine (DA) as their neurotransmitter signaling molecule. However, because they are all different from each other, each will react uniquely in each individual treated with them. so I trial-and-error is worth continuing.

Several other antidepressants are used. Tricyclics like Tofranil (imipramine) and Anafranil (chlomipramine - used when there are obsessive-compulsive components) are chosen, but seem to address the impulsive-hyperkinetic behavioral aspects of ADD rather than attention and cognition. They also have unpleasant side effects, and should be used with caution by people with heart conditions. Another drug worth mentioning is Effexor (venlafaxine). From the few studies I've come across on Medline, it looks to be effective. The dosages used were rather low: 37.5-75mg.

Just a few reviews:

1. "Antidepressants in the treatment of attention-deficit/hyperactivity disorder"

2. "Attention-deficit hyperactivity disorder: the pharmacist's role"

Unfortunately, many people with ADD AD/HD also have Tourette's or other tic disorder that stimulants may unmask or make worse. It is not my intent to scare you, but I think this is knowledge that you should have in your possession.

Check out the website recommended by Noa and others like it. You should be able to get more thorough and balanced information there.

Hope all goes well...

- Scott




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