The Link Between Tic Disorders and ADHD

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 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.

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.

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.

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.