Tics and Tourette’s syndrome
Tics used to be regarded as a manifestation of anxiety. Although anxiety or tension may worsen tics, they are just as likely to disappear during an absorbing activity, and come flooding back when the child relaxes. Tics can be suppressed for a time at will, but are essentially involuntary, or partly voluntary in response to a premonitory urge. Tourette" syndrome used to be regarded as very rare. Tourette's syndrome is associated with a number of other disorders, including attention-deficit hyperactivity disorder, obsessive-compulsive disorder, oppositional defiant disorder, self-injurious behaviour, failure to inhibit aggression, and anxiety and depression. Medication should be held in reserve for as long as possible. It is only partially effective, and all of the medications in common usage have significant side-effects. Clonidine is particularly useful with comorbid attention-deficit hyperactivity disorder. However, it probably reduces tic severity by one-third, compared to a figure of two-thirds with antipsychotics.