tics, tics and more tics

[jannie]

difficult child has been having so many tics lately. He used to do one or two things (mainly coughing), but for the past two weeks he is constantly ticing. He is sniffing his nose and moving his jaw up and down. It doesn't seem to stop. He is also opening and closing his fingers.

I feel so badly for him and my mommy heart hurts, because I am afraid of what will happen if his tics worsen and this really becomes a problem. He is not emotionally ready to handle kids making comments or asking questions. He is just learning to deal with losing games and not getting his way without major frustration. The more he tics, the more he gets agiated, which means frustration UUUGGGHHHH :crying:

The one thing that makes his crazy is when he thinks people are looking at him and talking about him. He doesn't want to stand out at all...and this is all before the noticeable tics. I can't believe the kids have not yet brought it up...but its coming. :sad:

The p-doctor said we could increase the abilify as this can decrease the tics. We've done this for about 5 days and no improvements have been seen.

 

[smallworld]

Are you sure they're tics and not a dystonic reaction to Abilify? Has a neurologist observed the tics?

 

[jannie]

I have not seen a neurologist. I guess I need to try and find a good one on our health insurance.

How can I tell if it's a dystonic reaction? What would that look like?

husband has Tourette Syndome....so I'm pretty certain its tic related. He has tics on and off for a few years.

 

[pepperidge]

My sons tics worsen on Abilify. Since it can both decrease and increase dopamine, stands to reason that it might worsen tics. it is definitely not a dystonic reaction.

 

[jannie]

Prior to the abilify he was on tenex, which is also used to treat tics.

The first time we tried a stimulant he reacted with tics, which was exactly what we feared.

I've often wondered what his tics would look like if he didn't take these medications which treat tics.

I don't think the abilify is making it worse. He has been on it since May or June.

 

[smallworld]

According to The Bipolar Child, a dystonic reaction involves involuntary muscle contractions that cause uncontrolled movements of the face, neck, tongue and back and an uncontrolled rolling of the eyes. Tardive dyskinesia is characterized by involuntary facial grimacing, lip-smacking, chewing and sucking movements, cheek puffing and wormlike movements of the tongue and fingers and toes.

When my son, who has tic disorder, was on Risperdal, we first thought his tics were acting up because he was experiencing uncontrollable lip licking, mouth opening and tongue thrusting. When we upped the Risperdal, the movements became worse, and it was at that point that we knew he was having a reaction to Risperdal because Risperdal (like Abilify) treats tics. When we discontinued Risperdal, my son's movements stopped within a few days.

Even though your husband has Tourette's Syndrome, I would not automatically assume difficult child is experiencing tics. I would recommend finding a neurologist tomorrow and have difficult child seen ASAP. If you can't get in to see a neurologist soon or your psychiatrist won't listen to you, I'd recommend a visit to the ER. You shouldn't mess around with APs because they can have serious side effects.

Good luck.

 

[jannie]

Even though your husband has Tourette's Syndrome, I would not automatically assume difficult child is experiencing tics. I would recommend finding a neurologist tomorrow and have difficult child seen ASAP. If you can't get in to see a neurologist soon or your psychiatrist won't listen to you, I'd recommend a visit to the ER. You shouldn't mess around with APs because they can have serious side effects.

Good luck. [/quote]

You're making me a bit nervous....(but I do appreciate and respect the advice) even at the age of four the doctors mentioned tic disorders. He has done this tic movement before but it was only for a very short period of time. neuropsychologist testing done in December also diagnosed him with a tic disorder.

Doesn't the dystonic reaction usually occur within a few days of starting a medication? It doesn't seem like it is dystonic if he has been taking it for 7 months.

I'm sure I'd never get in to see a neurologist this quickly.

 

[smallworld]

Jannie, I don't mean to make you nervous, but I did want to share our experience because my husband and I were convinced that our son's movements were tics. When we found out they were from Risperdal, we felt really terrible that he had suffered for nearly a month (and he got a nasty staph infection all over his face from constant lip licking).

We're not doctors and can't diagnosis over the internet. None of us can say whether it's a dystonic reaction or not. That's why I urged you to have a doctor observe your son to determine what's going on.

I honestly don't know about the timing of these movement disorders, but I'll google and see what I come up with.

 

[Sara PA]

Dystonia occurs in the short term, tardive dyskinesia is the result of long term use of neuroleptics.

 

[smallworld]

Here's what The Bipolar Child newsletter says about Abilify:

"Like other atypical antipsychotics, aripiprazole has a low risk of producing extrapyramidal symptoms (EPS)—the disorders of posture and movement that some patients experience with the older neuroleptic-type antipsychotics, such as chlorpromazine (Thorazine) and haloperidal (Haldol). Typical EPS include early and later muscle contractions (dystonia), slowed movements (akinesia, or parkinsonism), motor restlessness often accompanied by severe anxiety (akathisia), and later-emerging tardive dyskinesia (TD)."

 

[Sara PA]

The p-doctor said we could increase the abilify as this can decrease the tics. We've done this for about 5 days and no improvements have b

een seen.

The recommended target dose for Abilify is 10-15 mg/day for adults. (There is none for children because it hasn't been approved for use by children.) When APs are used to treat Tourette's Syndrome, it is my understanding that they are used in low doses. (APs are also known as the major tranquilizers and they are used to reduce tension or stress.)

 

[jannie]

I know it's not recommended for kids, however many are on it. I'd say the average dosage I've read on this site is 10-15 mg of abilify. Even though my difficult child is young, he is tall and weights 80 pounds.

My husband takes 20 mg a day of abilify. He takes it to treat his Tourette's Syndrome. It controls about 80% of tics.

 

[totoro]

Our difficult child 1's uncontrollable movements on Risperdal started about, 1 month after she started the medication, she also had the toungue thrust, drooling, mouth hanging open and extreme aggitation. Like Smallworld's difficult child... difficult child 1's also stopped quickly after stopping the medication.

Good luck I hope you figure it out!!! Poor guy.

 

[jannie]

Toronto-
I noticed you give difficult child 2 mg of abilify. I thought the smallest size pill was 5 mg. Do you just cut the 5 mg in half or do you get a 2 mg tablet?

 

[Bugsy]

Hi Jannie,

Oh boy, do I hear how worried you are. I certainly don't think you are wrong to worry. Remember, as serious as some of these things are they are very rare and if addressed are reversable. Obviously get on the phone today and call the doctors.

I am thinking of you and your little guy.

Bugsy's mom

 

[hearts and roses]

Hi Jannie,

I hope you're able to contact your DR today and perhaps get difficult child in to be seen.

My difficult child has tourettes and the only medications that ever helped with her tics were clonidine or risperdal. When she tried abilify, her tics worsened. difficult child recently began having trunk tics, which she hasn't experienced for a few years, but she doesn't want to take any medications for them at this time. She's seeing a chiro and *maybe* and accupressure specialist to help with that instead.

Obviously, we know that each person is different and even if the diagnosis is the same, the treatment may differ. I'd call your DR right away to be sure. Hugs -

 

[pepperidge]

Sorry on my post, I meant that my son's movements were definitely tics, not dystonia. Yours may be one or the other or neither. Just wanted to let you know that I wouldn't rule out the abilify causing the tics as you go up in doses. We had the same reaction on the first day of stimulants too. In fact, the first medicine my guy was on was Strattera, and that was the one that triggered the tics, much to the psychiatrists surprise.

 

[pepperidge]

Sorry on my post, I meant that my son's movements were definitely tics, not dystonia. Yours may be one or the other or neither. Just wanted to let you know that I wouldn't rule out the abilify causing the tics as you go up in doses. We had the same reaction on the first day of stimulants too. In fact, the first medicine my guy was on was Strattera, and that was the one that triggered the tics, much to the psychiatrists surprise.

 

[Bugsy]

Jannie,
Any word from the doctor? How is difficult child doing?

Bugsy's mom

 

[jannie]

Thank you for asking--

The tics have improved slightly--but it is still a noticeable problem. I did set an appointment with a neurologist. It's in three weeks. I do believe the tics are due to a tic disorder versus a reaction to medication.

I'm hoping to get more information from the neurologist, but I am not really sure what new ideas has can suggest.