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Tics and dyskinesias associated with stimulant treatment in attention-deficit hyperactivity disorder
P H Lipkin1, I J Goldstein, A R Adesman
1Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY.
Insights
Approximately 9% of children with attention-deficit hyperactivity disorder (ADHD) experienced tics or dyskinesias (T/D) when treated with stimulant medication. Most cases were temporary, with less than 1% developing chronic tics or Tourette's syndrome.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Pharmacology
Background:
- Stimulant medications are commonly prescribed for attention-deficit hyperactivity disorder (ADHD).
- Concerns exist regarding potential side effects, including tics or dyskinesias (T/D).
- Understanding the incidence and risk factors for T/D in children with ADHD is crucial for safe and effective treatment.
Purpose of the Study:
- To determine the incidence of tics or dyskinesias (T/D) in children with ADHD treated with stimulant medications.
- To examine associated clinical factors, such as age, medication type, dosage, and tic history, related to the onset of T/D.
Main Methods:
- A cross-sectional analysis was conducted using chart review of a clinic cohort.
- One hundred twenty-two children with ADHD treated with stimulant medication were included in the study.
- Data collected included medication details, T/D presence and onset, and personal/family tic history.
Main Results:
- The incidence of T/D was 9.0% among children or 8.2% of medication trials.
- One child (0.8%) developed Tourette's syndrome.
- No significant relationship was found between age, medication, dosage, or tic history and the onset of T/D.
Conclusions:
- Approximately 9% of children with ADHD treated with stimulants developed T/D, mostly transient.
- Fewer than 1% developed chronic tics or Tourette's syndrome.
- Personal or family tic history, medication choice, or dosage did not predict T/D onset.
Objective:
To determine the incidence of tics or dyskinesias (T/D) and examine associated clinical factors in children treated with stimulant medications for attention-deficit hyperactivity disorder.
Design:
Cross-sectional analysis of a clinic cohort with chart review.
Setting:
Hospital-based clinical service within a division of developmental and behavioral pediatrics.
Patients:
One hundred twenty-two children with attention-deficit hyperactivity disorder treated with stimulant medication. All children currently or recently treated were included.
Interventions:
None.
Measurements And Results:
Determinations were made of medication used, medication dosage, presence or absence of T/D, time of T/D onset, and history and family history of T/D. Incidence of T/D was 9.0% of children or 8.2% of medication trials. One child (0.8%) had development of Tourette's syndrome. Age, medication, dosage, history of tics, or family history of tics was not related to onset of T/D.
Conclusion:
Approximately 9% of children with attention-deficit hyperactivity disorder treated with stimulant medication had development of T/D, predominantly transient in nature, with less than 1% having development of chronic tics or Tourette's syndrome. Personal or family tic history, medication selection, or dosage was not related to onset of T/D.
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Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.