Commentary |

Stimulants and Tic Disorders:  From Dogma to Data

F. Xavier Castellanos, MD
Arch Gen Psychiatry. 1999;56(4):337-338. doi:10.1001/archpsyc.56.4.337.
Text Size: A A A
Published online


IT IS A simple question. Do psychostimulants worsen tic disorders? In the 1970s and early 1980s, the answer was unequivocally yes. The presence of a tic disorder in a patient, or even a history of tics in a close family member, became a contraindication to prescribing methylphenidate hydrochloride.1 However, the answer has not remained simple. In this issue of the ARCHIVES, Gadow et al2 present their longitudinal follow-up of 29 children with attention-deficit/hyperactivity disorder (ADHD) and chronic multiple tic disorder (mostly Tourette syndrome) who were treated for 2 years with methylphenidate. They pose a public health question: "to address the issue of potential tic exacerbation from the standpoint of group data (ie, is treatment ill-advised in this clinic population?), and not to verify possible tic exacerbations in individual children." They conclude that treatment with methylphenidate does not result in long-term exacerbations of motor or vocal tics in prepubertal children, at least when their tics are mildly to moderately severe. This is an important, carefully designed study, which, in conjunction with the complementary reports on this topic in the past decade,35 could lead to a more sophisticated understanding of the relationship between stimulants and tics.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 8

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles