I would definitely go to a psychiatrist, and the reason is simple: psychiatrists are trained in diagnosing a broader range of psychological problems.

I think of neurologist are brain disorder folks ... I don't think of them as trained to clinically evaluate moods, anxiety, stress, depression and a range of other disorders.

Good luck.

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A psychiatrist has the background, education, training and experience required for making a diagnosis, prescribing the medication, at the appropriate dose, and to monitor it closely during the initial stages, making adjustments as required. When initiating the drug the dose is based on weight and not the severity of symptoms. This allows the system to adjust to the med and adjustments to be made until the right dose is determined. Those tics are a big problem. The medication should be discontinued immediately. After a couple of weeks you might want to start it again at a lower dose and increase it in increments. There is a possibility that tics can become permanent. It makes no sense to mask them with an antidepressant. It may ultimately be determined that your son can't take a stimulant medication. That is rare if the medications are administered correctly. But when not done correctly by a doctors who don't know what they are doing a child might be excluded from benefitting from their help. Many physicians receive nothing more than a 20 minute speil from a pharmaceutical company sales rep, read about them in the brochures and talk with colleagues as far as drug education is concerned. Neurologists and pediatricians are the most guilty of this. The pediatrician's task is to make a referral to a psychiatrist, who will request an evaluation by a neurologist to rule out other causes and the psychiatrist ( preferably specialzing in chldren and more so those with ADHD) takes from there. Unfortunately there is a shortage of this type of psychiatrist and so unqualified physicians try to fill in. Many of the horror stories (zombies, ect) told about stimulant medication problems are the results of untrained individuals prescribing them. There is a lot of info missing in the description of your son's problems. Was he diagnosed? Does he have severe behavioral symptoms, primarily inattentive, or something in the middle. There are limitations to what a stimulant medication can do. When behavioral symptoms are severe the most you get is the intensity of them reduced and if there was any effective behavioral therapy available ( that anyone is aware of ) that in tandem with the medication can produce a successful treatment outcome. However, after age seven that becomes increasingly more difficult as time, social, intellectual and physical maturation result in a steady exacerbation of behavior problems. At this point there are limited choices in how you proceed and some are expensive. Ages five through seven are ideal for preventative interventions. Earlier intervention at shortly beyond three through four requires simply adjusting parenting practices so that the child is not inadvertly taught unacceptable social behavior as a result of parents responding incorrectly in the first place with typical parenting practices.They don't work for children with ADHD behavioral symptoms. The problem is a lack of trained behavior therapists with the skills required to resolve these problems during ages three through seven. That problem is the result of the ADHD professional communities, specifically those in the research field working on the development of the behavioral treatment half of the tandem necessary for successful incomes. Your neurologist I am sure is only trying to help, but obviously knows not what he is doing and turns to more drugs to solve the problem. This results in impairments in other functions; and what really disturbs me is the response to the tics. I hope it worked out for you. Rebounder

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