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Time to Go Off-Label?
"My son developed a tic after he started taking a stimulant. The tic went away after he stopped taking the drug. Should he try a different stimulant? Are there other options?"
If one stimulant brought on tics, another will probably do the same, so the next step is to try a nonstimulant.
There also have been reports of patients developing tics while taking Strattera, the only nonstimulant specifically indicated for ADHD, so it might not be the best choice, either. Instead, your son's doctor may want to prescribe “off-label” — that is, to give your son a medication that is not specifically indicated for ADHD.
The first option might be a tricyclic antidepressant, such as imipramine (Tofranil) or desipramine (Nopramin). The antidepressant bupropion (Wellbutrin) can also be effective against ADHD. It may take time, and some trial and error, to find the right medication for your son, so make sure he knows to be patient.
Larry Silver, M.D., is clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C. and director of training in child and adolescent psychiatry at Georgetown University School of Medicine. He is a former acting director and deputy director of the National Institute of Mental Health, as well as the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities.