toosaucey,
Please excuse all my questions but there are some things that I just don't understand ... e.g. I don't really understand the mix of medications that your child's doctor is using if your son has tics (Tourette's Syndrome) and no other comorbid diagnosis/es. I've never come across anyone who has diagnosis of Tourette Syndrome being prescribed Strattera/atomoxetine unless they also have comorbid ADHD diagnosis. Wondering still why the doctor prescribed the Strattera.
I can understand the Zoloft more because it can be helpful in treating compulsions as well as anxiety, but it's not usually a medication prescribed on its own to treat tics.
I'm wondering how long your son has been taking the Tenex? I have read it can take as long as 6 or more weeks to reach full efficacy in some people. [Zinner] [Robertson]
If your son has phonic tics that are so painful or causing problems to his larynx or other parts of the throat then I'm surprised that something other than Tenex hasn't been suggested before moving on to procedures such as Botox injection.
I was also going to ask you something about premonitory urge but I found my answer when looking at other articles. I know not everyone has this urge before ticcing and especially young children, but I was wondering how awful it would feel to have the premonitory urge and the inablility for the muscle to move because it was paralized.
However, it appears that botox has good effect on diminishing premonitory urge.
http://tsa-usa.org/Medical/images/As...Summer2003.pdf
"Ask The Medical Advisory Board" TSA-USA Summer 2003
Dr. Jorge Juncos is a member of the Tourette Syndrome Association’s Medical Advisory Board.
Dr. Juncos practices neurology at the Emory University School of Medicine.
Quote:
Alpha agonists e.g.clonidine
(Catapres) and guanfacine (Tenex) may be
somewhat less effective than the medications
cited above in treating vocal tics.
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http://www.tsa-usa.org/Medical/image...38-049T2R1.pdf
Tourette syndrome—much more than tics
Management tailored to the entire patient
By Samuel H. Zinner, MD
Quote:
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For severe focal tics, botulinum toxin A (Botox) is increasingly becoming an option. The protein is injected into tic-affected muscle groups, such as the vocal cords, upper thorax, neck, face, or extremities. A surprising discovery in trials is that the use of botulinum toxin A appears to reduce or eliminate the premonitory urge, in addition to denervating muscle. The effect lasts three or four months and may be quite effective for very specific severe tics, but is not a good option for generalized tics.
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