Hi all! Glad to have found a place that I can go to talk with others who are dealing with similiar situations.
My son in 9yo and has been having tics for about 5 years now. He is on zoloft, strattera, tenex, omega 3. We have not tried antipsychotic/neuroleptic due to fear of side effects. I was doing some research and came across information about botox for vocal tics and was wondering if anyone here had any knowledge about botox for tics.
Thanks for being here!!!

G'day toosaucey,
welcome to NeuroTalk.

I gather, from the medications you've listed, that your son has other conditions besides the tics? How's he doing with those? Unfortunately the age of 9/10 can be a time when tics are pretty full on for some little children. The good thing is that as time progresses it's very common for the actual tics with calm down a lot. I know of one adult who ended up having botox for extremely painful vocal tics. I'm not aware of this procedure being done very often and don't know of any children in my group of friends who've had that done. What sort of vocal tics does your son have? My children are grown now so we're not really dealing with the same issues now as we were when the children were little. Son is 20 and daughter is 18. It's good to meet you. Keep asking questions.

welcome toosaucy

I dont have any specific info on botox and TS tics but I do recall reading something about it , I think possibly even in a TSA newsletter.

on a personal note, we tried assorted meds for a year when my son was first dx with very severe TS, OCD and a bunch more associated stuff, but we really did find the side effects to be more problematic than any benefit of being on them, and so he went onto a more "natural" treatment protocol, essentially centered around nutrition and supplements, and with acupuncture, to help reduce the severity of his symptoms. we have been very pleased with the results over the past 6 years. He has TS and so he tics, but we no longer see the severe tics he used to have, and most especially his very troublesome OCD has changed in nature so as to not be so all consuming a factor in his life

Of course, as Lara mentioned, his nearing his 18th birthday is also a positive factor as tics do tend to diminish once the hormonal teen years are over

hope you find the info you are looking for, and again welcome to NeuroTalk
Cheri

Thanks for replying.
Actually he only really has a diagnosis of tourette's. some mild anxiety symptoms but nothing that has caused impairment. His psychiatrist put him on the strattera, hoping that the norepinephrine would help, for the tics as well as trying the zoloft, most recent addition, for the tics.
He has loud barking cough, grunts, throat clearing, and sniffing/snorting.

Well if we go through with this I will keep yall posted.

toosaucey,

Love the name! My heart really goes out to you. My son is highly ADD with OCD bordering on TS. He has gone through some vocalizeations that have caused him some problems. His 3rd grade teacher insisted that he was mentally challanged and would not let him stay in the classroom. She would hand him his papers in the morning and send him to the resource room. He got such wonderful one-on-one attention there, I didn't mind a bit. Come to find out, it was his throat clearing that drove her crazy. His Dr. put him on Zoloft, but when he was 12, during x-mas break, he had ran out and didn't tell me. After a few days he was having Day Terrors. He said it felt like there were bars around him with spikes and they were cutting into him. He felt like he was dieing. He was in the middle of detox, cold turkey, no turning back. We never gave him anything for the vocalizations again. Now that he is 15, they are hardly noticeable.

BTW, the reason I did not know he was out of meds was, part of his therapy for his ADD was that he was responsible for taking his medication daily, preparing for school, getting to the bus stop on time, letting me know when he was down to the last few meds. He normally did very well, but would miss an occational dose (often on weekends), so it would not be unusual for refills to be late.

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.
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

Tourette's affects the serotonin, dopamine, and norepinehrine systems. His rationale was to try and touch the norephinehrine system and a tad of the dopamine system with strattera. He had done very well with the strattera/tenex combination for about two years. End of last school year really started having problems with his vocal tics, to the point he didn't want to go to school. Thank goodness it was the end of school and he only missed a few days. I thought once school ended and maybe he was more relaxed that his tics would diminish or lessen but of course they didn't. So we started him on zoloft this summer. He is a little shy but doesn't meet the criteria for anxiety disorder but thought the zoloft may help. again trying to stay away from the big guns(antipsychotics). The zoloft hasn't helped with the tics but he is more social and easy going, so I think I will keep him on it even though it hasn't helped his tics.
Thanks for asking questions, it helps me figure out things as well.
Anyway I found a doctor in Baton Rouge, Louisiana and should be getting a call from them on monday to set up an appointment. I am looking forward to finding out more information.
I will let yall know what I find out.

toosaucey,

I just wanted to mention that I know someone that had botox done for tics & it made their tics worse. Everybody responds differently to treatments, but I still wanted to mention that.

Carolyn

Was always the opposite here.
The people in my family tend to tic more at home when in a relaxed environment where they are free to tic without undue attention or scrutiny... unlike at school. I tended to find the school year extremely stressful for that reason. The tics were being suppressed a lot more at school and so would explode the moment the day ended and we got in the car to go home.

What I found helpful for my son especially was that during the school day if his tics became somewhat overwhelming for him, he was allowed to leave the room and go for a walk to the office or take a book to the library or something similar. It enabled him to let out all the built up tics and also helped him concentrate more in the classroom for the lessons that were to come.

Of course, a lot depends on how much your child can suppress their tics. My son had so many tics all over his body, both motor and vocal that it was totally impossible to hold them all in, but as he got older he did begin to suppress more and more in class and that was a bit like a volcano waiting to erupt. The perfect environment at school would be one where the child didn't need to feel so stressed about their tics. It's an imposed stress adding on to an already stressed little body.

Medications are weird things. Different meds for different heads. Everything can be going along quite nicely then out of the blue everything can change. Some medications don't interact well and some medications tend to hit a wall and lose their effectiveness after some time.

In a condition that is so prone to change such as Tourette's Syndrome, the first thing I always wondered was if something new that happened.. e.g. increased social phobia, or increased generalized anxiety.. was actually a side effect of the medication. My son had extremely good results for about 3 months with a drug called Pimozide/Orap when he was about 10 but it caused the most shocking phobias and anxiety which stopped when that medication was ceased. If I knew then what I know now, I'd never have allowed the doctors to convince me to give my child that medication, but that's hindsight.

Well, I look forward to hearing about the information you gather next week. Please be very careful and cautious.

I meant to ask yesterday but think I forgot... What does your son think about having a procedure like this Botox for his phonic tics?

My daughter was prescribed Strattera to treat her tourettes several years ago by a chkd doctor. It was her first visit to him and after knowing her for a whole of 10 minutes, he had her drop her current medication and go on Strattera because he said it was 'so promising' for Tourettes. He was a neurologist and VERY respected and I trusted his judgement. It was one of the most aweful experiences she has ever gone through. She got horribly depressed and her symptoms got worse. She had only Tourettes, no adhd or anything else. I called Eli Lilly (sp?) to ask about the associated symptons because he never mentioned any of that to us and Lily said that they did not make that medicine to treat Tourettes and pretty much read a disclaimer to me that they were not responsible for mistreating blah blah. I would HIGHLY recommend not putting your child on Strattera unless you are prepared to really pay attention to mood swings, etc.. We went to another doctor who promptly took her off the Strattera and back on the Clonidine. Just be careful...