When managing pediatric tics and Tourette’s disorder, we do not seek to eliminate tic symptoms. Instead—based on evidence and our experience—we use a six-step approach to increase tic control, decrease our patients’ embarrassment and discomfort, and help them function more normally.

Drug therapy is not appropriate for all children and adolescents with tic disorders. Mild transient tics and Tourette’s disorder usually do not require treatment, and medication should not be given to patients whose tics do not impair their quality of life. Treatment is warranted, however, when tics interfere with peer relations, social interactions, academic performance, or activities of daily living.

Standard treatment of pediatric tic disorders is changing. Instead of using typical antipsychotics, many experienced clinicians are using other medications that are safer and more effective, particularly for children and adolescents with psychiatric comorbidities such as attention-deficit/hyperactivity disorder (ADHD). In these patients, it is difficult to avoid drug interactions and exacerbation of non-targeted conditions when you attempt to control the tics.