As Tics Decline in Tourette, Signs of OCD May Emerge

So effective is CBT for tics, she said, that she generally tries it first, before medications. For physicians who wish to learn the technique, she said, “the manual is out there” (see “Managing Tourette Syndrome: A Behavioral Intevention for Children and Adults: Therapist Guide,”New York: Oxford University Press, 2008).

The most difficult tic to treat with CBT, she said, is eye blinking. An alternative response for the child to try when feeling the urge to blink, she said, is to widen the eyes. But, Dr. Coffey added: “The response doesn't always need to be in the muscular area where the tic is occurring. You could suggest that the child clenches his fist, or takes a deep breath.”

When a medication is used and found effective, she said, treatment should generally be continued for at least 12 months and then reevaluated.

“I've had parents who are extremely anxious about taking their child off the medication, even though I know it's time to do that,” Dr. Coffey said. “A lot of support during that time is essential.”

Dr. Coffey disclosed that she has served as an adviser/consultant to Jazz Pharmaceuticals and the Novartis Pharmaceutical Corp. She has received research support from several pharmaceutical companies, including Bristol-Myers Squibb, maker of aripiprazole.

'The good news is that research in the past decade finds that peak lifetime severity occurs at about 10 or 11.'

Source DR. COFFEY