April 2025

NEUROSCIENCES

EFFECTIVE MANAGEMENT OF TICS AND TOURETTE SYNDROME

Read time: 90 seconds

​Danielle Larson, MD, highlights key interventions to help you manage tic and Tourette syndrome effectively.  

​Key Takeaways
  • Managing tics effectively requires a holistic approach that incorporates attention to comorbidities, behavioral therapies and medication when needed.
  • Recognizing and understanding tic disorders is essential for effective management.
  • Ongoing collaboration with a multidisciplinary team and education for patients and families can enhance quality of life.
​
​​5 Interventions for Holistic Tic Management
  • Address comorbidities. Coexisting conditions such as OCD, ADHD, anxiety or mood disorders can exacerbate tics. Collaborate with a mental health professional, such as a neuropsychiatrist, to prioritize treatment for these conditions.
  • Implement behavioral therapies. Work with nurse practitioners, physical therapists, occupational therapists or licensed social workers who are trained in these methods.
    • Comprehensive behavioral intervention for tics (CBIT): Focuses on increasing patient awareness of tics and using effective management strategies.
    • Habit-reversal training (HRT): There are two main parts of HRT. 
      • Tic-awareness training: Patients learn to identify pre-tic sensations.
      • Competing-response training: Patients learn a specific behavior to replace the tic action.
    • Consider medications if behavioral interventions do not adequately manage tics. Common medications include:
      • Alpha agonists like clonidine and guanfacine are often used as first-line treatments.
      • Dopamine-receptor blockers, such as haloperidol and pimozide, can be used to reduce the severity and frequency of tics if they are severe and not well-controlled with first-line medications. However, these medications should be used with caution given their potential significant side effects.
    • Provide monitoring and follow-up.
      • Schedule regular assessments every three to six months to evaluate treatment effectiveness and side effects.
      • Use standardized tools like the Yale Global Tic Severity Scale to measure tic severity.
      • Involve caregivers in the monitoring process.
    • Offer support and education.
      • Educate patients and families to reduce stigma and promote understanding.
      • Provide resources and encourage participation in support groups and workshops for shared experiences.
​Danielle Larson, MD, Assistant Professor, Neurology (Movement Disorders) at Northwestern Medicine

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