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Thread: Tics Getting Worse During Thirties

  1. #11
    Join Date
    Apr 2005
    Location
    Ottawa, Canada
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    5,941

    Default Re: Tics Getting Worse During Thirties

    Quote Originally Posted by nahnew View Post
    Hi steve

    Yes i am currently seeing a psychiatrist but he doesnt want to prescribe me any other medications for depression and told me that it might make my tics worse.He told me to continue taking resperidone despite me telling him that i am a diabetic and i know that resperidone might make my diabetes worse.He also asked to do a MRI scan on my brain which i will be doing in 2 months time.
    There are two important skills required by anyone interacting with the medical community, in particular individuals with Tourette Syndrome, since many practitioners have limited clinical experience with Tourette and are unaware of all treatment options.

    Each of us has to be prepared to advocate and negotiate on our own behalf, using evidence based knowledge that can be learned from trusted and reliable sources, presented in a tactful and constructive manner, so as to work in a partnership with one's healthcare provider.

    Care should be taken to avoid an adversarial or confrontational posture, because the clinician may a have legitimate rationale for proposing a given treatment option based on his/her clinical experience, but that doesn't preclude your presenting your own proposal, if you have the evidence based information to support your alternative.

    That being said, your doctor may have good reason to recommend Risperidone despite your being diabetic, especially if the FDA recommendations are followed"

    The FDA recommends that all patients treated with atypical antipsychotics be monitored for symptoms of hyperglycemia and undergo fasting blood glucose testing upon presentation. Patients diagnosed with diabetes mellitus (DM) should be monitored regularly for loss of glucose control. Patients with traditional DM risk factors should undergo fasting blood glucose testing at initiation of treatment with atypical antipsychotics.(Source: Medscape)
    Additional Reference: Antipsychotic-Induced Diabetes Mellitus | Medscape

    In treating Tourette tic symptoms, especially when other associated diagnoses are involved, such as in your case, depression and OCD, you and your doctor need to discuss prioritizing your symptoms and then pick your battles to target the symptoms that may be responsible to some others.

    At the moment your tics seem to be at the forefront, but ask your doctor, if you were to target your depression and anxiety disorders to see if by managing mood and anxiety, your tics may improve.

    Medication combined with supportive psychotherapy, working with a psychologist on CBT may be one option to discuss with your doctor.

    If you are unsatisfied or have concerns about the treatment plan suggested by your psychiatrist, can you ask for a second opinion from another doctor or ask your psychiatrist to refer you to a neurologist who could work in collaboration with your psychiatrist and your family doctor. That way you would have a team approach with all relevant specialties involved, coordinated by your family doctor, supported by your own research and evolving knowledge about Tourette and associated conditions.

    By doing so, you can become an empowered patient, who can intelligently advocate and negotiate on your own behalf, working toward the best possible outcome for your symptoms.

  2. #12
    Join Date
    Sep 2015
    Location
    Winnipeg, MB
    Age
    54
    Posts
    101

    Default Re: Tics Getting Worse During Thirties

    Quote Originally Posted by nahnew View Post
    Hi

    I visited a psychiatrist.There are no one trained in CBIT but i am visiting someone who is trained in CBT soon.Thanks for the information.But are there anyone that you know of whose tics got worse during adulthood ?

    And the care group in singapore doesnt seem to be active anymore .i didnt receive any reply from them.
    Hi Nahnew,

    Yes, you are not alone. I can't speak for others but personally the vocal tics started to get worse in my 30's; sniffing, snorting and throat clearing. Because of underlying medical issues there are many meds that I can't take but with the research and info found thanks to the forum and especially Steve's help I was able after a practically 6 month long back and forth debate with my GP, cardiologist and a psychiatrist (everyone was passing the ball to the other until I put my foot down and they gave in or gave up... who knows) my GP gave in reluctantly and prescribed clonidine and clonazepam which reduced my anxiety levels and tics. The other comorbid disorders haven't seen much of a change I'm still dysfunctional socially and emotionally but better than I was. My GP returned the (try this for me favor) and put me on Abilify which seems to help stabilize my mood swings and irritability.

    Although clonazepam isn't the best med to be on due to tolerance build-up and the potential for addiction and taking more than prescribed, in my case it has helped a lot.

    Being 54 they pretty much have given up on making me functional again and focus more on keeping me stable and on me not harming myself and not having another heart attack.

    The advice given by Steve and David are spot on for your situation and I wish you the best in finding the right help.
    Gary
    "If at first you don't succeed....
    CRY and CRY again!"

  3. #13
    Join Date
    Nov 2016
    Location
    singapore
    Age
    36
    Posts
    8

    Default Re: Tics Getting Worse During Thirties

    Hi steve and gary

    Thanks to know that i am not alone.i will try to get second opinion and hopefully there can be some improvements .Thank you so much!

    ---------- Post Merged on June 18, 2017 at 10:37 AM ---------- Previous Post was on June 17, 2017 at 11:56 PM ----------

    Hi steve

    What do you think of transcranial magnetic stimulation and also Chiropractic as a treatment for tics ? Do you think it will be helpful? I am thinking of this as its available in singapore.Do you think i can consider this as a alternative treatment ?

  4. #14
    Join Date
    Apr 2005
    Location
    Ottawa, Canada
    Posts
    5,941

    Default Re: Tics Getting Worse During Thirties

    Quote Originally Posted by nahnew View Post
    Hi steve
    What do you think of transcranial magnetic stimulation and also Chiropractic as a treatment for tics ? Do you think it will be helpful? I am thinking of this as its available in singapore.Do you think i can consider this as a alternative treatment ?
    Nahnew,

    Information provided on the Tourette Canada Forum is based on available published and peer reviewed medical evidence.

    Transcranial Magnetic Stimulation (TMS)
    Repetitive Transcranial Magnetic Stimulation (TMS) is a new experimental procedure being tested as a potential treatment for TS. Doctors place an electromagnet on the scalp over the supplementary motor area and activate the magnet for short periods, sending pulses of magnetic waves into the brain. The goal is to help to reduce tics by altering the rhythms in the brain. While the treatment is noninvasive, a risk of seizures exists, particularly if someone has had seizures in the past. This treatment is costly and not widely available. According to the Canadian Guidelines for the Evidence-based Treatment of Tourette Syndrome, there is currently no good evidence to support the use of TMS in the treatment of TS. (Source: Tourette Canada)

    Also: Deep TMS add-on treatment for intractable Tourette syndrome: A feasibility study.

    Various studies have taken place over the past seven years without any conclusive evidence on the effectiveness of TMS.

    There is zero clinical evidence that any chiropractic procedure has any benefit in relieving, moderating or having any effect on Tourette tics.

    There are no shortcuts, or "secret remedies" that are outside of mainstream medicine that have any evidence of effectiveness in treating or managing Tourette tics.

    If you intend to seek treatment for your tic symptoms, I would urge you to rely on the medical evidence currently available, and work on locating a medical practitioner who has training in movement disorders, with specific interest in Tourette and related disorders. Evidence based treatment options for Tourette tics are limited to medications that affect specific brain chemistry and behavior therapy in the form of CBIT.

    Behavior therapy (CBIT) has been found to be as effective as some of the commonly used medications that moderate tics, avoid the usual side effects of those medications and provides additional strategies that the individual can adapt to their particular lifestyle to help in managing their own tic symptoms.

    To assist in your understanding of the current options for Tourette related treatment guidelines:

    Diagnosis and Treatment of Tourette Syndrome

    specifically:

    Canadian Guidelines for the Evidence-Based Treatment of Tic Disorders | Tourette Canada Support Forum

    European clinical guidelines for Tourette syndrome and other tic disorders | Tourette Canada Support Forum

    also, please see the various "Sticky" posts related to medication options in the Diagnosis & Treatment section.

    You talked about CBIT earlier, and I pointed you to CBITInfo.ca where I would urge you to look at the various videos related to CBIT. These videos along with information contained here, can provide you with some strategies you might find you could implement on your own to get started in empowering yourself to manage some of your symptoms. Much of the same information and resource material can also be found on the Forum HERE

    What steps do you plan to take to treat the symptoms of depression and anxiety you said are causing impairment in your life?

  5. #15
    Join Date
    Sep 2005
    Location
    Ottawa, Canada
    Posts
    792

    Default Re: Tics Getting Worse During Thirties

    Quote Originally Posted by Steve View Post
    There is zero clinical evidence that any chiropractic procedure has any benefit in relieving, moderating or having any effect on Tourette tics.
    Indeed, there is zero clinical evidence that any chiropractic procedure has any enduring benefit for any medical condition.

  6. #16
    Join Date
    Nov 2016
    Location
    singapore
    Age
    36
    Posts
    8

    Default Re: Tics Getting Worse During Thirties

    Hi steve , david

    Thanks for the reply.guess i will skip the alternative treatments.

    Steve
    I will be seeing another doctor as what you had advised for my depression and other related conditions.

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