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World J Clin Pediatr. Feb 8, 2018; 7(1): 36-42
Published online Feb 8, 2018. doi: 10.5409/wjcp.v7.i1.36
Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder
Michael O Ogundele, Hani F Ayyash
Michael O Ogundele, Department of Community Paediatrics, NHS Fife, Glenwood Health Centre, Glenrothes KY6 1HK, United Kingdom
Hani F Ayyash, Cambridgeshire and Peterborough NHS Foundation Trust, Peterborough Integrated Neurodevelopmental Service, University of Cambridge Health Partners, Cambridge CB21 5EF, United Kingdom
Author contributions: Ogundele MO conceived the idea; Ogundele MO and Ayyash HA prepared the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors who contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Michael O Ogundele, MBBS, MRCP, MSc, Consultant Paediatrician, Department of Community Paediatrics, NHS Fife, Glenwood Health Centre, Napier Road, Glenrothes KY6 1HK, United Kingdom. m.ogundele@nhs.net
Telephone: +44-1592-765096
Received: October 27, 2017
Peer-review started: October 29, 2017
First decision: November 20, 2017
Revised: November 30, 2017
Accepted: December 5, 2017
Article in press: December 5, 2017
Published online: February 8, 2018
Core Tip

Core tip: Attention deficit hyperactivity disorder (ADHD) and Tic disorders (TD) are common co-morbidities in children and adolescents, with 60% of children with Tourette’s syndrome having ADHD. This review covers the classification, prevalence, aetiology, diagnosis and treatment of childhood TD and co-morbid ADHD. Most tics are mild or moderate, responding to psychoeducation and behavioural management. Level A evidence supports the use of alpha adrenergic agonists, Atomoxetine and stimulants for the treatment of Tics and co-morbid ADHD. Severe TDs may require antipsychotic treatment. Short clinical vignettes are presented to help guide the selection of the most appropriate treatment in each patient presenting with ADHD and co-morbid TDs.