Editing Tourette syndrome (section)

=== Medication ===
{{Further|Management of Tourette syndrome#Medication}}
[[File:Clonidine pills and patch.jpg|thumb|alt=Little white pills on a counter, next to a pill bottle and labels|[[Clonidine]] is one of the medications typically tried first when medication is needed for Tourette's.{{sfnp|Sukhodolsky|Gladstone|Kaushal|Piasecka|2017|p= 251}}]]
Children with tics typically present when their tics are most severe, but because the condition waxes and wanes, medication is not started immediately or changed often.<ref name=Zinner /> Tics may subside with education, reassurance and a supportive environment.<ref name=Stern2018 /><ref name= Efron2018 /> When medication is used, the goal is not to eliminate symptoms. Instead, the lowest dose that manages symptoms without adverse effects is used, because adverse effects may be more disturbing than the symptoms being treated with medication.<ref name=Zinner />

The classes of medication with proven efficacy in treating tics—[[Typical antipsychotics|typical]] and [[Atypical antipsychotic|atypical]] [[Antipsychotic|neuroleptics]]—can have long-term and short-term [[Adverse effect (medicine)|adverse effects]].<ref name=Frey2022a/><ref name= Seideman2020/> Some [[antihypertensive]] agents are also used to treat tics; studies show variable efficacy but a lower side effect profile than the neuroleptics.<ref name= Fernandez />{{sfnp|Sukhodolsky|Gladstone|Kaushal|Piasecka|2017|p= 251}} The antihypertensives [[clonidine]] and [[guanfacine]] are typically tried first in children; they can also help with ADHD symptoms,<ref name= Efron2018 />{{sfnp|Sukhodolsky|Gladstone|Kaushal|Piasecka|2017|p= 251}} but there is less evidence that they are effective for adults.<ref name= Stern2018 /> The neuroleptics [[risperidone]] and [[aripiprazole]] are tried when antihypertensives are not effective,<ref name= PringHoller2019 /><ref name= Efron2018 /><ref name=Frey2022a/><ref name= Seideman2020/> and are generally tried first for adults.<ref name= Stern2018 /> Because of lower side effects, aripiprazole is preferred over other antipsychotics.<ref name= EuropeanPartIII>{{cite journal |vauthors=Roessner V, Eichele H, Stern JS, et al |title=European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part III: pharmacological treatment |journal=Eur Child Adolesc Psychiatry |date=November 2021 |volume=31 |issue=3 |pages=425–441 |pmid=34757514 |doi=10.1007/s00787-021-01899-z|pmc=8940878 |s2cid=243866351 }}</ref> The most effective medication for tics is [[haloperidol]], but it has a higher risk of side effects.<ref name= Efron2018 /> [[Methylphenidate]] can be used to [[Management of Tourette syndrome#Treatment of ADHD in the presence of tic disorders|treat ADHD that co-occurs with tics]], and can be used in combination with clonidine.<ref name= Dale2017 /><ref name= Efron2018 /> [[Selective serotonin reuptake inhibitor]]s are used to manage anxiety and OCD.<ref name= Dale2017 />