1/2 www.nhs.uk/conditions/tics/pages/treatmentoptions.

aspx
Your health, your choices
Tics
Treatment options for tics
Treatment Pros Cons
Self help
Reducing stress and avoiding becoming tired or
overexcited
May help to reduce frequency and
severity of some tics
None
Behavioural therapy
Psychological therapies that aim to teach you new
ways to respond to your urge to tic, by performing a
competing response or suppressing the tic until the
urge goes away
Studies have shown that the severity of
tics can be reduced in about 50% of
people
Good results can be difficult to achieve as it
requires treatment and practice over a number
of sessions and perseverance
Medication
Neuroleptics
Medication that blocks the effects of dopamine on
the brain. Dopamine is thought to be partially
responsible for tic-like behaviour
Currently the most effective
medication available for preventing
tics
Tics decrease in about 70% of cases
Possible side effects include weight gain,
blurred vision, constipation, a dry mouth,
drowsiness, shaking, trembling, muscle
twitches, spasms and decreased sex drive
Alpha2-adrenergic agonists
Medication that reduces levels of norepinephrine in
the brain. High levels of norepinephrine are thought
to trigger tics
Reduces the frequency of both motor
and phonic tics in about 50% of cases
Possible side effects include drowsiness,
headaches, dizziness, fatigue, constipation,
diarrhoea, dry mouth and sleeping difficulties
Benzodiazepines
Medication that alters the way certain chemicals
transmit messages in the brain
Can be a useful short-term treatment
for tics
Some studies have shown
improvement in tics in about 50% of
cases
Possible side effects include drowsiness,
dizziness and unsteadiness or stumbling
Possibility of addiction, so should not be used
in the long-term
Tetrabenazine
Medication used to treat conditions that affect
movement
Some studies have found 80% of
people experience an improvement in
their tics
Has been shown to have long-term
benefits for some people
Possible side effects include drowsiness,
depression, insomnia and feeling sick
May need to be used for a long time
Botulinum toxin
Medication that is injected into the muscles involved
in a particular tic to relax them
Studies have shown more than 90% of
people have improved tics after
treatment and about half of people
treated are tic-free for three months
Can also reduce the feeling of building
tension before a tic
Best results achieved if used as a treatment
for tics that are confined to a small area, such
as vocal tics
Effect only lasts about three months, so
repeated injections may be needed
Most people have a temporarily weak or soft
voice afterwards if used to treat vocal tics
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Surgery
Deep brain stimulation
Surgery where electrodes are implanted in certain
sections of the brain to help regulate the workings
of the brain
Different studies have found that it can
be effective in 20-90% of cases
Access is limited because its still at an
experimental stage for the treatment of tics
Only recommended for adults with severe tics
that have not responded to other treatments
Not clear whether the treatment is safe and
effective in the long-term
Like all types of surgery there is a risk of
infection
Page last reviewed: 30/01/2013
Next review due: 30/01/2015