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Hi All So we have had on and off success on guanfacine wiht our 12 yr old son who suffers mainly from vocal tics this past year. He seems to be very sensitive to it even at 1mg and anything higher makes him super drowsy. He also has the dryness in the mouth a lot as a side effect. We recently switched to guanfacine ER or Intuniv from guanfacine IR or Tenex. Its been a week on it and I am yet to see if it helps him. If I ask him, he says the guanfacine helps him upto 20% with his tics at 1mg.

Hi Chemar He wakes up in the morning and starts ticcing right away all the way to the night ! Sometimes I hear him in the middle of the night as well. So there is no actual trigger I can think of! Its basically all day with some breaks in between when he is really concentrating on some activity. I have tried every possible thing on him from supplements, accupuncture, diet changes, mouth piece and nothing has drastically helped him so far. Till now his tics were not too bad and we were able to manage until March when the vocal tics kicked in so bad. The only thing I have not tried on him is neurofeedback which I am unable to schedule now due to covid. He is currently on these supplements...Let me know if I am missing anything important. He was generally ok with the below with minimal-moderate tics for last few years until March when it all blew up! Magnesium Taurate 500mg/day, Taurine 500mg/day, Vitamin C1000mg, l-glutamine 500mg, VitaminB6/B12/combination of all B(folate)P5P, DHA, COQ10, Ashwagandha, Quercetin to help with allergies, Multivitamin, Probiotics, NAC, Guanfacine 1.5mg, now on Lcarnitine. I have also tried 5HTP , GABA on and off but always felt it made him worse so did not continue them. Also tried Valerian on and off, Skullcap ... So I have tried lot of supplements, he was on antibiotics for 1+ year as doctors thought it was pandas but he only got strep once when he was 6yrs and never got strep after that. And his tics have been constant since then ...but manageable with few flareups. We manage his diet well, organic, gluten and dairy free. Not sure what else would help him and I am definetly loosing all hope.

Hi Chemar I am going a bit slow on the guanfacine and he is taking about 200mg/day (weighs around 70lbs). The reason is I remember he had loose stools earlier when he had tried it couple of years ago. Its been 3 days now, I cant tell if his vocal tics sound better as he is still screaming all day. We had gone out yesterday for a drive and it was considerably less while we were out all day but again since morning today its back to being bad. Did you notice your son's tics get better before the 2 week while on carnitine ?

Hi Chemar Thanks for the advice and I am going to try the levocarnitine again from today and will update you in a week. His tics are there constantly all day every few seconds. Nothing makes it worse or less. Also wanted to ask does Lecithin and Niacin make a difference since he is not on them ...?

Hi Sheila/Chemar Thanks for your messages. I am at a point where I really dont know what to try on him as there is nothing left to try. None of the meds work on him or have a bad side effect and he refuses to have it so I cut down the guanfacine to 1mg which is not helping. He hates feeling lethargic and drowsy. He tries his best when he can with cbt but he says its too hard. I just got his bloodwork done today for common markers just to see if he has anything going on which we don't suspect as he does not seem sick. Before the lockdown and when he was at regular school his tics were at minimal. It all started after couple of weeks of school beign closed. He shots constantly all day and almost lost his voice. Its never been so bad for us. Chemar, I did try one day of 150mg of levocarnitine(he used to be on this back when his levels were low) but somehow I felt it made him tic and shout more so I did not try more than a day. I am giving him quercetin with b vitamins and C and zinc , magnesium and taurine as per bonnies regimen. The only supplements he is not having as per bonnie's regimen are the niacin and lecithin. Do you think adding these 2 with carnitine one at a time will help him ? I am really broken down and already looking into deep brain stimulation surgery for him as I cant bear to see him suffer this way. We also tried the mouth piece(stent) but since his vocal tics were better past 6 months he did not wear it and now he has outgrown it and our dentist is not open to make him a new one. Any other pointers are greatly appreciated.

Carolyn, This is great information and I was looking into histamine for my son who is 11 and has really bad tics going on with stuffy nose every night. He is already on B6, NAC, Magnesium, zinc and i will be adding in the quercetin. He is suffering a lot with the vocal tics all day and I really dont know what else to do for him. Any pointers on what helped your son with vocal tic flare ups ?

Hi All So since the lockdown started and homeschooling since March , my son's (11yrs) vocal tics have flared up like crazy where he is shouting all day. He was on guanfacine 1mg for tics for 6 months before March and it sort of helped him and we did not see much side effects at 1mg but since his vocal tics are so flared and we didnt want him to loose his voice , the doc asked us to increase it to 2mg at night. Now since we have upped it this past 3 days , his vocal tics still remain the same and he is so lethargic and sleepy barely able to stay up during the day. Has anyone had success using guanfacine for vocal tics without much drowsiness? Will the drowsiness pass with continued using ? One other thing that might cause his vocal tics to flare could be the pollen , dust as he has a blocked nose almsot every night and its not a cold. So I think he could have some allergies and we are treating it with claritin and will add in few more supplements. I am really not sure which route to go anymore as his vocal tics are so flared up and we are already doing supplementss to help him and at this point nothing seems to help him and I am so frustrated seeing him suffer all day.

Hi All I am looking for any pointers if neurofeedback helps Tics in any way ? This treatment is a significant investment and is not covered for TS by insurance. I have found a couple of Doctors offering this in NY and still debating if its worth a try due to the time and money involved in this. Any feedback would be helpful. Thanks VVNY

Hi Any updates on neurofeedback Elise ? I am looking to start this for my son.

Hi Everyone I really need some help on Guanfacine that I recently started for my son after trying several things of diet and supplement and lifestyle changes nothing has helped him so far other than tics waxing and waning and now that he is finding it tough we have finally decided to give in to prescription that he is 10 yrs old. Any one with any information on how long does guanfacine help tics if it actually does and any serious side effects from stopping it later ? Do we need to keep upping the dose down the road ? Its been 2 days he is on it and he is so drowsy and lethargic and we are not liking him this way one bit. Thanks again VV

Hi All after trying many years with combination of supplements I have finally given into considering medication for my son entering 5th grade as his Vocal tics are really bad and doesn’t seem to be getting better . Guanfacine is my first try...any thoughts on this working long term for tics or is it a waste to even start it if it doesn’t work long term? Please help. thanks VV

Hi All I am in two minds if I should start my 10yr old on medication . We have Tenex and Propanalol prescribed for him and still holding on to it. We have managed with supplements so far and its been ok and manageable until now. My question is it worth starting Tenex ? From what I have read many posts have reported relief in tics in short term but seems to have stopped working long-term when tics come back more forcefully . Can someone who has been on this long-term share some advice if this is the case ? Any help is appreciated!

Hi Sirena When you meant enough of it how much of gaba and ltheanine is your son taking right now ? If you can please share what he is on and his weight it will give me an idea to what my son might need of the same.

Hi Kathy/Jason/JMACJA I have 10 yr old son as well whose tics are extremely flared up currently and we are debating if we need to try medication. He has had tics since he was 6yrs old and was doing antibiotics regimen (PANDAS/PANS) which we now stopped as it stopped working. Does stopping guanfacine make tics worse or more pronounced at later stage ? I do not want to start something that can help his condition now but make things worse for us later. Please advice as I am confused on this .

Cary How has the improvement been for your daughter so far ? We are scheduled to see Dr. K today.