Tourette syndrome
Tourette syndrome is a neurological condition in which a person has multiple motor tics and at least one vocal tic, lasting more than a year.
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Medicines commonly prescribed for Tourette syndrome
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 15 mgActive substance: aripiprazoleManufacturer: Aurovitas Spain, S.A.U.Prescription requiredDosage form: TABLET, 3 mgActive substance: risperidoneManufacturer: Aurovitas Spain, S.A.U.Prescription requiredDosage form: ORALLY DISINTEGRATING TABLET/LIOTAB, 15 mgActive substance: aripiprazoleManufacturer: Laboratorios Alter S.A.Prescription required
Tourette syndrome is a neurological condition in which a person has multiple motor tics and at least one vocal tic, lasting more than a year. It usually begins between the ages of 5 and 7, peaks in adolescence and eases in adult life for most people. It is not a matter of character or upbringing: tics arise from the way the brain regions controlling movement work, and a person cannot simply "pull themselves together".
What tics are
- simple motor — blinking, raising the eyebrows, head jerks, shoulder shrugs, grimaces;
- complex motor — sequences of movements: jumping, touching objects, copying other people's gestures;
- simple vocal — throat clearing, grunting, sniffing, whistling, guttural sounds;
- complex vocal — words and phrases, repeating what has been heard or one's own words.
A key feature worth explaining to families: a tic is usually preceded by a building internal sense of tension — an itch, a pressure, an urge to move. The tic brings relief. This is why a person can suppress a tic briefly — but not for free: the tension accumulates and the tics then come out more forcefully. A child who "sat quietly through the whole lesson" often erupts in tics immediately afterwards, and that is not bad behaviour but the consequence of holding them in.
How it runs
- tics come in waves: they intensify and ease by themselves and change in form;
- they increase with excitement, tiredness, arousal and illness, and sometimes with strong happiness too;
- they reduce when a person is absorbed in something interesting;
- during sleep they usually diminish but can persist;
- the peak is between 10 and 14; after that most people improve;
- in roughly a third of adults tics disappear, in a third they become mild and in a third they persist.
About coprolalia
Uttering obscene words is the best-known feature but the rarest: it occurs in fewer than 10% of people with Tourette syndrome. This film stereotype does a great deal of harm: people do not seek help because "mine isn't like that", and those around them fail to recognise the real manifestations.
Associated conditions
This is an important part: in most people it is the associated conditions, rather than the tics, that affect daily life most.
- attention deficit hyperactivity disorder;
- obsessive-compulsive disorder;
- anxiety disorders;
- learning difficulties, particularly with handwriting;
- sleep problems;
- outbursts of anger and difficulties with self-regulation;
- heightened sensitivity to sounds, light and textures.
When to see a doctor
- tics have lasted more than a year;
- they interfere with school, work or relationships;
- tics are painful or cause injury — sharp head movements, hitting oneself;
- a child is teased or bullied because of tics;
- obsessive thoughts and rituals have appeared;
- there are difficulties with attention and learning;
- mood has dropped or anxiety has appeared;
- tics have appeared abruptly in adulthood — this is atypical and needs neurological assessment;
- alongside tics there is weakness, incoordination or visual change.
How it is diagnosed
There are no specific tests: the diagnosis is clinical, based on description and observation. The doctor asks about age of onset, the nature and duration of the tics and the presence of a premonitory sensation, and assesses associated conditions. Investigations — MRI, EEG, blood tests — are arranged only if the picture is atypical, to exclude other causes. A video recording of the tics is very useful: they often vanish in the consulting room.
Treatment
Treatment is not always needed: if the tics are not troublesome, explanation and monitoring are enough. Treatment begins when tics interfere with life.
- behavioural therapy — the first-line approach. The person is taught to recognise the premonitory sensation and perform an incompatible movement instead; effectiveness is comparable to medication without the side effects;
- acceptance and mindfulness-based approaches — help reduce the tension surrounding tics;
- medication for marked tics: drugs acting on the dopamine system, certain blood pressure medicines at low doses, and botulinum toxin injections for localised tics;
- treating associated conditions — often this brings the greatest relief;
- deep brain stimulation for very severe forms in adults where nothing else has helped;
- support at school — the option to leave the classroom, extra time in exams, explanation to classmates.
What helps day to day
- do not comment on the tics or ask the person to stop — this raises tension and makes them worse;
- enough sleep and a predictable routine;
- reduce stress where possible;
- physical activity;
- absorbing activities: tics ease during them;
- explain the situation to teachers and classmates — openness removes most of the strain;
- limit caffeine if you notice a link;
- support groups, for both the child and the parents.
Common questions
Will it go away? In most people tics ease noticeably by adulthood.
Can a tic be held in? Briefly, yes — but at the cost of mounting tension. It takes effort and is exhausting.
Is upbringing to blame? No. It is a neurological condition with a significant hereditary component.
Does it affect intelligence? No. Learning difficulties, where present, relate to associated conditions rather than to the tics.
Is medication necessary? Only if tics interfere. For many people behavioural therapy and understanding from those around them are enough.
Online consultation
In an online consultation the doctor reviews the nature and course of the tics from your description and videos, explains how genuine Tourette syndrome differs from the popular idea of it, assesses associated conditions — attention, anxiety, obsessions — and helps you decide whether treatment is needed now and where to start.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Aug 1, 2026
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