Understanding Tourette Syndrome and Tic Disorders: A Holistic Guide

Tourette syndrome and tic disorders affect individuals in deeply personal ways—interrupting daily life, complicating social dynamics, and often co-occurring with other challenges like ADHD or anxiety. At Alpine Psychiatry, we recognize the complex interplay of genetic, neurochemical, immune, and environmental factors in these conditions. Our integrative approach blends conventional treatment with innovative biomedical and therapeutic modalities to help individuals manage symptoms and improve quality of life.

What Are Tic Disorders and Tourette Syndrome?

Tic disorders involve sudden, involuntary movements or vocalizations. Tourette syndrome is diagnosed when both motor and vocal tics have been present for over a year. Tics may be simple (eye blinking, throat clearing) or complex (gestures, repeated phrases), and are often worsened by stress or fatigue.

Risk Factors for Tourette Syndrome

Genetics: Multiple gene variants affect neurotransmitter signaling and immune pathways.
Inflammation: Allergies (asthma, eczema) and infections (e.g., strep) can increase tic frequency. Conditions like PANS/PANDAS often present with sudden onset tics.
ADHD: Commonly co-occurs, requiring coordinated care.
Gender and Age: Boys are more affected (4:1 ratio), with symptoms typically starting between ages 5–10.

Learn more about our care for PANS & PANDAS.

Behavioral Therapies That Work

Comprehensive Behavioral Intervention for Tics (CBIT)

A gold standard therapy that includes habit reversal and competing response training. Shown to reduce tic severity by up to 31%.

Exposure and Response Prevention (ERP)

Helps patients tolerate premonitory urges without performing the tic. A promising alternative when CBIT isn’t accessible.

Explore our therapy services for children and adults.

Evidence-Based Medications

First-Line

Clonidine / Guanfacine: Safe, non-stimulant options that help with tics, ADHD, and anxiety.
Guanfacine (Intuniv): Especially helpful for ADHD with co-occurring tics.

Antipsychotics

Aripiprazole, Risperidone, Pimozide: Highly effective for severe tics but with potential side effects. Aripiprazole is often best tolerated.

Dopamine Agonists

Pramipexole / Ropinirole: Investigated for tic reduction in Parkinson's and RLS; used off-label with growing interest.

VMAT2 Inhibitors

Tetrabenazine / Deutetrabenazine: Reserved for refractory cases.

Cannabinoids

THC / CBD: Promising but still under investigation. May benefit select individuals under close supervision.

Neuromodulation Therapies

Transcranial Magnetic Stimulation (TMS)

Low-frequency rTMS targeting the supplementary motor area has shown success in reducing tics with minimal side effects.

tDCS

Non-invasive brain stimulation that shows early promise in reducing tics for up to six months post-treatment.

Deep Brain Stimulation (DBS)

Surgical option for treatment-resistant cases, leading to 45–52% symptom reduction in select studies.

Integrative and Supplement Support

Magnesium Glycinate & Vitamin B6

Help stabilize neurons and reduce excitability. Dosed gradually over 3 weeks and maintained for at least 4 months.

L-Theanine + Vitamin B6

A study found a 30% decrease in tic severity in 71% of participants using this combination.

Vitamin D3

Deficiency correction may significantly reduce tic symptoms. Testing is essential before supplementing.

Taurine

Supports GABAergic function; may reduce tics and is generally well-tolerated.

Herbal and Traditional Therapies

Ningdong Granule (NDG) & 5-Ling Granule (5-LGr)

Used in Traditional Chinese Medicine to modulate neurotransmitters. Early studies from China suggest benefit, though quality control remains a concern.

Looking Ahead: Emerging Options

Ecopipam

A dopamine D1-receptor antagonist currently under review, with clinical trials showing positive outcomes in children.

Our Approach at Alpine Psychiatry

At Alpine Psychiatry, we recognize that treating Tourette syndrome means looking at the whole person—not just the diagnosis. We integrate:

Medication management
Functional testing
Therapeutic support
Biomedical interventions
Nutritional supplementation

We partner with families to develop care plans that are compassionate, personalized, and evidence-based.

If you or your child is navigating the challenges of tics or Tourette syndrome, our team is here to help. Contact us today to schedule a consultation.

Understanding Tourette Syndrome and Tic Disorders: A Holistic Guide

Jun 02, 2025