For the past several years, I’m guessing four years but it could be more as time is passing so quickly, Chris has been struggling with motor tics. They didn’t exactly come out of nowhere as ever since starting on antipychotics Chris has exhibited mild twitches and odd mannerisms which I describe in my book. That has led me all along to question whether what I was seeing was the effect of the drugs or the underlying condition. There are a lot of other odd things that go along with schizophrenia, and as most of you only too well know, we parents are always asking ourselves concerning the drugs if the chicken came before the egg and vice versa.
A neurologist Chris consulted twice ruled out tardive dyskinesia and any other neurological condition (although I never spoke with him and was getting my information from Chris and Dr. Stern. The consensus between Dr. Stern and the neurologist seemed to be that Chris’s motor tics were caused by anxiety and they would go away when his life normalized (?) after he had successfully transitioned to Florida. Well, he has successfully transitioned to Florida, he’s in good mental shape, and his motor tics are still there, causing some of the people at the program he is in to ask him if he has Tourette’s Syndrome.
Let me be clear. His motor difficulties wax and wane. I have seen them disappear for a few months then creep back in. Recently, they disappeared for a whole week, only to pop up the next day. Because the word Tourette’s has also been popping up a lot of late, I went straight to “the Google” to see if I could figure this out. The symptoms of Tourette’s seem to fit the bill, except that, according to the NIMH, Tourette’s is something that starts in childhood and diminishes greatly in late adolescence. For whatever reason, probably because all of these disorders are linked in some way that science hasn’t been able to crack, I looked into what the NIMH says about OCD. Now “everyone knows” (right?) that OCD is about obsessions and compulsions — handwashing, germaphobia, checking, checking, checking. OCD is something that first manifests in childhood and in adolescence. What made me almost fall off my chair was found half way down the page:
Some individuals with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.
Whoa, I thought. I‘ve never heard of this! Have you? Since when does OCD involve motor tics? The NIMH page is silent on providing an answer to my question. I put OCD aside for about a day, because Chris’s motor tics popped up when he was 30, not 18 and the NIMH page would lead you to believe that the tics are related to the prime age group where OCD occurs.
After a bit more research I figured out (and please correct me if I’m wrong) that motor tics as a feature of OCD were added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in its 5th edition published in 2013. This is rather big news, I would think.
My next thought was Jeez, this sounds an awful lot like tardive dyskinesia, which is drug related. Maybe that’s why the NIMH is silent on this.
I did a bit more googling and managed to find a couple of publications linking OCD-like motor tics to use of certain second generation antipychotics. I’m not even going to try to retrace my steps and repost them. It’s just too upsetting to me, and I already lost a night’s sleep.
Ever the optimist (because I have to be), I took apart (tried to rationalize) what the journal articles were saying. First of all, it was hard for me to understand specifically what the articles were saying because I’m not well versed in medical vocabulary. Second, as usual, the articles seemed to say that as this is a little documented area, further research is needed. Third (and here’s where you’ve got to be an optimist or you won’t feel any personal relief), just because they think the symptoms are linked to the drugs, doesn’t mean they are.
Stay tuned. There’s a lot more going on behind the scenes right now that I’ll write about later. Chris also has an appointment with a new psychiatrist this week and he’s going to have to come up with the right spin on the tics to avoid a new drug being introduced if the doctor notices something.