Clonidine Plus Methylphenidate for ADHD and Tics in Children

Attention-deficit/hyperactivity disorder (ADHD) occurs frequently in children with Tourette's syndrome (TS), and pharmacotherapy for children with both conditions remains an important clinical problem. The concern that stimulant therapy may exacerbate tics has led to the widespread use of clonidine, an imidazoline derivative that acts as an agonist at presynaptic alpha₂-noradrenergic receptors, but the efficacy of this agent in children with both ADHD and TS has not been established in randomized clinical trials.

This multicenter, randomized, double-blind trial compared clonidine alone, methylphenidate alone, clonidine plus methylphenidate, and placebo in a large group of school-aged children with both ADHD and a tic disorder. The greatest r…