Natural Support for Tourettes Syndrome

How I Put A Stop To Tourettes Tics! No Drugs No Side Effects

The key to stopping this disorder is to use a unique & effective technique to eliminate the vicious cycle of Tourette's. Various types of relaxation methods can help to calm the nerves but does Not cure anxiety disorders. The quick and effective technique that I am offering goes right down to the root cause of the problem and simply turns it off. Once you have learnt this technique properly you can even use it while walking. In the e-book The Root Cause this technique is explained step-by-step from an ex-sufferers point of view. A person suffering from this disorder for a long period could also develop other anxieties such as Panic attacks, Fear of rejection, Fear of failure, Social fear and Comunication fear. In this e-book, one simple cure for all these anxiety disorders is explained. In this book I not only describe how I struggled in my personal life since childhood, my student life and working life, but also detailed the number of therapies that I went through over the years in order to find a cure. Finally I go on to describe how I came about finding the cure and how much easier life became without having to deal with the disorder that I had most of my life.

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Tourettes Syndrome Nicotine And Animal Models

Tourette's disorder (TD) is a neuropsychiatry disorder with childhood onset that is characterized largely by the expression of sudden, rapid and brief, recurrent, non-rhythmic, stereotyped motor movements (motor tics) and sounds (vocal tics) that are experienced as irresistible, but can be suppressed for varying lengths of time.1 These motoric symptoms range from relatively mild to very severe over the course of a patient's lifetime.23 Most patients with TD also exhibit comorbid neuropsychiatry features including obsessive compulsive symptoms,4 inattention, hyperactivity, impulsivity,56 emotional liability, anxiety,78 and associated visual-motor deficits.9 Problems with extreme temper or aggressive behavior are also frequent,10-12 as are school refusal and learning disabilities.1314 While the specific etiology of TD is currently unknown, some believe that the disorder is caused by pathophysiology of cortical-striato-thalamo-cortical circuits in the brain.15 Several lines of evidence...

Differential diagnosis

Personal distress and functional impairment, which are required for the diagnosis, differentiate OCD from ordinary or mildly excessive worries, thoughts, and habits. The medical differential diagnosis includes tic disorders (especially Tourette's syndrome), temporal lobe epilepsy, trauma, and postencephalitic complications.

Summary of drug treatment for OCD

The third stage in non-responders, and in cases of only a partial response, includes small doses of antipsychotics (especially in Tourette's syndrome), a combination of SRIs and clomipramine, or the addition of lithium or trazodone, buspirone or tryptophan. The fourth stage consists of atypical neuroleptics, thyroid supplementation, clonidine, a monoamine oxidase inhibitor, intravenous clomipramine, or clonazepam. In resistant cases, electroconvulsive therapy or neurosurgery should be tried.

Motor Functions and Schizophrenia

Based on the above, it is not surprising that investigations are conducted into the possibility of using cannabinoid-based medicines for the treatment of impaired motor functions, many of which are thought to involve the dopamine system. Such conditions include Parkinson (128) and Huntington's diseases (129), Tourette syndrome (130), multiple sclerosis (131), and schizophrenia (132). However, especially in the case of schizophrenia, the complexity and chronicity of the condition and its treatments (133,134) warrant further experimental work until widespread clinical applications may be endorsed (135).

Chapter References

Robertson, M.M. and Stern, J.S. (1997). The Gilles de la Tourette syndrome. Critical Reviews in Neurobiology, 11, 1-19. 23. Tanner, C.M. and Goldman, S.M. (1997). Epidemiology of Tourette syndrome. Neurologic Clinics, 15, 395-402. 24. Alsobrook, J.P. and Pauls, D.L. (1997). The genetics of Tourette syndrome. Neurologic Clinics, 15, 381-93. 25. Eldelberg, D., Moeller, J.R., Antonini, A., et al. (1997). The metabolic anatomy of Tourette's syndrome. Neurology, 48, 927-34. 27. Sallee, F.R., Nesbitt, L., Jackson, C., Sine, L., and Sethurman, G. (1997). Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette's disorder. American Journal of Psychiatry, 154, 1057-62.

Performance Deficits By Nicotinic Drugs

Attention deficit hyperactivity disorder (ADHD) is among the most prevalent of childhood and adolescent disorders, accounting for up to 50 of clinic visits in these populations. The predominant characteristics of ADHD, inattention and dis-tractibility, are also among the symptoms associated with prenatal and early postnatal exposure to a variety of toxicants, as well as with a wide variety of neurologic and psychiatric disorders including AD, Parkinson's disease, Huntington's disease, Tourettes syndrome, and schizophrenia. The primary therapeutic agents utilized for ADHD and other disorders where distractibility and inattention are prominent features include methylphenidate, dextroamphetamine, mixed amphetamine isomers, and pemoline. While the efficacy of these agents has been demonstrated, they are also associated with a wide variety of adverse effects including insomnia, decreased

Administration pharmacokinetics and dosage Administration

The major uses of the antipsychotic drugs are for the treatment of schizophrenia, mood disorders, and senile psychoses. (3,4) Other indications are discussed elsewhere in this book in the consideration of the management of specific disorders, such as Tourette's syndrome, and aggression. The major advantage of the typical neuroleptic drugs is their ability to improve positive symptoms, i.e. delusions and hallucinations. Administration of typical neuroleptic drugs leads to the complete or nearly complete elimination of positive symptoms and disorganization of thought and affect in about 60 to 70 per cent of patients with schizophrenia and an even higher proportion of those with psychotic mania and psychotic depression.(3) The antipsychotic response in schizophrenia and mania is sometimes apparent within a few days in many patients but usually takes up to several weeks or months. A reasonable duration for a clinical trial with one of these agents is 4 to 6 weeks. It is not appropriate to...

Indications and contraindications

The main indication for the antipsychotic drugs is the treatment of all phases of schizophrenia, including acute, florid symptoms of psychosis, prevention of relapse, and deficit symptoms. Important other uses include the psychotic phase and prophylaxis of mania, depression with psychotic features, the psychosis, agitation, and aggression of various dementias, the treatment of psychoses due to L-dopa or other dopamine agonists in Parkinson's disease, Tourette's syndrome, treatment-resistant obsessive-compulsive disorder, self-injurious behaviour, porphyria, antiemesis, intractable hiccoughs, and as antipruritics. Some current research has suggested that the antipsychotic drugs may be of use to prevent the onset of schizophrenia by administering them to individuals who are in the prodromal phase of the illness. The atypical antipsychotic drugs are being tried on an experimental basis in patients with treatment resistant non-psychotic depression and various character disorders such as...

Aetiology Psychological factors

Even though psychological factors are insufficient to cause Tourette's disorder, tic behaviours have long been identified as stress-sensitive conditions, and an intimate association has been noted between the content and timing of tics and dynamically important events in the lives of children.

Dysfunction of the frontalsubcortical circuits

It has been known for a long time that obsessive-compulsive symptoms could be associated with neurological disorders of motor control, including Tourette's disorder, Huntington's disease, Parkinson's disease, as well as traumatic or infectious lesions of the basal ganglia. (33) Advances in neuroimaging have allowed the study of brain functioning in OCD patients and controls. Studies using single-photon electroencephalography, positron emission tomography, and functional magnetic resonance imaging have generally demonstrated metabolic abnormalities in the circuits involving orbitofrontal cingulate cortex and the basal ganglia most particularly the caudate nuclei in obsessive-compulsive patients. Studies done at rest and during symptom provocation demonstrated selective increases in regional blood flow in the caudate and orbitofrontal cortex, which correlated with symptom intensity. (1 ) In Tourette's disorder, morphological studies have provided evidence of volume differences within...

Course and prognosis

The course and outcome of childhood tic disorders have been less formally studied. It is known that, in the majority of cases, the tic disorder will be transient (by definition, no longer than 12 consecutive months) or will tend to improve with age. Tourette's disorder is considered as a chronic disorder. Symptoms are often at their most severe during the first decade of the disorder, but tend to improve in late adolescence and early adulthood (50) motor tics may be reduced in frequency and number, with most patients having a more or less stable repertoire that wax and wane over a reduced range of severity, and vocal tics may disappear. Chronic motor or vocal tic disorders usually have a similar course.

Clinical features Neurodevelopmental disorders

Attention-deficit hyperactivity disorder, pervasive developmental disorders, obsessive-compulsive disorder, Tourette's syndrome, and childhood-onset schizophrenia are developmental neuropsychiatric disorders under active investigation and each is reviewed in the respective chapters. Their developmental psychopathology is investigated by addressing the origins and course of individual patterns of behavioural maladaptation in each of these disorders and determining their genetic bases, thought to be complex, and involving more than one gene. Information derived from genetics, developmental psychology, clinical psychology, psychiatry, sociology, The interrelationship of the various child neuropsychiatric disorders is an important consideration. Disorders may be risk factors for other conditions, so that attention-deficit disorder may be a risk factor for conduct disorder. In this instance, the child's behaviour affects the adult and the transactional interactions between child and adult...

Other anticonvulsive drugs

Desipramine was superior to clonidine and placebo in the treatment of attention-deficit hyperactivity with Tourette's syndrome. (43) However, one other study(44) reported that the efficacy of clonidine was similar to that of methylphenidate in controlling symptoms of attention-deficit hyperactivity. One well-controlled study, including children, of the effects of clonidine in Tourette's syndrome showed 'no improvements'. (45) Overall, on the basis of existing evidence, clonidine cannot be recommended for children or adolescents with either attention-deficit hyperactivity or Tourette's syndrome. More research is needed before its possible place in child and adolescent psychopharmacology is determined.

Psychopharmacological treatments

Drugs are widely used in mental retardation. Besides being used for disorders which are simply more frequent in this population, such as epilepsy, Gilles de la Tourette syndrome, and psychosis, drugs play a part in the management of a wide range of symptomatology which includes aggression, self-injury, social withdrawal, compulsive routines, outbursts of distress, and social withdrawal. About one-third of the people in institutions are on neuroleptics and a further third are on antiepileptics. As discharge to the community does not bring much change, the figures probably reflect the nature of these populations as much as that of the institutions.

ADHKD and anxiety disorder53 Diagnosis and differential diagnosis Assessment of children

During the assessment, the physician must investigate the presence of a concurrent disorder and the relationship of the symptoms of a comorbid disorder and AD-HKD. For example, are the restlessness and inattentiveness of a child limited to a period of anxiety or depression Are the AD-HKD symptoms part of a conduct disorder, substance use disorder, or Tourette's syndrome

Terminology Used in Describing Movement Disorders

Tics are temporarily suppressible movements seen in Tourette's syndrome. The frequency and severity of tics are exacerbated after voluntary suppression. This is a rebound effect. Tics can be motor or vocal in nature. Simple motor tics are isolated, brief and sudden movements involving one body part. Complex motor tics may involve more than one body part and may have a component of dystonia or tremor. Complex motor tics may take the form of purposeful movements. A complex motor tic that is an obscene gesture is termed copropraxia. A simple vocal tic may be a grunt or a throat clearing. Complex vocal tics may be more elaborate vocalizations, words or phrases. When the words include profanities, the term coprolalia is used.

Diagnosis and differential diagnosis

Sometimes, complex motor tics can be confused with other complex repetitive behaviours, such as stereotypies or compulsive rituals, and differentiation between them may be difficult. Unlike tics, stereotyped movements are often rhythmic and repeated endlessly over a discrete period of time. Complex motor tics are rare in the absence of simple tics. Typically, compulsions are quite complex, they are aimed at neutralizing the anxiety resulting from an obsession, and or they are performed according to rules that must be applied rigidly. Both compulsive rituals and complex tics may be preceded by premonitory urges, which persist until the action is completed. In individuals with both Tourette's disorder and OCD, these symptoms are sometimes so closely intertwined that efforts to distinguish them would be futile.

Scope of developmental neuropsychiatry

Neurodevelopmental disorders that are described in other chapters of this book, including attention-deficit and hyperactivity disorders ( Chapter 9.2.3), pervasive developmental disorders and childhood-onset schizophrenia ( Chapter 9.2.2), obsessive- compulsive disorder and Tourette's syndrome (Chapter .9.2.6), and specific developmental disorders (Chapter 9.2.1).

Children with psychiatric disorder

Other psychiatric disorders in which different types of sleep disturbance is reported to be prominent are autism (including circadian sleep rhythm disorders), Asperger's syndrome (hypersomnia), tic disorders including Tourette's syndrome (sleeplessness and parasomnias), and obsessive-compulsive disorder (poor-quality sleep). Sleep complaints are also prominent in the chronic fatigue syndrome. As mentioned earlier, disruption by frequent awakenings (not obviously attributable to daytime inactivity) has been described in teenagers with this condition (22) suggesting that daytime symptoms might be at least partly attributable to poor sleep quality. Occasionally, Munchausen's syndrome by proxy comes to light in the form of complaints of a sleep disturbance. The sleep of conduct-disordered children has received little attention but preliminary reports are in keeping with the expectation that their sleep is disturbed because of their adverse or disorganized home and social circumstances and...

Levine Critchley Syndrome

Marriage and manifestation of autosomal recessive traits. He clearly describes severe orofacial dyskinesia with a tongue that would involuntarily push food out on to the plate, generalized chorea severely interfering with gait, sudden trunk flexion and hyperextension, some neuropsychiatry and cognitive impairment and possible epileptic seizures. Critchley also noted the resemblance to the tics of the Gilles de la Tourette syndrome 20 .


This has led to a whole new method of treating many other diseases such as Parkinson's disease, dystonia, essential tremor, Tourette's syndrome, mental diseases, and a whole new field of functional neurosurgery. The need for DBS to relieve pain has diminished in the past few years with development of intrathecal pumps for opiate delivery and with spinal cord stimulation. But there is still a small subgroup of patients where the location and character of their pain leaves no other choice for reduction of severe pain.


The most compelling evidence for dopaminergic involvement in OCD comes from the abundance of OCD symptoms in basal ganglia disorders, such as Tourette's syndrome, Sydenham's chorea, and postencephalitic parkinsonism. The therapeutic benefits obtained with the coadministration of dopamine blockers and SRIs in a subset of patients with OCD and tic disorders(32 has also suggested a role for dopamine dysfunction. A study evaluating levels of platelet sulphotransferase, an enzyme involved in the catabolism of catecholamines (providing a marker of presynaptic dopamine function), reported a decreased level of platelet 3H imipramine binding and a parallel increase in the level of sulphotransferase activity in OCD compared with controls. This provides further support for the hypothesis of reduced 5-HT activity and increased dopamine transmission in OCD. (2

Immune factors

Antibodies against two peptides of the basal ganglia have also been found. (34 A strong connection was reported between OCD Tourette's syndrome and the B-cell antibody D8 17, another antibrain antibody. (35 The specificity of these antibodies to OCD is as yet unclear. Cell-mediated immune-function alterations have been reported in OCD, but replication studies are still needed.

Abnormal movements

Certain abnormal movements such as facial tics, blepharospasm, dyskinesia including tardive dyskinesias, and Tourette's syndrome were often thought to be psychological in origin. Opinion changed after the introduction of L-dopa in the treatment of parkinsonism. (16) Many parkinsonian patients under treatment with L-dopa would switch from a state of rigidity or parkinsonian tremor into a facial dyskinesia, indistinguishable from conditions that were once diagnosed as abnormal hysterical facial movements. Few blepharospasms and dyskinesias found in clinical practice are now thought to be psychological in origin. Occasionally, blepharospasm can accompany a depressive illness or other emotional changes and remit with them, but the emotional state underlying the movement disorder should be readily apparent. Toone(lZ notes the prevailing view that dystonia is organic in origin but mentions two patients in whom it appeared to have psychological causes.


This female patient of Asian descent was born in 1970 in Korea, but moved as a child to a foster family in Europe. Of her family nothing is known. At the age of 16 tics started to appear. These consisted initially of jerks of her head to the left, but gradually over the years more involuntary movements appeared, such as contractions of eyes, mouth and lips accompanied by vocalisations. In 1993 a diagnosis of Gilles de la Tourette syndrome was made, despite the findings of areflexia and a CPK of 700 U L (normal 170 U L for females). As the symptoms worsened over the years psychiatric interventions became necessary. There was loss of concentration and increasingly chaotic behaviour. Haloperidol, tetrabenazine and pimozide were prescribed in high doses. These resulted in severe depression and somnolence, and an increase of orofacial dyskinesias was seen which was initially interpreted as tardive dyskinesia. Her situation worsened in that she showed self-mutilation with biting of her lips...

Tic disorders

In both DSM-IV and ICD-10, tic disorders are divided into four categories, according to duration of the symptoms and presence of vocal tics in addition to motor tics Tourette's disorder, chronic motor or vocal tic disorder, transient tic disorder, and tic disorder not otherwise specified. By definition, all tic disorders must have onset before age 18 years (criterion D). In all, the disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning (criterion C in DSM-IV), and is not due to the direct physiological effects of a substance or a general medical condition (criterion E in DSM-IV, and criterion C in ICD-10). Transient tic disorder is defined by single or multiple motor and or vocal tics (criterion A) that occur many times a day, nearly everyday for at least 4 weeks, but for no longer than 12 consecutive months (criterion B). Both Tourette's disorder and chronic motor or vocal tic disorder each have a duration of...

Genetic factors

Several studies have shown that OCD is much more common among relatives of individuals with OCD than would be expected from estimated occurrence rates for the general population 37) Lenane et al.(38) investigating 147 first-degree relatives of children and adolescents with OCD found that 44 per cent of the families had a positive history of tics in at least one first-, second-, or third-degree relative. Pauls et al.(39) reported that the prevalence rates of OCD and tic disorders were significantly greater among the first-degree relatives of 100 probands with OCD (10.3 per cent and 4.6 per cent respectively) than among relatives of psychiatrically unaffected subjects (1.9 per cent and 1.0 per cent). It has been suggested that at least some forms of OCD could be genetically related to Tourette's disorder. The pattern of vertical transmission among family members in Tourette's disorder has led to specific genetic hypotheses favouring models of autosomal dominant transmission 19 However,...

Autoimmune factors

Recently, a strong association has been demonstrated between OCD and Sydenham's chorea, a childhood movement disorder associated with rheumatic fever which is thought to be a result of an antineuronal antibody-mediated response to group A b-haemolytic streptococcus ( GABHS), directed at portions of the basal ganglia.(41) OCD or some of its symptoms are seen in 70 per cent of Sydenham's chorea cases. Swedo et al.(42) have also documented post-streptococcal cases of OCD and or tics in children and adolescents, without the neurological symptoms of Sydenham's chorea, giving them the acronym of PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections). Therapeutically, this finding of a probable autoimmune-caused OCD raises the clinical possibility that immunosuppressant and even antibiotic treatments will be effective in treating or preventing some cases of OCD. An antigen labelled D8 17, on the surface of peripheral blood mononuclear cells has...


There has been one adequately controlled study showing pimozide to be effective in the short to intermediate term in reducing the tic symptoms associated with Tourette's syndrome.(22) Side-effects, such as sedation and negative extrapyramidal symptoms, were less marked with pimozide than with haloperidol, although, according to another study, pimozide prolonged the QT interval on ECG,(23,) but with no clinically observable impact on the heart.

Structural Imaging

The globus pallidus, another basal ganglia nucleus, has also been shown to be smaller and to differ from normal asymmetry in ADHD subjects. Singer et al. (1993) found that the left globus pallidus was smaller in children with Tourette's Syndrome with comorbid ADHD than in normal controls. This finding was replicated by Aylward et al. (1996), who also found reduced total globus pallidus volume, which was predominant on the left, in 10 children with ADHD. In contrast, Castellanos and colleagues (1996a 1996b) found that the right globus pallidus was smaller and that the normal right left asymmetry was reversed in ADHD subjects.

Clinical Disorders

A third classification of disorders related to nicotinic function is those where there is no known loss or genetic alteration of nicotinic receptors, but there is evidence that stimulating nicotinic receptors may have therapeutic value. These disorders include ADHD, anxiety and depression, and Tourette's syndrome. Tourette's syndrome (TS) is a neurological disorder characterized by motor and vocal tics, often accompanied by hyperactivity, anxiety, fear, and symptoms of obsessive-compulsive disorder. Studies have demonstrated that nicotine administration (via transdermal patch or nicotine gum) can potentiate the action of traditional neuroleptics and is effective in managing the symptoms of TS.3132 These effects are fairly long lasting, with improvements in symptoms being reported up to four weeks after two days of nicotine exposure.33 It is hypothesized that this effect is related to the regulation of dopamine resulting from the desensitization of nicotinic receptors through chronic...