I have been struggling with facial tics my whole life

Good evening,

Thank You for detailed description of your medical problem. We agree that tics may affect life in negative way on many levels. You wrote that you already had consultations in the past and diagnosis was made, but it is always good to confirm it. It can be done during a visit with psychiatrist or neurologist. In diagnostic process apart thorough interview (onset of symptoms, their description, situations that provoke symptoms) it is good to perform CT Scan or MRI of your head, EEG also should be done. Usually psychiatrist/neurologist can refer you for such diagnostic imaging.

As you are mostly interested in therapy, as well cognitive-behavioral therapy or relaxation training are suggested. Unfortunately at the moment in our Center there is no CBT psychotherapist fluent in english, but we invite You for psychiatric consultation. During consultation with psychiatrist pharmacological treatment also may be consider, but we think about using medication rather in severe tics. Drugs which block D2 (dopamine receptor) have efficacy confirmed in medical trials. Typical neuroleptics like haloperidol may be used, although they are given in smallest efficient doses, because it is not easy to avoid side effects like sedation or cognitive problems. Also atypical neuroleptics can be used like risperidone or olanzapine. They are usually better tolerated by patients. For short-term therapy benzodiazepines may also be used, but only for symptomatic treatment, especially in stress induced tics. Decision about proper therapy is always made individually.

Kind Regards

Przemysław Wierzbicki