REFERENCE · RECOVERY TECHNIQUE
Keeping Other Conditions and Medicines in the Plan
Original entry 5: Coexisting-condition and medication review.
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For the Person With FND
Why this belongs in recovery
A functional-tic diagnosis does not explain everything a person may experience. A primary tic disorder, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, depression, pain, sleep difficulties or other FND symptoms may need care alongside it. Treating those problems can matter even if the functional tics continue. [1]
For example, poor sleep can make an already difficult day harder to manage. A sleep assessment has its own purpose. It should not be presented as a promise that better sleep will remove the tics.
Make the appointment easier to use
Bring a short list of the two or three problems affecting you most. Include what you take, what each medicine was prescribed for, any recent changes and unwanted effects. Ask which clinician is responsible for each part of the plan.
Useful questions include: “Could I have more than one type of tic?” “Which problem is this medicine meant to help?” and “How will we decide whether it is worth continuing?” You can ask for the answers in writing.
What medication can and cannot mean
A medicine may be appropriate for a coexisting primary tic disorder or another condition. That does not establish that it treats the functional symptom mechanism. Equally, being diagnosed with functional tics is not a reason to abruptly stop a medicine prescribed for something else. Review changes with the prescriber. [1]
A follow-up study found associations between treatment of anxiety or depression and lower subsequent tic severity. People were not randomly assigned to treatments, so it cannot tell us that a particular medicine caused the tic improvement. [2]
Keep room for follow-up
Write down who to contact if symptoms change or treatment causes problems. New confusion, breathing difficulty, a serious suspected drug reaction or a new neurological change needs appropriate urgent assessment. Continuing symptoms also deserve a planned review rather than being left without care.
For the Person With FND
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For Family, Friends, and Other Supporters
Help prepare the medicine list if asked, including over-the-counter products. Describe changes you have observed without deciding that a medicine is the cause.
Make room for the person’s priorities. A problem that is less visible than tics, such as low mood or poor sleep, may be the part of the day they most want help with.
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For Clinicians and the Care Team
Review primary tic disorder coexistence, neurodevelopmental needs, psychiatric comorbidity, sleep, pain and other functional symptoms. Keep indications explicit and coordinate prescribers. Avoid escalation of anti-tic medication solely on the assumption that all tic-like phenomena share a treatment mechanism. [1]
Discuss observational associations as associations. Nilles and colleagues followed a pandemic-onset cohort; treatment selection, confounding and follow-up limit causal interpretation and generalization. Track the intended condition-specific benefit and adverse effects as well as tic severity. [2]
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Research and Sources
Coordinated care is supported by expert guidance. The prospective study informs discussion of outcomes and coexisting-condition care; it is not evidence to prescribe an antidepressant to everyone with functional tics.
| Citation | Figure | Full citation and scope |
|---|---|---|
| [1] | — | Malaty IA, Anderson S, Bennett SM, et al. Diagnosis and management of functional tic-like phenomena. Journal of Clinical Medicine. 2022;11(21):6470. Source. FND-CIT-0110. |
| [2] | — | Nilles C, Szejko N, Martino D, Pringsheim T. Prospective follow-up study of youth and adults with onset of functional tic-like behaviours during the COVID-19 pandemic. European Journal of Neurology. 2024;31(1):e16051. Source. Prospective observational cohort; treatment associations are not causal treatment comparisons. FND-CIT-0218. |
Evidence checked September 24, 2026. Human review pending. No new community quotations have been verified.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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