This article discusses symptoms of vocal tics, potential causes, and treatments.
Symptoms of Vocal Tics
Tics commonly show up during childhood. Vocal tics range from subtle to more severe, and symptoms can include:
Barking (or other animal noises)Clearing the throatCoughingGruntingHissingHummingRepeating phrases or wordsSniffingUse of profanityYelling or calling out
Symptoms often get worse with:
CaffeineExcitementHeatLack of sleepStress
Causes of Vocal Tics
The cause of vocal tics isn’t always known. Vocal tics can be part of an underlying health condition or a side effect of certain medications.
Biting lipsBlinkingCopying other people’s movementsFacial expressionsJumpingShrugging shouldersSmelling thingsSkippingTwitching
Tic Disorders
Tic disorders are conditions with specific criteria for diagnosis, found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). For all types of tic disorders, symptoms begin before age 18.
These include:
Persistent (Chronic) motor or vocal tic disorder: A person with this condition has vocal or motor tics, but not both. Symptoms are present for at least one year. Provisional tic disorder: People with this disorder have both motor and vocal tics, and symptoms have been present for less than one year. Tourette’s syndrome: Criteria for diagnosing this condition include two or more motor tics and one or more vocal tics. Symptoms are present for at least one year.
Other Health Conditions
Vocal tics can occur with other health conditions, such as:
Attention deficit hyperactivity disorder (ADHD) Autism Obsessive-compulsive disorder (OCD) Schizophrenia Traumatic brain injury
Side Effect of Medications
Tics can be a side effect of certain medications. These tics typically cause jerky movements of the body or face rather than vocalizations. This condition—called tardive dyskinesia—often occurs with antipsychotic medications.
Tics can also develop from the use of medications such as:
Anticholinergics (chronic obstructive pulmonary disease, bladder control) Anticonvulsants (seizures) Antidepressants (depression) Antiemetics (nausea, acid reflux) Antihistamines (allergies) Antimalarials (malaria) Anxiolytics (anxiety) Antiparkinsonian agents (Parkinson’s disease) Decongestants (cold and flu) Mood stabilizers Stimulants (caffeine, amphetamines, nicotine)
How to Treat Vocal Tics
Vocal tics that are mild or infrequent may not require treatment. Tics that develop in childhood can resolve without treatment as a person becomes an adult. If medication is causing tics, switching to another drug can help.
Tics can negatively impact a person’s social life. Medications and therapy can help decrease the frequency and intensity of tics.
Medications
Medications can be used to help treat tics. These include:
Abilify (aripiprazole)Haldol (haloperidol)Orap (pimozide)
Some providers may prescribe “off-label” medications, meaning they are approved to treat something other than tics but appear to help with tics. For example, Tenex (guanfacine) and Catapres-TTS-2 (clonidine) are drugs to treat blood pressure issues and are also used to treat tics.
Comprehensive Behavioral Intervention for Tics (CBIT)
Comprehensive behavioral intervention for tics (CBIT) is a therapy used to support people with tics. The goals of this treatment are:
Education in stress management and coping strategiesIncreased awareness of tics and urges to ticRecognition of triggers for tics and ways to change themSubstitution of a new behavior to replace tics
Summary
Vocal tics are involuntary sounds or words. They can occur without a known cause, be part of an underlying health condition, or be a side effect of certain medications. Treatment for tics is not always necessary, but the symptoms can be embarrassing and prompt treatment. Medications and CBIT therapy can help reduce the frequency and intensity of tics.
A Word From Verywell
Vocal tics can make social situations uncomfortable. However, stressing about your tics can make them even worse. Talk to your healthcare provider about treatment options if you or your child suffers from tics. Consider talking to a therapist to learn coping strategies and tools to reduce the tics.
