Vocal Tics: Symptoms, Causes, and Treatment

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Vocal tics are sudden verbal sounds or words not in a person's control. These tics range from subtle sounds to shouting or yelling repeated words or phrases. Vocal tics are not harmful but can be embarrassing for some people. Symptoms can occur without a known cause, as part of an underlying health condition, or as a side effect of medication.

This article discusses symptoms of vocal tics, potential causes, and treatments.

Young boy being bullied by his classmates

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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 throat
  • Coughing
  • Grunting
  • Hissing
  • Humming
  • Repeating phrases or words
  • Sniffing
  • Use of profanity
  • Yelling or calling out

Symptoms often get worse with:

  • Caffeine
  • Excitement
  • Heat
  • Lack of sleep
  • Stress

Vocal Tics and Motor Tics

Vocal tics may occur alongside motor tics, like:

  • Biting lips
  • Blinking
  • Copying other people's movements
  • Facial expressions
  • Jumping
  • Shrugging shoulders
  • Smelling things
  • Skipping
  • Twitching

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.

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.

Tics in Adults

Although tics usually develop during childhood, they can spontaneously appear in adulthood as well. While children may outgrow their tics, symptoms are more likely to be permanent for people who develop them later in life.

Other Health Conditions

Vocal tics can occur with other health conditions, such as:

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 strategies
  • Increased awareness of tics and urges to tic
  • Recognition of triggers for tics and ways to change them
  • Substitution of a new behavior to replace tics

When to See a Healthcare Provider

Vocal tics are not harmful but can significantly impact your social life. Talk to your healthcare provider about treatment options if your tics negatively affect your life.

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.

Frequently Asked Questions

  • What causes vocal tics?

    The cause of vocal tics is not always known. Vocal tics can signify a tic disorder or other health conditions. Occasionally, they can be a side effect of medication, but motor tics are more likely to occur than vocal tics.

  • How are vocal tics treated?

    Vocal tics can go away on their own. Medications and comprehensive behavioral intervention for tics (CBIT) can help decrease the frequency and severity of tics.

  • What makes vocal tics worse?

    Vocal tics are intensified by stress, lack of sleep, excitement, heat, or stimulants, like caffeine.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.