They may occur in an individual who is already predisposed to a psychotic reaction. They may also occur when someone takes an overdose of the stimulant. Recent data seems to indicate that low to moderate doses of amphetamine or methylphenidate do not exacerbate tics. It is important to do a careful history and mental status examination before starting an adult or child on stimulant medication. We often get outside data such as relatives reports or school checklists to help verify the diagnosis.
Inattention is a fairly non-specific phenomenon.
It may be caused by anxiety, depression or medical illness. In the past, children often got medication coverage only for the hours they were in school. Some clinicians still use stimulants only for school or work situations. We prefer a more individualized approach. Such an individual might take a short acting stimulant only to cover school or difficult work situations.