Possible additions if revised

A 2-year naturalistic study with 1,410 participants (1,147 with ADHD, the rest without ADHD) provided important information relevant to the safety of methylphenidate (MPH) in tic patients \citep{36958362}. Their main goal was to see if the stimulant, which suppresses appetite, suppressed growth. There was no significant difference in growth among children in or out of the MPH group. Blood pressure and pulse were significantly higher in the MPH group, but only trivially (about 1 mm Hg and 1 beat per minute after correcting for baseline differences). Tic prevalence decreased significantly in all 3 groups, more in the ADHD groups. There was slightly less tic improvement at 12 months in the group taking MPH (< 2 points on the YGTSS) but no significant difference at 6 months. Note that randomized, placebo-controlled studies show that tics actually improve, on average, on MPH \citep*{Black_2024}. In summary, MPH is relatively safe in ADHD.