Three boys with an early history of attention deficit disorder with hyperactivity developed Tourette disorder. At 13, 12 and eight years of age, respectively, each met DSM-III criteria for a manic episode or bipolar disorder. Each of the boys had a family history of affective or affective spectrum disorder. Lithium carbonate in a range of 0.8 to 1.2 meq/L markedly improved their bipolar symptomatology with Tourette symptoms improving in two patients. Further study is suggested to determine the significance of these findings.
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