While methylphenidate (MPH) is a core medication for ADHD, side effects have been reported where it induces tics or exacerbates existing ones due to increased dopamine activity. For children with both tics and ADHD, atomoxetine or clonidine are sometimes considered as alternatives to MPH. When combined with herbal medicine, caution is required with ingredients that alter drug metabolism, such as St. John's wort. However, metabolic competition with MPH is rarely an issue for the herbal medicines used by Dongjedang, such as those that soothe liver wind to alleviate nervous excitement or those that nourish both the mind and the spleen and stomach. During the consultation, please inform us of your child's current medications, dosages, and the progression of ADHD symptoms so that we can prescribe safely. Since stopping MPH on one's own can cause ADHD symptoms to worsen rapidly, please be sure to consult with your attending pediatrician or psychiatrist. For children with both tics and ADHD, Korean medicine treatment selects a prescription that simultaneously addresses both the concentration impairment associated with ADHD and the "wind" (pathogenic) aspect of tics. Strengthening the heart and spleen has a positive effect on both concentration and impulse control.