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Was the doctor willing to try the Tenex and the Concerta together? Tenex, known better in ADHD circles in its extended release form, Intuniv, is fairly new for ADHD treatment. It's been used previously as an anti-hypertensive, and has shown promise in treating several ADHD symptoms, including self control and concentration. Another med in the same class, called Clonidine has been used in conjunction with ADHD meds for some time to control tics, but more recently has been used to counteract the sleep disruption that often comes along with stimulant treatment.

If Tenex doesn't do the trick on its own (keep an eye out for symptoms of low blood pressure, and it may well cause somnolence), you may consider trying it in addition to the Concerta, the Concerta for the ADHD, the Tenex for the sleep disruption and tics.

Best of luck.

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