I have an 11-y-o son with tics (first dx at 8). His are all facial, no vocal and he's slightly OCD. The tics were getting pretty bad, so the ped referred us to a neurologist that suggested medication.
We were really hesitant to medicate, but worried that he would be starting middle school soon and didn't want him to get picked on. We put him on guanfacine (worked up to 2 mg/ day), and it really hasn't been as bad as expected. At first (and anytime we increased dosage), he was tired a lot and often fell asleep in the middle of the day, but that stopped after a few weeks.
The good news, most of the tics have stopped, except for when he gets really excited or anxious about something. We never thought he had a concentration problem, but since going on the meds, his grades have improved dramatically, making straight A's on all but two report cards in the last 2 years (and when he didn't make straight A's, he was bumped off by only one B.) He had never come close to principals list until he went on the medication.
All in all, I think the medication has improved his life. I know what you're going through. We debated and stressed and prayed to make the right decision. (Before we put him on, we had never had either of our kids on anything other than antibiotics before, and that was only once or twice. We were really terrified of long-term medication.) We are glad that we did chose the medication. He's happy, well adjusted and has made lots of new friends in middle school. It sure beats worrying about kids making fun of him because he's different.