Loud swearing, obscene exclamations and uncontrolled twitching – that’s what most people think of when they think of Tourette syndrome. In fact, this neuro-psychiatric disorder manifests itself very differently in those affected. Motor and vocal tics are characteristic.
Medical cannabis can be used for a variety of neurological and psychiatric conditions. Some studies and reports suggest that medical cannabis can reduce the tics that occur in Tourette’s syndrome.
What is Tourette Syndrome?
Tourette syndrome (TS) is the most common tic disorder in adults. Worldwide, approximately 0.5 to 1 percent of the population suffers from TS. “Tics” can be uncontrolled, short, rapid movements or spontaneous vocalizations. Usually they are small movements of facial expressions, but they can also be sweeping movements or sounds.
Unfortunately, it is not yet known exactly what causes Tourette syndrome.
Researchers currently suspect that it is a movement disorder in which the suppression of excess movement impulses in the brain does not function properly. Hereditary factors obviously play a role, because there are many families in which several family members have tics (1).
Tourette syndrome symptoms:
- Motor tics such as eye blinking, eye rolling, nasal blinking or grimacing.
- Vocal tics such as throat clearing, coughing, or even screaming, rarely repeating words or uttering profanities
Comorbidities
Researchers have shown that approximately 80 to 90 percent of patients with Tourette syndrome have comorbidities. This means that the individuals suffer from other (psychological) symptoms in addition to the tics (2).
Comorbidities in Tourette syndrome (2):
- In children and adolescents:
- Attention deficit hyperactivity disorder (ADHD) (in about 50%)Obsessive-compulsive disorder (in about 30%)Social behavior disorderLearning disordersAnxiety disordersDepressionsleep disorders
- auto aggressive behavior
- In adults:
- Obsessive-compulsive symptoms
- depression
- ADHD
- Impulse control disorder
Treatment of Tourette’s syndrome
Experts recommend behavioral therapy and medication, mainly with antipsychotics, as initial treatment for tics.
Despite these proven therapeutic approaches, many patients are dissatisfied because their tics are not sufficiently reduced, or they have intolerable side effects.
Studies suggest that cannabis-based medications may be an alternative treatment for these sufferers.
Medical cannabis and Tourette’s syndrome
Prof. Kirsten R. Müller-Vahl, M.D., of a German Medical School, has been conducting research on Tourette syndrome and cannabis therapy for years.
In a review paper, she screened and evaluated several case studies and two randomized controlled trials on the topic.
The case studies provided evidence that cannabis may be effective not only in suppressing tics but also in treating associated behavioral problems. The two controlled studies explored the effects of THC in the treatment of TS.
Both studies showed a significant reduction in tics after treatment with THC compared to placebo. Overall, the data suggest that treatment with THC should be considered in treatment-resistant adult patients*, the author said. (3)
In a more recent review, researchers assessed all studies on cannabis-based medications and Tourette syndrome published through July 1, 2021, and listed in the PubMed database. Again, researchers found that the majority of studies were still limited to case reports, case series, and open-label, uncontrolled studies.
To date, only two small randomized controlled trials of tetrahydrocannabinol (THC, dronabinol) have been published demonstrating the safety and efficacy of cannabis in the treatment of tics.
On the other hand, there is growing evidence that cannabis-based medications are effective in treating tics and psychiatric comorbidities in individuals with Tourette syndrome. (4)
Conclusion
THC has positive effects on the tics associated with Tourette syndrome according to a recent review. Therefore, therapy with THC should be considered in adult treatment-resistant affected individuals. However, more large-scale randomized-controlled trials are needed to better explore the associations and an effective treatment modality.
The results of ongoing larger studies such as CANNA-TICS, a large multicenter study investigating the efficacy of the cannabis-based drug Sativex® (nabiximols) for treating people with tic disorders or Tourette syndrome, will further clarify the role of cannabis in treating patients* with TS.
Sources
- Barmer Krankenkasse
- Medizinische Hochschule Hannover
- Müller-Vahl KR. Treatment of Tourette syndrome with cannabinoids. Behav Neurol. 2013;27(1):119-24. doi: 10.3233/BEN-120276. PMID: 23187140; PMCID: PMC5215298.
- Szejko N, Saramak K, Lombroso A, Müller-Vahl K. Cannabis-based medicine in treatment of patients with Gilles de la Tourette syndrome. Neurol Neurochir Pol. 2022;56(1):28-38. doi: 10.5603/PJNNS.a2021.0081. Epub 2021 Oct 28. PMID: 34708399.