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Cannabinoids and Tourette’s Syndrome

What is Tourette’s Syndrome?

Contrary to what the media portrays, not all people suffering from Tourette’s Syndrome randomly scream out curse words. In fact, according to the National Institute of Neurological Disorders and Stroke, only about 10% of those with the disorder actually do that. Tourette’s Syndrome is a neurological disorder characterized by uncontrollable vocal and motor tics, which can be mild, moderate, or severe. About 3% of children have the condition and it affects all ethnicities, but boys are more likely to have the condition than girls. Tourette’s is first noticed when children are around six or seven years old with symptoms lasting into adulthood.

According to the NIH, tics can either be simple or complex. Simple tics include a limited number of muscle groups and include movements like blinking, eye-rolling, facial grimacing, head and/or limb jerking, and shoulder shrugging. Simple vocal tics are clearing one’s throat repetitively, grunting, and sniffing. Complex tics “are distinct, coordinated patterns of movements involving several muscle groups”. Some examples are jumping and hopping, as well as twisting and bending. Complex vocal tics include words and phrases. Tics can get worse when the patient is excited or anxious.

In addition to having tics, Tourette’s sufferers are likely to have comorbidities like anxiety, ADHD, OCD, social struggles, behavioral issues, and learning disorders.

What causes Tourette’s?

Currently, there is no known cause and no cure. Doctors and researchers believe genetic and environmental factors play a role, but aren’t able to pinpoint a specific cause. What they do know is that it can run in families, but that isn’t always a predictor of who will develop the disorder. Doctors think exposure to some environmental factors can play a role, as well. Tourette’s involves abnormalities in multiple regions of the brain, such as the basal ganglia, frontal lobes, and cortex. Because of the complexity of symptoms, experts feel that the cause of the disorder is complex as well.

What is the treatment for Tourette’s?

Although there isn’t a cure for Tourette’s, there are treatment options to lessen the severity of tics. Treatments to reduce tics consist of behavioral therapy, medication, and deep-brain stimulation just to name a few. However, nothing has been proven to completely eliminate the tics and many of the medicinal treatments have unwanted side effects. Some of these side effects are even long term. Thankfully, the latest in marijuana news provides information from recent research about cannabinoids being well-tolerated without serious side effects, making it a safer treatment option.

Cannabinoids and Tourette’s

It only makes sense that researchers are finally testing the effectiveness of cannabinoids on Tourette’s Syndrome since people have been benefitting from the plant’s medicinal properties for hundreds of years. Below are several studies on the effectiveness of cannabinoids on Tourette’s and related disorders.

Sativex is a prescription medication containing both THC and CBD and is supposed to reduce both motor and vocal tics. A four week, single case study was conducted at Tauranga Hospital in New Zealand using Sativex to control severe motor and vocal tics. The study showed improvement “in the frequency and severity of motor and vocal tics post-treatment.” Their results “supported previous research that suggests cannabinoids are a safe and effective treatment for Tourette’s and should be considered in treatment-resistant cases.” (Trainor D, et al. Australia’s Psychiatry. 2016)

Another study conducted by the Pharmacopsychiatry Journal tested Delta-9 THC on 12 adult patients to assess the reduction of tics and associated behavioral disorders. They also found significant improvement of tics and obsessive-compulsive behavior after the single-dose treatment compared to placebo. Similar to the previous study, the treatment was found to be safe and effective. (Müller-Vahl KR, et al. Pharmacopsychiatry. 2002.)

Yet another study tested a treatment-resistant patient with Nabiximols to assess tic reduction. Nabiximols contain both THC and CBD. This was a single case study on a 22-year-old male with severe Tourette’s syndrome. The treatment was 1 puff per day and slowly increased to 3 puffs per day. The patient was assessed before treatment and after 2 weeks of treatment. They reported, “major improvements of both tics (22.2%) and premonitory urges, as well as health-related quality of life” (78.4%). Consistent with the previously mentioned studies, they also reported the medication was well tolerated and there were no serious side effects deeming the treatment safe and effective. (Brain Sci. 2017 May; 7(5):47.)

Cannabinoids and OCD

Obsessive-compulsive disorder can be mistaken for Tourette’s since the symptoms can be very similar. Both disorders can cause a strong urge to do a certain movement or sound. According to the Tourette’s Canada website, the difference is a tic has no reasoning behind it and is spontaneous. OCD is anxiety focused and has an inner purpose. There is a growing number of research studies that have focused on treating OCD symptoms with the use of cannabinoids. Below are some of the findings.

Cannabis and Cannabis Research published a review article for Cannabis as an effective treatment for OCD. They examined results from animal and human studies that imply the treatment is effective. “The evidence links the endocannabinoid system to the pathology underlying OCD.” Researchers feel they can target that system to reduce OCD, tics, anxiety, and impulse control disorders. The great thing about using cannabinoids to treat disorders like OCD is that the patients won’t have to wait for months to assess whether or not the medication is effective like they would on antidepressant medication. The results of taking cannabinoids take effect quickly.

Anxiety is also related to Tourette’s and a significant number of studies have shown promising results with CBD treatment. One study is discussed in The Journal Of Psychopharmacology. They conducted a study on the effects of cannabidiol on generalized anxiety disorder. Researchers measured regional cerebral blood flow (rCBF) at rest twice, on ten patients. Patients were given an oral dose of 400mg CBD or placebo in the first session. In the second session, patients were given whichever they didn’t receive during the first session. Compared to the placebo, CBD showed a decrease in the patient’s anxiety. The journal reports that the participants’ anxiety decreased due to the effects on the limbic and paralimbic brain areas.

In addition to clinical trials, there are numerous testimonials from individuals who have had positive results from the use of cannabinoids in the treatment of Tourette’s Syndrome and related disorders.

Administration

There are various ways to ingest medicinal cannabis. Most studies have tested the effectiveness of inhalation and the pill form of ingestion.

Smoking and vaping provide fast results, but won’t last as long as the ingested forms. There are also many different ways to get cannabinoids into the lungs through inhalation. If a person is experiencing acute tics due to excitement or anxiety, this may be the way to go since the calming effects are experienced fairly quickly.

Oral ingestion includes pills, edibles, and any other way that introduces the cannabinoids into the stomach. This method lasts longer than inhalation.

Other ways to administer medicinal cannabis is sublingual (under the tongue), dermal absorption, suppositories, and IV solutions.

This research is great news for those suffering from Tourette’s. It indicates cannabinoids can reduce the frequency and severity of both motor and vocal tics, which could provide patients with a better quality of life. Especially in those patients who are resistant to other forms of treatment.

Sources:

Center for Disease Control and Prevention: CDC.gov

Journal articles: PubMed: ncbi.nlm.nih.gov

Tourette’s Syndrome facts: www.ninds.nih.gov

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