Cannabinoids improve driving ability in a Tourette's patient

Abstract

Gilles de la Tourette syndrome (GTS) is a common psychiatric movement disorder that is characterized by motor and vocal tics and a strong association with comorbid obsessive compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD). On a systems level, the primary abnormality has been shown to be related to dopaminergic neurotransmission within cortico-striato-thalamo-cortical (CSTC) circuits, though a complete picture of the disorder’s pathophysiology remains elusive. Clinically, the therapeutic spectrum for GTS has been expanding over the last decade, though current treatment strategies are often ineffective and unsatisfactory. As a result, there is an urgent need for uncovering novel treatment strategies that could ameliorate both motor and behavioral symptoms, are more effective in treatment resistant patients, and cause less adverse effects. Early anecdotal reports have provided evidence that patients with GTS choose cannabinoids as a form of self-medication. As a result, several groups began investigating the role of the endocannabinoid system in GTS pathophysiology and cannabinoid based medicines as a form of treatment. Currently, there are a limited number of studies suggesting that oral Δ9-tetrahydrocannabinol (THC) is effective in the treatment of tics and behavioral comorbidities. Consequently, the role of the endocannabinoid system in GTS pathophysiology remains speculative, as further investigation on the role of the endocannabinoid system in GTS is needed. In this chapter, we review the state of the art and highlight studies that explored the role of the endocannabinoid system and cannabinoids based medicine in GTS.