Delta-9-tetrahydrocannabinol for the treatment of a child with Tourette syndrome: case report

Abstract

Background: Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by motor and vocal tics. In severe treatment-resistant cases of TS, cannabis-based medicine could be used alternatively as a therapy of last choice. Case Presentation: We present the case of an 7-year-old boy with severe TS and comorbid attention deficit/hyperactivity disorder (ADHD), who significantly benefitted from treatment with cannabis-based medicine. During an episode with increased tics, he became depressed, developed suicidal ideation, and exhibited separation anxiety resulting in social isolation. As treatment with various antipsychotics and Habit Reversal Training turned out to be unsuccessful, we implemented therapy with oral delta-9-tetrahydrocannabinol (THC) as oil-based drops. Starting dose was as low as 0.7 mg THC/day once a day and was gradually increased up to a maximum dose of 29.4 mg THC/day, resulting in a significant improvement of both tics and behavioral symptoms. Follow-up visits over a period of 4 months demonstrated a sustained treatment effect without any adverse events. Conclusion: From this single case report, it is suggested that THC is effective and safe in the treatment of tics, depression, and ADHD in children with severe and otherwise treatment-resistant TS.