Abstract
Cannabinoids have been used for hundred of years for medical purposes. To day, the cannabinoid delta-9-tetrahydrocannabinol (THC) and the cannabis extract nabiximols are approved for the treatment of nausea, anorexia and spasticity, respectively. In Tourette syndrome (TS) several anecdotal reports provided evidence that marijuana might be effective not only in the suppression of tics, but also in the treatment of associated behavioural problems. At the present time there are only two controlled trials available investigating the effect of THC in the treatment of TS. Using both self and examiner rating scales, in both studies a significant tic reduction could be observed after treatment with THC compared to placebo, without causing significant adverse effects. Available data about the effect of THC on obsessive-compulsive symptoms are inconsistent. According to a recent Cochrane review on the efficacy of cannabinoids in TS, definite conclusions cannot be drawn, because longer trials including a larger number of patients are missing. Notwithstanding this appraisal, by many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.
Highlights
The therapeutic spectrum in the treatment of Tourette syndrome (TS) has expanded during the last years, there is still a substantial number of patients who is unsatisfied with well established treatment strategies either due to less efficacy or significant adverse effects
A comparable observation has been made in a 28year-old male suffering from attention deficit hyperactivity disorder (ADHD) whose driving-related performance significantly improved after oral intake of THC [17]
Available data obtained from several single case studies and two small controlled trials consistently provide evidence for beneficial effects of cannabinoids in the treatment of tics in patients with TS
Summary
The therapeutic spectrum in the treatment of Tourette syndrome (TS) has expanded during the last years, there is still a substantial number of patients who is unsatisfied with well established treatment strategies either due to less efficacy or significant adverse effects. There is still no therapy known that is effective in the treatment of tics, and improves associated behavioural disorders In those patients who are impaired by their tics, and by psychiatric comorbidities combined treatment with several drugs is often inevitable [1]. New therapeutic strategies are desirable that are more effective, cause less adverse effects, and ideally improve tics, and associated behavioural problems. Against this background, many patients with TS seek alternative or complementary medicine including special diets and nutritional supplements [2,3] as well as legal and illegal drugs such as nicotine, alcohol and cannabis sativa [4, 5]
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