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Treatment of Tourette syndrome with cannabinoids

Affiliation

  • 1 Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany. [email protected]
  • PMID: 23187140
  • PMCID: PMC5215298
  • DOI: 10.3233/BEN-120276

Free PMC article

Treatment of Tourette syndrome with cannabinoids

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Author

Affiliation

  • 1 Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany. [email protected]
  • PMID: 23187140
  • PMCID: PMC5215298
  • DOI: 10.3233/BEN-120276

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.

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 p …

Different responses of repetitive behaviours in juvenile and young adult mice to Δ 9 -tetrahydrocannabinol and cannabidiol may affect decision making for Tourette syndrome

Affiliation

  • 1 Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
  • PMID: 33125731
  • DOI: 10.1111/bph.15302

Different responses of repetitive behaviours in juvenile and young adult mice to Δ 9 -tetrahydrocannabinol and cannabidiol may affect decision making for Tourette syndrome

  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

Authors

Affiliation

  • 1 Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
  • PMID: 33125731
  • DOI: 10.1111/bph.15302

Abstract

Background and purpose: Medicinal cannabis is in increasing use by patients with Tourette syndrome, a neuropsychiatric disorder that affects about 1% of the general population and has a childhood onset. However, the pharmacological effects of Δ 9 -tetrahydrocannabinol (Δ 9 -THC) and cannabidiol (CBD) have not been systematically screened or compared between juvenile and young adult rodents in a model of Tourette syndrome.

Experimental approach: The administration of 2,5-dimethoxy-4-iodoamphetamine (DOI) increases head twitch response (HTR) and ear scratch response (ESR) and has been proposed as an animal model useful to respectively study motor tics and premonitory urges associated with tic disorders.

Key results: Comparing the potency of Δ 9 -THC to inhibit DOI-induced repetitive behaviours, the rank order was ESR > grooming > HTR versus ESR = grooming > HTR in young adult versus juvenile mice. Δ 9 -THC (5 mg·kg -1 ) induced severe adverse effects in the form of cataleptic behaviour in control mice and significantly increased ESR in juveniles. The pharmacological effects of CBD have not been studied in models of Tourette syndrome. In juveniles, CBD had no effect on DOI-induced ESR and grooming behaviours. CBD alone induced side effects, significantly increasing the frequency of HTR in juveniles and young adults.

Conclusion and implications: Δ 9 -THC efficaciously reverses peripheral but not central motor tics. Δ 9 -THC may reduce ambulatory movements and evoke premonitory urges in some paediatric patients. The small “therapeutic window” in juveniles suggests that CBD may not effectively treat motor tics in children and may even exacerbate tics in a population of patients with Tourette syndrome.

Keywords: 2,5-dimethoxy-4-iodoamphetamine (DOI); Tourette syndrome; motor tic; premonitory urge; side effect; tic disorder; Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD).

© 2020 The British Pharmacological Society.

Δ<sup>9</sup> -THC efficaciously reverses peripheral but not central motor tics. Δ<sup>9</sup> -THC may reduce ambulatory movements and evoke premonitory urges in some paediatric patients. The small "therapeutic window" in juveniles suggests that CBD may not effectively treat motor tics in children …