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The Potential of Cannabinoid-Based Treatments in Tourette Syndrome

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Abstract

Novel pharmacological treatments are needed for Tourette syndrome. Our goal was to examine the current evidence base and biological rationale for the use of cannabis-derived medications or medications that act on the cannabinoid system in Tourette syndrome. We conducted a comprehensive literature search of PubMed for randomized controlled trials or clinical trials of cannabis-derived medications in Tourette syndrome. Data regarding the population, intervention, safety profile, and outcomes for each trial were extracted and reported and the evidence supporting use of individual cannabis-derived medications was critiqued. There is a strong biological rationale regarding how cannabis-derived medications could affect tic severity. Anecdotal case reports and series have noted that many patients report that their tics improve after using cannabis. However, only two small randomized, placebo-controlled trials of Δ9-tetrahydrocannabinol have been published; these suggested possible benefits of cannabis-derived agents for the treatment of tics. Trials examining other agents active on the cannabinoid system for tic disorders are currently ongoing. Cannabinoid-based treatments are a promising avenue of new research for medications that may help the Tourette syndrome population. However, given the limited research available, the overall efficacy and safety of cannabinoid-based treatments is largely unknown. Further trials are needed to examine dosing, active ingredients, and optimal mode of administration of cannabis-derived compounds, assuming initial trials suggest efficacy. Clinical use for refractory patients should at the very least be restricted to adult populations, given the uncertain efficacy and risk of developmental adverse effects that cannabinoids may have in children. Even in adult populations, cannabis-derived medications are associated with significant issues such as the effects they have on driving safety and the fact that they cause positive urine drug screens that can affect employment.

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  1. Yale University, Yale Child Study Center, PO Box 207900, New Haven, CT, 06520, USA

    Bekir B. Artukoglu

  2. Department of Psychiatry, Yale University, Yale Child Study Center, New Haven, CT, USA

    Michael H. Bloch

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Dr. Bloch is on the Scientific Advisory Board of Therapix Biosciences and receives research support from Biohaven Pharmaceuticals, Neurocrine Biosciences, Janssen Pharmaceuticals, and Therapix Biosciences. Dr. Bloch also receives research support from the Lesbian Health Fund, the National Institutes of Health, Tourette Association of America, the Brain & Behavior Research Foundation (formerly NARSAD), and the Patterson Foundation. Dr. Artukoglu has no conflicts of interest to disclose.

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Artukoglu, B.B., Bloch, M.H. The Potential of Cannabinoid-Based Treatments in Tourette Syndrome. CNS Drugs 33, 417–430 (2019). https://doi.org/10.1007/s40263-019-00627-1

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