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Using Medical Cannabis to Treat Tourette’s Syndrome

Though it is only one among a group of tic disorders, Tourette’s Syndrome (TS) is by far the best known neurodevelopmental condition. People with Tourette’s generally begin exhibiting motor and/or vocal tics between the ages of five to seven, and while most children grow out of the disorder in adolescence, some continue to show symptoms throughout their lives. Approximately one percent of children in the US are affected by Tourette’s, and while treatment for the disorder is available, current therapies are limited by significant side effects.

Researchers have been exploring the apparently positive effect of cannabis on TS since the 1980s. Today, medical marijuana’s rapid ascent into the political and legal mainstream has breathed new life into this investigation, giving many sufferers hope that some form of the drug might be used to alleviate symptoms without the harsh side effects associated with traditional treatments.

How Cannabis Interacts With Tourette’s

The symptoms of Tourette’s can include “simple” tics, such as grunting or blinking, or more complex ones, like jumping, twirling, repeating back other people’s speech, or repetitively saying a certain phrase. The tic most popularly associated with Tourette’s is coprolalia, a vocal tic that includes a crude or inappropriate phrase, though this only occurs among 10-15 percent of those with the conditions who exhibit complex vocal tics.

Because little is known about the cause of Tourette’s, treatment for the condition is varied, and each form of treatment comes with its own problematic side effects. Dopamine blockers and inhibitors are among the most popular form of treatment, but they are known to cause weight gain and repetitive movements in some sufferers. Botox can be injected into affected muscles in order to stop motor tics, though this can cause stiffness and is a fairly invasive approach for a chronic condition. Medications like Ritalin are sometimes prescribed to treat the ADD that is associated with Tourette’s, but this can have the very unfortunate effect of exacerbating tics.

Many medical professionals believe that Tourette’s is associated with a dysfunction in the brain’s endocannabinoid system, making medical cannabis among the most direct ways of approaching the problem that the condition presents. This hypothesis is strengthened by clinical evidence suggesting that marijuana-based treatments decrease Tourette’s symptoms without negatively impacting patient’s cognition.

Could Cannabis Help Tourette’s Patients?

Various studies testing the effectiveness of several cannabis derivatives have found evidence that the drug helps to relieve tics, premonitory urges, and comorbidities experienced by those with Tourette’s. One retrospective evaluation discovered that cannabis had decreased tics among adult Tourette’s patients by 60%, while another observed a significant treatment effect of THC, the primary psychoactive component of marijuana, on both tics and OCD symptoms for TS patients.

In spite of this promising research, however, much remains to be learned about the relationship between cannabinoids and tic disorders like Tourette’s. The studies cited above both were reviewing prior research, and new research must be conducted in order to definitively conclude anything about marijuana’s efficacy.

What’s more, little is known about precisely which cannabinoid is responsible for the observed benefits of medical marijuana for TS sufferers. Some believe that both THC and the non-psychoactive cannabinoid CBD are partially responsible for lessening the occurrence and duration of tics experienced by patients, while others believe that CBD alone could be used to treat the condition. This would allow patients to treat their tic disorder with CBD oil or pills without having to experience the “high” produced by ingesting standard marijuana.

Little is known about the relationship between Tourette’s and marijuana, but anecdotal evidence and some scientific research both suggest that the drug could improve the experiences of patients by reducing the frequency of tics and alleviating comorbid conditions like ADD. If you suffer from Tourette’s or care for a child with Tourette’s, consider reaching out to Lakewood Medical Clinic for a medical consultation. We can help you decide whether medical marijuana should be a path to treatment you should pursue and determine the best potential course of treatment.

Cbd oil for child with tourettes

The trial is the first of its kind in Australia and will take place at Wesley Medical Research in Brisbane led by Chief Investigator and neuropsychiatrist Dr Philip Mosley. Participants will complete two periods of treatment with either a medicinal cannabis drug or a placebo, with both investigators and participants unaware of treatment status until the end of the trial.

"There is already early evidence to support the successful treatment of Tourette syndrome with cannabinoids," said Professor Iain McGregor, Academic Director of the Lambert Initiative. "This clinical trial could have a major impact and greatly improve the lives of those living with Tourette syndrome."

"Given the public interest in therapeutic use of cannabis, it’s important to conduct rigorous and methodologically-sound research," Dr Mosley said. "The purpose of this clinical trial is to investigate whether medicinal cannabis is a potential therapy for people with Tourette syndrome."

About Tourette syndrome

Tourette syndrome is a neurological disorder that develops in childhood and is characterised by involuntary movements and vocalisations (known as tics), which may be painful, embarrassing and functionally impairing.

There is currently no known cure for Tourette syndrome. Treatment aims to help control tics that inhibit everyday functioning, however current medication has been known to produce negative side effects such as weight gain, sleepiness and depression.

Tourette syndrome trial participant Chris Wright (left) and Dr Philip Mosley of Wesley Medical Research in Brisbane.

Living with Tourette syndrome

Chris Wright is the first participant in the trial. Chris developed Tourette syndrome in childhood and despite medication, his condition has persisted. Some people with Tourette syndrome experience side-effects to existing therapies including fatigue and weight gain.

At 31, Chris is working full-time in a customer service position in Brisbane and spends his day trying to regulate his tics. "Any reprieve would be very welcome. It is getting to the point where I don’t know what to do, it feels as though it all gets too much sometimes," said Chris.

Participants in the clinical trial at Wesley Medical Research will complete two six-week "crossover" periods of treatment with active drug or placebo, with both participants and investigators unaware of treatment status until the trial is complete.

"Tourette syndrome has really been a blow to my confidence . my life in general, I often spend my days off sleeping and recovering just to do it all again," Chris said.

Medicinal cannabis for the Tourette syndrome trial.

The trial drugs

Medicinal cannabis, developed to pharmaceutical standards, contains a mixture of cannabidiol (CBD) and tetrahydrocannabinol (THC) – two active ingredients derived from the cannabis plant.

In collaboration with the Lambert Initiative, Bod Australia Limited will be supplying the pharmaceutical grade cannabis extract to be used in the trial. The trial will examine the safety and efficacy of cannabinoids on tic frequency as well as the psychiatric and cognitive symptoms associated with Tourette syndrome.

"Our focus is to give people like Chris these opportunities to improve their quality of life. We offer hope and answers through medical research. We are fortunate to have dedicated frontline clinicians like Dr Mosley leading this important work and donors who continue to support this valuable work," said Dr Jennifer Schafer, Senior Clinical Trials Manager.

About the Lambert Initiative

The Lambert Initiative was established in 2015 following a $33.7m donation from Barry and Joy Lambert to the University of Sydney to conduct high quality research to discover, develop and optimise safe and effective use of cannabinoid therapeutics in medicine. Lambert Initiative is based at the Brain and Mind Centre at the University of Sydney.

About the Wesley Medical Research

Wesley Medical Research is an independent, not-for-profit organisation based in Brisbane, Queensland. They conduct medical research with a strong focus on improving patient care and quality of life. Their clinical and applied research aims to discover, test and refine new techniques for better diagnosis and treatment of illness and disease. Wesley Medical Research collaborates with doctors, nurses, and allied health professionals to accelerate contemporary care.