Evidence suggests that medical marijuana can reduce tics and behavioral problems associated with Tourette’s syndrome.
In 1884, a French neurologist published an account of 9 patients with similar symptoms of an unknown disorder that he dubbed “maladie des tics“. His name was Georges Gilles de la Tourette and his early account of this tic-related disorder made him the first to identify what is known today as Tourette’s syndrome (TS).
Although Tourette’s syndrome is often depicted by the media as someone who can’t stop cursing and shouting obscene thoughts, most patients with TS experience much milder symptoms. Nevertheless, patients with TS whose symptoms are moderate to severe often find pharmaceutical treatments to be unsatisfactory.
But scientists now know that pharmaceuticals are not the only option for patients with TS. In recent years, anecdotal evidence and a few small studies have showed that medical marijuana may be able to improve both the tics and behavioral problems associated with TS.
What is Tourette’s Syndrome?
Tourette’s syndrome is an inherited disorder characterized by repetitive, compulsive actions known as tics. TS begins in childhood and tends to improve as the sufferer reaches early adulthood. It frequently occurs alongside other behavioral problems such as obsessive compulsive behavior (OCD), attention deficit hyperactivity disorder (ADHD), auto aggression, depression and anxiety.
Tics are central to Tourette’s syndrome and can be either motor or vocal. Sniffing, grunting, blinking and shrugging are all examples of common tics. Patients with TS describe the urge to perform a tic as a feeling of mounting tension or stress, which can only be relieved by carrying out the tic.
How Can Marijuana Help?
Although a substantial amount of anecdotal evidence exists for the treatment of TS with medical marijuana, very few scientific studies have ever been conducted.
Our search of numerous medical databases revealed only 2 clinical studies, both published by German researcher Dr. Muller-Vahl and her team of scientists. The first study was published in 2002 and involved 12 patients given a single oral dosage of THC. The second study was published a year later and involved 24 patients monitored over a 6-week period.
Both studies were successful in showing that THC was associated with tic reduction. And although the studies were unable to prove any impact on behavioral problems, evidence from case reports suggests that medical marijuana can help with TS-associated symptoms of obsessive compulsive behavior, auto aggression, attention span and impulse control.
Unfortunately, despite these positive findings, no clinical trials have been conducted since 2003.
How Does It Work?
Scientists still haven’t figured out the underlying neurological mechanisms that cause TS, although there are a few theories.
One of the theories suggests that too much dopamine may be the cause of tics. If this were true, the strong interactions that exist between the endocannabinoid system and dopamine release might explain why marijuana helps to reduce tics.
In an article published in the Expert Opinion on Pharmacotherapy journal, Dr. Muller-Vahl outlines her recommendations for the treatment of Tourette’s syndrome with marijuana-based medication.
If a patient with TS finds treatment with traditional pharmaceuticals to be ineffective, Muller-Vahl believes THC pills (Marinol®) should be considered as an alternative treatment. Patients should be given a starting oral dosage of 1-2 mg per day, which can be slowly increased by increments of 1-2 mg per day every 3-5 days. THC should be taken twice daily and clinical effects should start to be noticeable at a daily dose of 2.5-5 mg, but patients can be given up to 15-20mg/daily until desirable effects are achieved.
Patients using THC pills or other forms of medical marijuana should be monitored closely for side effects or adverse reactions. Common side effects include dizziness, tiredness, dry mouth and anxiety/panic (in rare cases).