NEJM EvidenceTetrahydrocannabinol and Cannabidiol in Tourette Syndrome

Could the THC-CBD treatment be the much-needed breakthrough for severe Tourette syndrome, despite its cognitive side-effects?

In an exploration of alternative treatments for severe Tourette syndrome, a recent double-blind, crossover trial studied the efficacy of coadministered THC and CBD. The study evaluated the impact on motor and vocal tics, with compelling results, while also examining potential adverse effects.

Key Points:

• The study focused on patients with severe Tourette syndrome, treated with escalating doses of oral oil containing 5 mg/ml of THC and 5 mg/ml of CBD.
• The study utilized a double-blind, crossover trial methodology, with a primary outcome measure being the total tic score on the Yale Global Tic Severity Scale (YGTSS).
• Total tic score reductions (YGTSS) at week 6 relative to baseline were more significant in the active group than in the placebo group: 8.9 (±7.6) versus 2.5 (±8.5).
• There was a significant correlation between plasma 11-carboxy-tetrahydrocannabinol levels and the primary outcome.
• Adverse effects were observed in the active treatment group, including cognitive difficulties such as slowed mentation, memory lapses, and poor concentration (n=8).

Additional Points:

• The study enrolled 22 participants in total, including eight females.
• Besides tic score reduction, secondary outcomes like global impairment, anxiety, depression, and obsessive-compulsive symptoms were also analyzed.
• The most common adverse effect in the placebo period was a headache (n=7).

Conclusion:

• This study suggests that in severe Tourette syndrome, a combined treatment of THC and CBD can reduce tics and possibly the impairment due to tics, anxiety, and obsessive-compulsive disorder. However, this was accompanied by some cognitive difficulties.

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Did You Know?
Tourette Syndrome affects 1 in every 160 children between the ages of 5-17, yet we are still exploring effective treatments for severe cases.