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Tourette’s syndrome is a neurological disorder in children characterized by making involuntary movements and sounds along with several behavioral or psychiatric changes. In general, the word “tics” is used to describe such involuntary actions. The child would have at least two movement tics and at least one vocal tic for a period of more than one year. Blinking, grimacing, jumping, eye rolling, and touching different objects are clear examples of motor tics, whereas vocal tics include throat clearing, tongue clicking, grunting, or swearing.
Currently, there is no cure for Tourette’s syndrome, whether for the tics or the altered behavior. Thus, researchers strive for reaching an optimal therapy for both aspects, including nutritional therapy, legal and illegal drugs. With the introduction of cannabinoids in the medical field, it is important to investigate their effects on Tourette’s syndrome.
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Mechanism of action of cannabinoids and their potential role in Tourette’s syndrome
Cannabinoids act on their specific receptors in the body, CB1 (primarily in the nervous system) and CB2. Focusing on the nervous disorders, many cannabinoids, such as tetrahydrocannabinol (THC) and its synthetic derivatives, have been effective in the treatment of neuropathic pain and the disorders of movement. The recommended medical marijuana compounds may exert their actions on CB1 receptors of the treatment of tics of Tourette’s syndrome. Furthermore, THC may have a direct effect on reducing the behavioral changes (including impaired concentration, perception, anxiety, and obsessive-compulsive disorder) or acts by enhancing the role of other medications of the same effect.
Efficacy of cannabinoids for the treatment of Tourette’s syndrome
Müller-Vahl (2013) showed that a single oral dose of THC reduced the tics and improved the attention and movement control. In addition, another patient observed that a combination of THC and amisulpride, which is used for the control of psychotic symptoms, was associated with a significant improvement of both motor and vocal tics along with behavioral changes. Such effects were markedly better than THC alone. The same results have been obtained in the relevant clinical trials that included both males and females, where the oral THC induced an excellent action on the tics and the scores of behavioral symptoms when compared to an inactive drug.
Side effects and precautions
In general, the reported side effects of THC in the patients with Tourette’s syndrome were quite similar to other types of diseases. The active component may be associated with dizziness, tiredness, dry mouth and some psychological effects, such as euphoria, “high sensation”, relaxation, impaired memory, and some cognitive changes. Therefore, THC and other psychic-altering cannabinoids are contraindicated in patients with psychic disease.
Cannabinoids, particularly THC, can be considered an effective treatment for patients with Tourette’s syndrome as they have favorable actions on the motor and vocal involuntary aspects as well as the behavioral symptoms. Future studies should target other cannabinoids which would be safer with respect to the psychic side effects.