←Tourette Syndrome
Study register · detail Fallserie · Tourette Syndrome · 2019

Pure delta-9-tetrahydrocannabinol and its combination with cannabidiol in treatment-resistant Tourette syndrome: A case report.

Pichler et al. ·International journal of psychiatry in medicine Impact 1.3
Clear benefit GRADE Very low 22 citations
Samplen = 1 Pat.
Durationunclear
EndpointYGTSS
Blindingn.a.
DesignFallserie
Cannabinoidkombination
THC:CBD1:2
Max. dose30.0 mg
Routeoral
Key finding

The patient showed a rapid and highly significant improvement on the Yale Global Tic Severity Scale after administration of 10 mg delta-9-THC combined with 20 mg CBD.

Summary

Case report of a patient with treatment-refractory Tourette syndrome; monotherapy with THC 10 mg/day ineffective, combination of THC 10 mg + CBD 20 mg/day led to rapid and highly significant improvement on the Yale Global Tic Severity Scale.

P
PopulationFemale patient with treatment-resistant Tourette syndrome, n=1
I
InterventionTHC 10 mg/day combined with CBD 20 mg/day (oral)
O
OutcomeRapid and highly significant improvement on the Yale Global Tic Severity Scale (YGTSS) after combination of THC and CBD
Confidence in the evidence
Very low

The lowest GRADE level, the effect estimate remains uncertain.

Downgraded for
Imprecision
Quality profile
Sample size ★★★★★
Blinding —
Effect size Clear benefit
Citations / year ★★★★★
Authors
Pichler EM, Kawohl W, Seifritz E, Roser P
DOI 10.1177/0091217418791455↗
Design: Fallserie
Share
Abstract
Objectives: Anecdotal reports and preliminary studies suggest a therapeutic potential of cannabis in Tourette syndrome. We report the case of a female patient suffering from treatment-resistant Tourette syndrome. Methods: Guideline-directed antipsychotic treatment with risperidone and aripiprazole as well as pure delta-9-tetrahydrocannabinol had no significant effect on Tourette syndrome symptomatology. Results: Following administration of a daily dosage of 10 mg delta-9-tetrahydrocannabinol combined with 20 mg cannabidiol (CBD), the patient showed a rapid and highly significant improvement in the Yale Global Tic Severity Scale. Conclusions: It can be speculated whether the beneficial effects may rely on the pharmacological properties of cannabidiol.
Indication
Further studies on Tourette Syndrome
All studies →
S Koppel et al. · 2014 · Neurology
545 citations
Systematic review: Efficacy and safety of medical Cannabis in selected neurologic disorders [RETIRED]
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AAN-Leitlinie (Guideline Development Subcommittee) — Systematische Review über k=34 Studien (davon 8 Class I) zu medizinischem Cannabis bei neurologischen Erkrankungen. Für Tourette-Syndrom: orale Cannabinoide von unbekannter Wirksamkeit (insufficient evidence). Risiko schwerer psychopathologischer Nebenwirkungen ~1%. [RETIRED-Status]

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S Pringsheim et al. · 2019 · Neurology
249 citations
Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders.
Clear benefit Systematic Review

American Academy of Neurology Leitlinie basierend auf systematischer Review zu Tic-Behandlung bei Tourette-Syndrom. Hohe Konfidenz für Comprehensive Behavioral Intervention for Tics vs. Psychoedukation. Moderate Konfidenz für Haloperidol, Risperidon, Aripiprazol, Tiaprid, Clonidin, OnabotulinumtoxinA, 5-ling granule, Ningdong granule und Tiefenhirnstimulation des Globus pallidus zur Tic-Reduktion vs. Placebo. Niedrige Konfidenz (möglicherweise wirksam) für Pimozid, Ziprasidon, Metoclopramid, Guanfacin, Topiramat und Tetrahydrocannabinol. Evidenz für verschiedene Nebenwirkungen (Gewichtszunahme, medikamenteninduzierte Bewegungsstörungen, erhöhte Prolaktinspiegel, Sedierung, kardiovaskuläre Effekte).

10.1212/wnl.0000000000007467 View study →
A Rice et al. · 2024 · European child & adolescent psychiatry
24 citations
Efficacy of cannabinoids in neurodevelopmental and neuropsychiatric disorders among children and adolescents: a systematic review.
No benefit demonstrated Systematic Review

Systematische Review zu Cannabinoiden bei neuro­psychiatrischen und neuro­entwicklungs­bedingten Störungen bei Kindern/Jugendlichen (≤18 Jahre); k=18 eingeschlossene Artikel zu 8 Störungsbildern, davon n=3 zu Tourette-Syndrom. Nur 1 RCT identifiziert; Rest: 1 Open-Label-Studie, 3 unkontrollierte Vorher-Nachher-Studien, 2 Fallserien, 11 Fallberichte — hohes Bias-Risiko. Schlussfolgerung: limitierte und generell schlechte Evidenzqualität für Cannabinoid-Wirksamkeit.

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The impediment to action advances action. — Marcus Aurelius