Severe motor and vocal tics controlled with Sativex(R).

Trainor et al. ·Australasian psychiatry Impact 0.8

Clear benefit GRADE Very low 34 citations

Samplen = 1 Pat.

Duration4 weeks

EndpointYale Global Tic Severity Scale

Blindingeinfachblind

DesignFallserie

Cannabinoidkombination

THC:CBD1:1

Max. dose20.8 mg

Routeoromukosal

Key finding

Subjective and objective measurements showed marked improvement in frequency and severity of motor and vocal tics following treatment with Sativex.

Summary

Single case report: treatment-resistant Tourette syndrome, therapy with Sativex® (10.8 mg THC + 10 mg CBD daily, 2× oro-mucosal sprays). Assessment pre-treatment and at week 1/2/4. Subjective (Yale Global Tic Severity Scale) and objective measurement (Original Rush Videotape Rating Scale, blinded raters) showed marked improvement in frequency and severity of motor/vocal tics. Good inter-rater reliability.

PopulationPatient with treatment-resistant Tourette syndrome, n=1

InterventionSativex (THC 10,8 mg + CBD 10 mg/day), 2 oromucosal sprays twice daily

OutcomeMarked improvement in frequency and severity of motor and vocal tics in subjective (YGTSS) and objective assessment (Rush Videotape Rating Scale)

Confidence in the evidence

Very low

The lowest GRADE level, the effect estimate remains uncertain.

Downgraded for

Imprecision

Quality profile

Sample size ★★★★★

Blinding Single-blind

Effect size Clear benefit

Citations / year ★★★★★

Authors

Trainor D, Evans L, Bird R

DOI 10.1177/1039856216663737↗

Design: Fallserie

Abstract

Objectives: A single case report on cannabinoid treatment for treatment-resistant Tourette syndrome (TS). Method: Our subject received 10.8 mg Tetrahydocannabinol and 10 mg cannabidiol daily, in the form of two oro-mucosal sprays of 'Sativex((R))', twice daily. Assessment was pre-treatment and at week one, two, and four during treatment. He completed the Yale Global Tic Severity Scale as a subjective measure, and was videoed at each stage. The videos were objectively rated by two assessors, blind to the stage of treatment, using the Original Rush Videotape Rating Scale. Results: Both subjective and objective measures demonstrated marked improvement in the frequency and severity of motor and vocal tics post-treatment. There was good interrater reliability of results. Conclusions: Our results support previous research suggesting that cannabinoids are a safe and effective treatment for TS and should be considered in treatment-resistant cases. Further studies are needed to substantiate our findings.

The impediment to action advances action. — Marcus Aurelius