Tourette Syndrome is a neurological condition characterized by uncontrollable movements which are often repetitive in nature referred to as tics. This can include blinking, twitching, shoulder shrugging, etc. The condition can also involve repeated and compulsive sounds, oftentimes characterized by offensive language and/or profane speech.
The early symptoms of Tourette Syndrome (TS) are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.
Behavioral issues including hyperactivity, impulsivity and aggression are also common. Children with Tourette’s often have cognitive and learning disabilities associated with the condition, requiring individualized education planning.
Although the symptoms of TS are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed (against their will). Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.
There are numerous pharmaceutical treatments for Tourette’s, including:
- Haloperidol – Haloperidol is an antipsychotic agent. Exactly how it works is not known, but it may work by blocking certain chemicals in the brain. It is also used for treating schizophrenia.
- Risperidone – Risperidone is a antipsychotic medicine. It works by changing the effects of chemicals in the brain. Also used to treat schizophrenia and symptoms of bipolar disorder (manic depression). It is also used in autistic children to treat symptoms of irritability.
- Pimozide – Pimozide is an antipsychotic medication. It works by changing the actions of chemicals in the brain. Pimozide is used to suppress the motor and phonic tics associated with Tourette’s disorder.
- Aripiprazole – Aripiprazole is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression).
Neurologist and psychiatrists can be involved in the treatment of the condition, while behavioral therapies and relaxation techniques are often employed.
There have been numerous clinical trials that have displayed profound success in treating Tourette’s with the cannabinoid THC. As low as a 2.5 milligram dose of THC has been proven effective in the significant reduction of tics. A dose of 2.5 milligrams of THC has been taken by mouth daily, increasing to 5, 7.5 and 10 milligram doses over a four-day time period for six weeks.
Difference between CBD and THC in Medical Marijuana
THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana’s psychological effects. It acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA).
Cannabinoid receptors are concentrated in certain areas of the brain associated with thinking, memory, pleasure, coordination and time perception. THC attaches to these receptors and activates them and affects a person’s memory, pleasure, movements, thinking, concentration, coordination, and sensory and time perception, according to NIDA.
THC is one of many compounds found in the resin secreted by glands of the marijuana plant. More of these glands are found around the reproductive organs of the plant than on any other area of the plant. Other compounds unique to marijuana, called cannabinoids, are present in this resin. One cannabinoid, CBD is nonpsychoactive, according to the National Center for Biotechnology Information, and actually blocks the high associated with THC.
Cannabidiol or CBD, is the cannabis compound that has significant medical benefits, but does not make people feel “stoned” and can actually counteract the psychoactivity of THC. CBD does not cause a high, unlike THC. The reason why CBD is non-psychoactive is due to its lack of affinity for CB1 receptors. CB1 receptors are found in high concentrations in the brain, and are the pathways responsible for the psychoactive effects of THC.
CBD and THC levels tend to vary between different strains and varieties of cannabis. By using selective breeding techniques, we have managed to create varieties with high levels of CBD and THC.
Previous studies provide evidence that marijuana and delta-9-tetrahydrocannabinol (Delta(9)-THC), the major psychoactive ingredient of marijuana, respectively, are effective in the treatment of tics and behavioral problems in Tourette syndrome (TS). It has been speculated that the central cannabinoid receptor system might be involved in TS pathology.
Results from this study corroborate previous data suggesting that in patients suffering from TS, treatment with Delta(9)-THC causes neither acute nor long-term cognitive deficits.
The administration of cannabis capsules is the most common delivery method reported in clinical trials. Anecdotal reports of relief from symptoms from the smoking and vaporizing of cannabis has also been documented.
As reported in the March 1999 issue of the American Journal of Psychiatry, researchers at Medical School of Hanover in Germany reported that a 25 year old male had his total tic severity score reduced from 41 to seven within two hours of a 10 milligram dose of THC. The improvement lasted for seven total hours.
For the first time, patients’ subjective experiences when smoking marijuana were confirmed by using a valid and reliable rating scale. – American Journal of Psychiatry
A data review published in a 2003 issue Expert Opinions in Pharmacotherapy, confirmed that THC has been successful in the treatment of Tourette’s, and recommended adult sufferers try the treatment should traditional treatment fail to reduce symptoms. A 2013 study similarly concluded, “By many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.”
Following Maine’s 2013 decision to keep Tourette Syndrome off their list of medical marijuana qualifying conditions, Dr. Dustin Sulak and one of his patients were interviewed for local television, and demonstrated the profound effect cannabis has on the disorder. The results were immediate and lasted up to two hours via both smoked and vaporized cannabis. As the patient described, “just one puff” produced dramatic symptom relief.