A New Use for Medical Marijuana? Tourette’s Syndrome

April 2, 2010 – “There’s one thing that helps my Tourette’s more than anything, and it’s marijuana,” says Louis Centanni, the 24-year-old actor and comedian featured in Patient Voices: Tourette’s Syndrome. Dr. Robert A. King and Dr. James F. Leckman of the Yale School of Medicine, who recently joined the Consults blog to answer readers’ questions about Tourette’s, here respond to readers asking about the use of marijuana for easing the tics, vocalizations and jerking movements of the syndrome.

Is Marijuana Effective for Tourette’s?

Q.  Clinical studies have shown that marijuana can be effective in relieving the symptoms of this disease: http://norml.org…Paul Kuhn, Nashville
Q. I see that the first patient with Tourette’s featured in the Patient Voices series uses marijuana to calm his tics. How do the chemicals in marijuana help Tourette’s patients, and do other depressant-type drugs also help? Rafi, N.Y.
A. Dr. King and Dr. Leckman respond:

A number of individuals with severe Tourette’s regularly use marijuana and report that it calms them and eases their tics. And a few randomized clinical trials of delta 9-tetrahydrocannabinol, or THC, the active ingredient in marijuana, have been carried out. Some of the investigators are convinced that THC and related compounds in marijuana called cannabinoids are helpful; others are more equivocal.

The most comprehensive review to date of the efficacy of cannabinoids in Tourette’s comes from a research group in Britain, the Cochrane Collaboration, that reviewed all the available data. They found that “the improvements in tic frequency and severity were small and were only detected by some of the outcome measures.” The group concluded that there is not enough evidence to support the use of cannabinoids in treating tics and obsessive-compulsive behavior in people with Tourette’s syndrome.

In addition, regular use of marijuana also has potential physical and psychological side effects, including apathy, depression or even psychosis in vulnerable individuals. As with other drugs, suitability depends on the patient, and risks and benefits must be weighed. We certainly wouldn’t recommend it for adolescents.

As for mode of action, there is a growing scientific literature concerning the body’s ability to make substances called endocannabinoids, which resemble the active compounds in marijuana. Our bodies contain various  enzymes that make these endogenous cannabinoids, and two specific types of receptors for these substances are distributed throughout our body, including the brain.

It appears that the cannabinoids can modulate major neurotransmitter systems in the brain – including those involving GABA and glutamine.  These pathways provide one hypothesis for why marijuana sometimes has the effect of reducing tics.  Source.

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