Can Marijuana Cure Tourette’s Syndrome?
Recent studies suggest weed may be a highly effective treatment for Tourette’s Syndrome
What is Gilles de la Tourette’s Syndrome?
Tourette’s syndrome is known widely in popular culture, not by its primary characteristics, but by the impulse to loudly utter obscene words and phrases. This condition, which occurs only in a small subset, around 10%, of individuals with Tourette’s Syndrome, is known as coprolalia from the Greek words for dung and speech. Current research indicates that only 10% of individuals with Tourette’s Syndrome have coprolalia. So, if Tourette’s Syndrome is not primarily characterized by “shit talking”, what exactly is it?
Discovered in 1895 by researchers Jean-Martin Charcot and his student, Gilles de la Tourette while researching movement disorders at the Salpêtrière Hospital in Paris, Tourette’s syndrome was initially characterized as a maladie des tics (disease of tics) by Tourette. The pair had been trying to determine whether there was a separate condition from hysteria and chorea, a condition which features quick dance-like involuntary motions of the hands and/or feet. In a landmark study of 13 individuals, published by Charcot who would later name the condition after his student, Tourette’s syndrome was differentiated from other tic disorders in that it occurs primarily in facial muscles, notably blinking and sniffing. Modern research also indicates correlations between symptomology and environmental stress as well as a tendency for symptoms to be noticeably less severe in adulthood when compared with the same individuals in childhood.
Initially, with the then recent advent of psychoanalysis, it was thought that there was some kind of psychological underpinning to the disorder. Treatment languished until the latter part of the 20th century when it was discovered that antipsychotics, medicines that are defined by their effectiveness on various forms of psychosis such as schizophrenia, mania in bipolar disorder, and various forms of hallucinations, caused a noticeable reduction in symptoms. The first antipsychotic medicine to be studied was haloperidol, which is the most common antipsychotic medicine still prescribed today. Since haloperidol proved to be effective in treating the condition, psychiatric treatments for the disorder have become standard.
Aside from treatment with antipsychotic medications, modern approaches such as Cognitive Behavioral Therapy have shown promise, although they are less likely to be effective in childhood. These approaches center around redirecting thought patterns when the person begins to feel the impulse, known as the Premonitory Urge, to have a tic and the cognitive tax of that redirection is itself an impairment to learning in the classroom, for example. Research into Parkinson’s disease has also led to cognate treatments for Tourette’s Syndrome, such as brain implants. However, these surgeries are very invasive and new, often causing more harm than they alleviate, if symptoms are relatively mild.
How does cannabis affect someone with Tourette’s Syndrome?
Cannabis Sativa, the same plant which gives us both THC and CBD, is known to have a wide variety of effects on different forms of psychosis. High intake of THC in pre-adolescent boys with a predisposition to schizophrenia, for example, is known to cause an increased likelihood of developing the condition later in life. However, none of the active constituents of the cannabis plant, known as cannabinoids, have very direct effects on neurotransmitters the way other more potent drugs have. Rather, their impact on the Central Nervous System occurs through the endocannabinoid system, a recently discovered system which has a wide variety of psychological and physiological effects when there is modulation of its two primary receptors, CB1 and CB2.
The endocannabinoid system is incredibly important to a lot of things that we consider incredibly important to us, such as our sense of appetite (the reason weed gives us the munchies), stress, immunity, pain and our sex drive. Because one of the features of tics occurring as a result of Tourette’s Syndrome is that their frequency and severity are heavily correlated to measurements of stress, researchers began looking at the endocannabinoid system as a possible neurological origin of Tourette’s Syndrome. Indeed, in 2020, researchers studied the genetic profiles of 267 people with Tourette’s Syndrome and found a strong correlation with a mutation in the expression of the CNR1 gene, which controls the number of CB1 receptors in our bodies. Findings such as this have led researchers to test Medical Cannabis as a possible therapy for the disorder.
How much THC does it take?
In a recent overview of 28 studies on the relationship between the ECS and Tourette’s Syndrome, 25 were found to demonstrate a measurable reduction in tic frequency and severity. In many of the studies, the reduction of the severity of symptoms was correlated to higher doses of THC, and to a lesser extent, CBD. One study that showed promise looked at the dose of 10mg of THC (about 1/4th the THC in a joint) and 1mg of CBD per dose. There are important caveats though. In a study of 18 people, 3 people did not complete the study because of an increase in anxiety, a common reaction that some people have when consuming THC.
Although Medical Cannabis may not be the solution for everyone with Tourette’s Syndrome, the future of research is bright. As more and more cannabinoids are isolated from Cannabis Sativa, particularly those such as THCv which show promising anti-psychotic qualities, further study may find more effective therapeutic value in America’s most popular smoke. If you are someone with Tourette’s Syndrome and considering cannabis as an avenue you want to explore, please consult with your doctor and read up on the latest research before diving in.
Research Consulted for this Article
Szejko, Natalia, and Kirsten Müller-Vahl. “Cannabinoids: Possible role in the pathophysiology and therapy of Gilles de la Tourette syndrome.” (2022).
Barchel, Dana, et al. “Use of Medical Cannabis in Patients with Gilles de la Tourette’s Syndrome in a Real-World Setting.” Cannabis and Cannabinoid Research (2022).
Abi-Jaoude, Elia, et al. “A Double-Blind, Randomized, Controlled Crossover Trial of Cannabis in Adults with Tourette Syndrome.” Cannabis and Cannabinoid Research (2022).
Anis, Saar, et al. “Medical Cannabis for Gilles de la Tourette Syndrome: An Open-Label Prospective Study.” Behavioural Neurology 2022 (2022).
