Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2009 Oct 7;2009(4):CD006565.
doi: 10.1002/14651858.CD006565.pub2.

Cannabinoids for Tourette's Syndrome

Adrienne Curtis  1 , Carl E Clarke, Hugh E Rickards
Affiliations
Meta-Analysis

Cannabinoids for Tourette's Syndrome

Adrienne Curtis et al. Cochrane Database Syst Rev. .

Abstract

Background: Gilles de la Tourette Syndrome (GTS) is a developmental neuropsychiatric disorder characterised by the presence of chronic motor and phonic tics. Drugs currently used in the treatment of GTS either lack efficacy or are associated with intolerable side effects. There is some anecdotal and experimental evidence that cannabinoids may be effective in treating tics and compulsive behaviour in patients with GTS. There are currently no systematic Cochrane reviews of treatments used in GTS. There is one other Cochrane review being undertaken at present, on the use of fluoxetine for tics in GTS.

Objectives: To evaluate the efficacy and safety of cannabinoids as compared to placebo or other drugs in treating tics, premonitory urges and obsessive compulsive symptoms (OCS), in patients with GTS.

Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (in The Cochrane Library Issue 4 2008) , MEDLINE (January 1996 to date), EMBASE (January 1974 to date), PsycINFO (January 1887 to date), CINAHL (January 1982 to date), AMED (January 1985 to date), British Nursing Index (January 1994 to date) and DH DATA (January 1994 to date). We also searched the reference lists of located trials and review articles for further information.

Selection criteria: We included randomised controlled trials (RCTs) comparing any cannabinoid preparation with placebo or other drugs used in the treatment of tics and OCS in patients with GTS.

Data collection and analysis: Two authors abstracted data independently and settled any differences by discussion.

Main results: Only two trials were found that met the inclusion criteria. Both compared a cannabinoid, delta-9-Tetrahydrocannabinol (Delta(9)THC), either as monotherapy or as adjuvant therapy, with placebo. One was a double blind, single dose crossover trial and the other was a double blind, parallel group study. A total of 28 different patients were studied. Although both trials reported a positive effect from Delta(9)THC, the improvements in tic frequency and severity were small and were only detected by some of the outcome measures.

Authors' conclusions: Not enough evidence to support the use of cannabinoids in treating tics and obsessive compulsive behaviour in people with Tourette's syndrome.

PubMed Disclaimer

Conflict of interest statement

There is no potential conflict of interest

Update of

  • doi: 10.1002/14651858.CD006565

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Muller‐Vahl 2002 {published data only}
    1. Muller‐Vahl KR, Schneider U, Koblenz A, Jobges M, Kolbe H, DaldrupT, Emrich HM. Treatment of Tourette's syndrome with Delta‐9‐tetrahydrocannabinol (THC): A randomidsed crossover trial. Pharmacopsychiatry 2002;35(2):57‐61. [0176‐3679] - PubMed
Muller‐Vahl 2003/1 {published data only}
    1. Muller‐Vahl KR, Schneider U, Prevedel H, Theloe K, Kolbe H, Daldrup T, Emrich HM. Delta‐9‐tetrahydrocannabinol is effective in the treatment of tics in Tourette syndrome: A 6 week randomised trial. Journal of Clinical Psychiatry 2003;64(4):459‐465. [0160‐6689] - PubMed

References to studies excluded from this review

M‐V KR 2001 {published data only}
    1. Muller‐Vahl KR, Koblenz A, Jobges M, Kolbe H, Emrich HM, Schneider U. Influence of Treatment with D9‐THC on Neuropsychological Performance. Pharmacopsychiatry 2001;34:19‐24. [ISSN 0176‐3679] - PubMed
    1. Muller‐Vahl KR, Koblenz A, Jobges M, Kolbe H, Emrich HM, Schneider U. Influence of treatment with delta‐9‐tetrahydrocannabinol on neuropsychological performance. Pharmacopsychiatry 2001;34(1):19‐24. [0176‐3679] - PubMed
M‐V KR 2003 {published data only}
    1. Muller‐Vahl KR, Prevedel H, Theloe K, Kolbe H, Emrich HM, Schneider U. Treatment of Tourette Syndrome with Delta‐(‐Tetrahydrocannabinol (D9‐THC): No Influence on Neuropsychological Performance. Neuropsychopharmacology 2003;28:384‐388. - PubMed

Additional references

Advances in Neurology 2001
    1. Cohen DJ, Jankovic J, Goetz CG. Advances in Neurology. Vol. 85, Philadelphia: Lippincott, Williams & Wilkins, 2001.
Baker 2003
    1. Baker D, Pryce G, Giovannoni G, Thompson AJ. The therapeutic potential of cannabis. The Lancet Neurology 2003;2:291‐298. - PubMed
Bruggeman 2001
    1. Bruggeman R, Linden C, Buitelaar JK, Gericke GS, Hawkridge SM, Temlett JA. Risperidone versus pimozide in Tourette's disorder: a comparative double blind parallel‐ group study. Journal of Clinical Psychiatry 2001;62:50‐56. - PubMed
Chappell 1995
    1. Chappell PB, Leckman JF, Riddle MA. The pharmacological treatment of tic disorders. Child and adolescent Psychiatric Clinic of North America 1995;4:197‐216. - PubMed
Dion 2002
    1. Dion Y, Annable L, Sandor P, Chouinard G. Risperidone in the Treatment of Tourette Syndrome: A double blind placebo controlled trial. Journal of Clinical Psychopharmacology 2002;22:31‐39. - PubMed
DSM 1V 1994
    1. AMERICAN PSYCHIATRIC ASSOCIATION. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS. Fourth. WASHINGTON DC: AMERICAN PSYCHIATRIC ASSOCIATION, 1994.
Gaffney 2002
    1. Gaffney GR, Perry PJ, Lund BC, Bever‐Stille KA, Arndt S, Kuperman S. Risperidone versus clonidine in the treatment of children and adolescents with Tourette's syndrome. Journal of the American Acadamy of Child and Adolescent psychiatry 2002;41(3):330‐336. - PubMed
Gancher 1990
    1. Gancher S, Conant‐Norville D, Angell R. Treatment of Tourette Syndrome with transdermal clonidine: a pilot study. Journal of Neuropsychiatry and Clinical Neurosciences 1990;2(1):66‐69. - PubMed
Goetz 1987
    1. Goetz CG, Tanner CM, Wilson RS, Carroll CS, Como PG, Shannon KM. Clonidine and Gilles de la Tourette Syndrome: Double blind study using objective rating methhods. Annals of neurology 1987;21(3):307‐310. - PubMed
Hemming 1993
    1. Hemming M, Yellowlees PM. Effective treatment of Tourette's syndrome with marijuana. Journal of Psychopharmacology 1993;7(4):389‐391. - PubMed
Johns 2001
    1. Johns A. Psychiatric effects of cannabis. British Journal of psychiatry 2001;178:116‐122. - PubMed
Matsuda 1990
    1. Matsuda LA, Lolait SJ, BrownsteinMJ, Young AC, Bonner T. Structure of a cannabinoid receptor and functional expression of the cloned cDNA. Nature 1990;346:561‐564. - PubMed
Matsuda 1993
    1. Matsuda LA, Bonner TI, Lolait SJ. Localisation of cannabinoid receptor mRNA in rat brain. Journal of comparative neurology. 1993;327:535‐550. - PubMed
McDougle 1994
    1. McDougle CJ, Goodman WC, Leckman JF, Lee NC, Heinger GR, Price LH. A double blind placebo controlled study in patients with and without tics. Archives of General Psychiatry 1994;51:302‐308. - PubMed
Moher 2001
    1. Moher D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel‐group randomised trials. The Lancet 2001;357:1191‐1194. - PubMed
Muller‐Vahl 1998
    1. Muller‐Vahl KR, Kolbe H, Schneider U, Emrich HM. Cannabinoids: Possible role in the patho‐physiology and therapy in Tourette syndrome. Acta Psychiatrica Scandinavia 1998;98:502‐506. - PubMed
Munro 1993
    1. Munro S, Thomas KL, Abu‐shar M. Molecular characterisation of a peripheral receptor for cannabinoids. Nature 1993;365:61‐65. - PubMed
Romero 2002
    1. Romero J, Lastres‐Becker I, Miguel R, Berrendero F, Ramos JA, Fernandez‐Ruiz J. The endogenous cannabinoid system and the basal ganglia: Biochemical, pharmacological, and therapeutic aspects. Pharmacology and Therapeutics 2002;95:137‐152. - PubMed
Ross 1978
    1. Ross MS, & Moldofsky H. A comparison of pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome. American Journal of Psychiatry 1978;135(5):585‐587. - PubMed
Sandyk 1988
    1. Sandyk R, Awerbuch G. Marijuana and Tourette's syndrome. Journal of Clinical Psychopharmacology 1988;8(6):444‐445. - PubMed
Shapiro 1984
    1. Shapiro AK, & Shapiro E. Controlled study of pimozide vs. placebo in Tourette's Syndrome. Journal of the American Academy of Child Psychiatry 1984;23(2):161‐173. - PubMed
Shapiro 1989
    1. Shapiro E, Shapiro AK, Fulop G, Hubbard M, Mandeli J, Nordlie J, Phillips RA. Controlled study of haloperidol, pimozide, and placebo for the treatment of Gilles de la Tourettes's Syndrome. Archives of General Psychiatry 1989;46:722‐730. - PubMed
Thomas 1996
    1. Thomas H. A community survey of the adverse effects of cannabis use. Drug and alcohol dependence 1996;42:201‐207. - PubMed
TSSG 2002
    1. The Tourette's Syndrome Study Group. Treatment of ADHD in children with tics: A randomized controlled trial. Neurology 2002;58:527‐536. - PubMed
Walkup 1992
    1. Walkup JT, Rosenberg LA, Brown J, Singer HS. The validity of instruments measuring tic severity in Tourette's syndrome. Journal of the American Academy of Child & Adolescent Psychiatry May 1992;31(3):472‐7. - PubMed

MeSH terms