Exploring the potential of medical cannabis on Tourette's Awareness Day

A brief history of Tourette's syndrome

Up until the mid-1900s, Tourette's syndrome was poorly understood and often simply dismissed as a behavioural issue or worse. People with the syndrome faced heavy stigma and discrimination, leading to a lack of support and resources for managing their condition.

While there are mentions of individuals exhibiting tic-like behaviours stretching back to the 15th century (in the 1489 book Malleus Maleficarum, which translates to "The Hammer of Witches"), Tourette's sufferers at this time were considered to be "possessed" or practitioners of witchcraft.

It wasn't until 1885 when a French neurologist, Dr Jean-Martin Charcot (led by his top student - Dr. Gilles de la Tourette), published a comprehensive study titled "Study of a Nervous Affliction" that formal recognition of TS began. The paper detailed nine patients with what he coined "convulsive tic disorder," offering the first comprehensive clinical description of the syndrome, which was subsequently named after him. But the stigma and lack of understanding continued for more than a century, and still continues somewhat today.

Thankfully, by the mid-1960s, researchers started to gain a better understanding of Tourette's and the mechanisms behind it. Progress was slow, and proper scientific comprehension of the right way to treat TS continued to lag well behind. A 1975 New York Times article was among the first piece of openly published media to suggest that TS might involve a chemical imbalance in the brain, but a quote from this write-up is also very telling of the times:

“The bizarre symptoms of this illness are rivalled only by the bizarre treatments used to treat it.”

It was only in the 1990s that a more balanced, objective view of Tourette's emerged. Researchers were able to show that both genetics and environmental factors have a role to play in the development of the syndrome.

But again, public and medical perceptions were slow to catch up.

Initially, Tourette syndrome was considered a rare and severe disorder. However, it is now recognised as more common and often mild. Despite this, TS remains widely misunderstood by the general public, and many still believe that cursing tics are prevalent, even though they affect only a small minority of people with TS.

What is Tourette's Syndrome?

Tourette's Syndrome (TS) is a surprisingly common neurodevelopmental disorder that almost always develops before the age of 20 but can, in extremely rare cases, start in adulthood. To be diagnosed with TS, a person must display multiple motor tics (sudden, involuntary movements) and at least one vocal tic (repetitive sounds or words) for a minimum period of 12 months.

These tics can range from subtle eye blinking to much more complex behaviours.

They can include the well-known and often misunderstood symptom of coprolalia (involuntary swearing, especially in inappropriate settings) but also much less sensational tics, such as throat clearing, eye flutters, or sniffing.

Diagnosis can often be delayed as even the medical profession is often under-educated about TS. A recent study showed that the average age of diagnosis for Tourette's is 15 years old, which is relatively late compared to other neurodevelopmental conditions such as autism or ADHD. Some doctors may be of the belief that TS is rare, always involves coprolalia, or must be severely impairing, but this is slowly changing as more research and education is carried out.

What are the current conventional treatment options for Tourette's Syndrome?

As there is currently no known cure for TS, treatment plans focus on reducing the severity of the symptoms and managing the frequency and intensity of tics. No single treatment works for everyone, and it may take some trial and error to find the right combination of therapies.

• Behavioural Therapies, including "Comprehensive Behavioural Intervention for Tics (CBIT)" and "Cognitive Behavioural Therapy (CBT)," are the most commonly used approaches for managing TS. These therapies involve identifying and addressing external triggers, using techniques to manage or suppress tics, and focusing on changing negative thought patterns and behaviours.
• Pharmacotherapy is also a common treatment approach. Antipsychotics are often used to help reduce tics and have been shown to have some success, although they come with a range of potential side effects. OCD and ADHD are quite common co-diagnoses with TS, and so medications like SSRIs and stimulants may be prescribed to manage these comorbid conditions.
• Alternative therapies, ranging from supplements to acupuncture, hypnosis and more, may also be used in conjunction with conventional treatments. While evidence backing the efficacy of these approaches is lacking, many people with TS have reported some level of success.
• Lifestyle changes such as exercise, relaxation techniques, breathing exercises, and stress management can also help to reduce tic severity.

Can medical cannabis help with Tourette's Syndrome?

Yes, that's what the ever-growing body of emerging clinical research of medical cannabis for Tourette's is showing, and that backs up anecdotal evidence from Tourette's sufferers and their families.

How does medical cannabis potentially help with Tourette's Syndrome?

Researchers believe that medical cannabis can help with TS by regulating the endocannabinoid system in the body, which regulates homeostasis and plays a major role in motor control and mood.

THC, the psychoactive compound in cannabis, binds to CB1 receptors in this system, reducing the excitability of motor neurons and thus potentially suppressing tics. CBD is non-psychoactive and binds to CB2 receptors, which are located in the immune cells and can have anti-inflammatory and anti-anxiety effects. CBD also reduces the breakdown of anandamide, one of our own naturally produced cannabinoids, which also binds to CB1 and CB2 receptors.

What does current research say about medical cannabis for Tourette's Syndrome?

There are few research papers and clinical trials we can take a look at, with more promised as the scientific community slowly responds to public demand.

"Tetrahydrocannabinol and Cannabidiol in Tourette Syndrome", a double-blind, crossover trial from June 2023 involved 22 participants who were given a medical cannabis oil containing 5 mg/ml of THC and 5 mg/ml of CBD. Half were given the oil for the first six weeks, with the remaining receiving a placebo, and then the groups were swapped for another six weeks.

The results were pretty clear, with the authors stating:

"In severe Tourette syndrome, treatment with THC and CBD reduced tics and may reduce impairment due to tics, anxiety, and obsessive-compulsive disorder; although in some participants, this was associated with slowed mentation, memory lapses, and poor concentration"

In a follow-up interview published by the University of Sydney, Chris Wright (a 35-year-old male trial participant) stated:

“My tics were really painful, not to mention embarrassing and made me self-conscious. The oil has reduced my tics by about 50 per cent, and I have been able to read a book for the first time in 10 years. Some days I get home from work and realise I haven’t focused on my Tourette syndrome the entire day. It’s changed my life.”

A 2022 Open-Label Prospective Study titled "Medical Cannabis for Gilles de la Tourette Syndrome" backs these findings up, concluding that "MC treatment demonstrates good efficacy and tolerability in adult GTS patients".

As does this 2013 research paper, which finished with “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.”

Can medical cannabis be prescribed for Tourette's Syndrome in the UK?

Yes, but not through the NHS. The National Health Service is unwilling to offer medical cannabis prescriptions in most cases, even for hard to treat conditions like Tourette's Syndrome.

Thankfully for UK residents with TS, private medical cannabis clinics like us here at Releaf have the legal authority to work with specialists and prescribe medical cannabis for a very extensive range of conditions, syndromes, diseases, and other health concerns - Tourette's Syndrome included.

How do you receive a private prescription for medical cannabis for Tourette's Syndrome in the UK?

If you live in the UK and suffer from Tourette's syndrome, as well as other conditions that have not been effectively managed by conventional/traditional treatments, then you may qualify for a medical cannabis prescription.

As long as you:

• Have tried at least two conventional treatments with no success
• Have a diagnosed condition or syndrome that can be treated with medical cannabis
• Have no history of psychosis or schizophrenia
• Are over 18 years old
• Live in the UK

then you can apply for a medical cannabis prescription through clinics like Releaf. To find out if a cannabis-based medicine prescription may be appropriate for you, feel free to check out our quick and easy eligibility checker. It takes less than 30 seconds to complete, and you'll come out with a clear idea of where you stand and what your options are.

Final thoughts

While further peer-reviewed studies and in-depth research are required to fully understand the potential of medical cannabis for treating Tourette's Syndrome, the current clinical and anecdotal evidence suggests that it can help reduce tics and associated symptoms like anxiety.

If you would like to learn more about the potential of cannabis-based medical options, head over to our blog and education sections. Both are full to the brim with informative articles and guides.

And if you would like to speak to one of our leading UK cannabis specialist doctors about your health needs, reach out at any time.