Affiliations: Clinic of Psychiatry, Socialpsychiatry and
Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover,
Germany. Tel.: +49 511 5323551; Fax: +49 511 5323187; E-mail:
[email protected]
Abstract: Cannabinoids have been used for hundred of years for medical
purposes. To day, the cannabinoid delta-9-tetrahydrocannabinol (THC) and the
cannabis extract nabiximols are approved for the treatment of nausea, anorexia
and spasticity, respectively. In Tourette syndrome (TS) several anecdotal
reports provided evidence that marijuana might be effective not only in the
suppression of tics, but also in the treatment of associated behavioural
problems. At the present time there are only two controlled trials available
investigating the effect of THC in the treatment of TS. Using both self and
examiner rating scales, in both studies a significant tic reduction could be
observed after treatment with THC compared to placebo, without causing
significant adverse effects. Available data about the effect of THC on
obsessive-compulsive symptoms are inconsistent. According to a recent Cochrane
review on the efficacy of cannabinoids in TS, definite conclusions cannot be
drawn, because longer trials including a larger number of patients are missing.
Notwithstanding this appraisal, 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.
