THC alone did nothing for treatment-resistant Tourette syndrome, but adding CBD produced rapid improvement

A patient with treatment-resistant Tourette syndrome showed no improvement with antipsychotics or pure THC, but a combination of 10 mg THC with 20 mg CBD produced rapid, significant improvement in tic severity.

Pichler, Eva-Maria et al.·International journal of psychiatry in medicine·2019·Preliminary EvidenceCase Report
RTHC-02230Case ReportPreliminary Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

Standard antipsychotic treatments (risperidone, aripiprazole) and pure delta-9-THC had no significant effect on tics. When the patient received a daily combination of 10 mg THC and 20 mg CBD, there was a rapid and highly significant improvement on the Yale Global Tic Severity Scale.

Key Numbers

Daily dose: 10 mg THC + 20 mg CBD. Outcome: rapid, highly significant improvement on the Yale Global Tic Severity Scale. Prior treatments (risperidone, aripiprazole, pure THC) all failed.

How They Did This

Single case report of a female patient with treatment-resistant Tourette syndrome who sequentially tried multiple treatments.

Why This Research Matters

This case suggests that the combination of THC and CBD may be more effective than either alone for Tourette syndrome, and that CBD may be the key therapeutic component.

The Bigger Picture

The concept that cannabis components work better together than alone (sometimes called the entourage effect) has been debated. This case adds a data point suggesting CBD may enhance or enable the therapeutic effects of THC in at least some conditions.

What This Study Doesn't Tell Us

Single case report; results may not generalize. No blinding or placebo control. The sequential nature of treatments makes it hard to rule out time-related or placebo effects.

Questions This Raises

  • ?Would CBD alone have produced the same improvement?
  • ?What is the optimal THC:CBD ratio for Tourette syndrome?
  • ?Can these findings be replicated in a controlled trial?

Trust & Context

Key Stat:
THC alone failed; THC + CBD produced rapid tic improvement
Evidence Grade:
Preliminary: single uncontrolled case report.
Study Age:
Published in 2019.
Original Title:
Pure delta-9-tetrahydrocannabinol and its combination with cannabidiol in treatment-resistant Tourette syndrome: A case report.
Published In:
International journal of psychiatry in medicine, 54(2), 150-156 (2019)
Database ID:
RTHC-02230

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

Describes what happened to one person or a small group.

What do these levels mean? →

Frequently Asked Questions

What is the Yale Global Tic Severity Scale?

It is a standardized clinical tool used to measure the number, frequency, intensity, complexity, and interference of motor and vocal tics in Tourette syndrome.

Why might CBD help when THC alone didn't?

CBD has distinct pharmacological actions from THC, including anti-anxiety and neuroprotective properties. The authors speculated that CBD's unique mechanisms may be responsible for the therapeutic benefit.

Read More on RethinkTHC

Cite This Study

RTHC-02230·https://rethinkthc.com/research/RTHC-02230

APA

Pichler, Eva-Maria; Kawohl, Wolfram; Seifritz, Erich; Roser, Patrik. (2019). Pure delta-9-tetrahydrocannabinol and its combination with cannabidiol in treatment-resistant Tourette syndrome: A case report.. International journal of psychiatry in medicine, 54(2), 150-156. https://doi.org/10.1177/0091217418791455

MLA

Pichler, Eva-Maria, et al. "Pure delta-9-tetrahydrocannabinol and its combination with cannabidiol in treatment-resistant Tourette syndrome: A case report.." International journal of psychiatry in medicine, 2019. https://doi.org/10.1177/0091217418791455

RethinkTHC

RethinkTHC Research Database. "Pure delta-9-tetrahydrocannabinol and its combination with c..." RTHC-02230. Retrieved from https://rethinkthc.com/research/pichler-2019-pure-delta9tetrahydrocannabinol-and-its

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.