Sativex Markedly Reduced Severe Tics in a Treatment-Resistant Tourette Syndrome Case | Research

The takeaway

A patient with severe Tourette syndrome that had not responded to standard treatments showed marked improvement in both motor and vocal tics after starting Sativex, confirmed by both subjective and blinded objective measures.

Read this if you have Tourette syndrome that has not responded to standard treatments and are considering cannabinoid therapy.

Marked improvement in tic frequency and severity confirmed by two blinded video assessors.

What the researchers found

A patient with treatment-resistant Tourette syndrome received Sativex (10.8 mg THC and 10 mg CBD daily, delivered as two oro-mucosal sprays twice daily) for four weeks.

Both subjective and objective measures showed marked improvement. The patient completed the Yale Global Tic Severity Scale, showing substantial self-reported improvement. More compellingly, video recordings made before and during treatment were rated by two assessors who were blind to the treatment stage, using a standardized rating scale. Both blinded assessors confirmed significant reductions in the frequency and severity of motor and vocal tics, with good inter-rater reliability.

Why it matters

Tourette syndrome has limited treatment options, and many patients do not respond adequately to available medications. This case adds to the growing evidence that cannabinoids may be effective for tic disorders, and the use of blinded objective assessment strengthens the finding beyond typical case reports.

The numbers in context

10.8 mg THC and 10 mg CBD daily. Assessment at pre-treatment and weeks 1, 2, and 4. Both subjective and blinded objective measures showed marked improvement. Good inter-rater reliability between two blinded assessors.

How the study worked

Single case report with assessment at pre-treatment and weeks 1, 2, and 4. Subjective assessment via Yale Global Tic Severity Scale. Objective assessment via blinded video rating using the Original Rush Videotape Rating Scale by two independent assessors.

What this study cannot tell us

Single case report, the weakest level of clinical evidence. Placebo effects cannot be ruled out, even with blinded video assessment. Four weeks of follow-up is short. The patient's specific characteristics may not represent all Tourette syndrome patients.

How to read the evidence

Preliminary evidence from a single case report, though the blinded objective assessment methodology is stronger than typical case reports.

When this study was published

Published in 2016. Clinical interest in cannabinoids for Tourette syndrome continues, with some controlled trials underway.

The bigger picture

Previous research has suggested cannabinoid efficacy for Tourette syndrome, and this case supports those findings with unusually rigorous methodology for a case report. The combination of THC and CBD in Sativex may offer advantages over THC alone, as CBD may attenuate some of THC's psychoactive effects while potentially contributing its own therapeutic benefits.

Questions still open

Would controlled trials of Sativex for Tourette syndrome confirm this finding? Is the THC or CBD component more important for tic reduction? What is the long-term durability of the tic reduction? Would lower doses be sufficient?

Common questions

Can cannabis treat Tourette syndrome?

This case report showed marked improvement in severe tics with Sativex (THC + CBD). Previous research has also suggested cannabinoid benefits for tics. However, the evidence is still limited to case reports and small studies, and controlled trials are needed.

What is Sativex?

Sativex is a pharmaceutical cannabis spray containing equal amounts of THC and CBD. It is approved in many countries for MS spasticity but has been studied off-label for other conditions including Tourette syndrome.

Read the original research

Severe motor and vocal tics controlled with Sativex®.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 24(6), 541-544

View on PubMed ↗

Citation

Trainor, David; Evans, Lois; Bird, Rupert. (2016). Severe motor and vocal tics controlled with Sativex®.. Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 24(6), 541-544.