Tourette’s Syndrome

Benefits of Cannabis: Cannabis has been shown to significantly reduce tics in the majority of these patients and reduce anxiety and depression symptoms.

Risks of Cannabis: There are no specific risks in this patient population.

Suggested Initial Therapy [Inhaled Cannabis]: THC is the primary cannabinoid of interest in treating Tourette syndrome. Inhaled THC works quickly to treat tics. Strains high in Limonene and β-caryophyllene are preferred. Additional CBD should be considered for patients with coexisting depression and anxiety.

Suggested Initial Therapy [Tinctures]: Inhaled cannabis can be used, especially for intermittent symptoms to achieve an immediate response. Patients with day-long, chronic symptoms will be better addressed using tinctures. THC should be used, the addition of CBG may help to decrease anxiety and depression symptoms.

• THC Tincture: use a “sativa” THC tincture to fully leverage the entourage effect. Start at a 5mg THC dose administered with CBD tinctures (if using). The THC will help decrease tic symptoms.
• CBD Tincture: start at 8mg dose of a whole plant extract, use every 12 hours. The CBD will help with coexisting anxiety and depression symptoms.

Titration of Doses: after 7 days of therapy, adjustment of dose may be considered. Tincture doses are modified based on response. The THC tincture should be titrated up if tics are not adequately controlled. CBD increased to treat anxiety and depression. Adjustment of dose should be considered based on the patient's response every week or two. If side effects are experienced, the last dose administered which was well tolerated should be used.