PMID- 36040329
OWN - NLM
STAT- MEDLINE
DCOM- 20231026
LR  - 20231103
IS  - 2378-8763 (Electronic)
IS  - 2378-8763 (Linking)
VI  - 8
IP  - 5
DP  - 2023 Oct
TI  - A Double-Blind, Randomized, Controlled Crossover Trial of Cannabis in Adults with 
      Tourette Syndrome.
PG  - 835-845
LID - 10.1089/can.2022.0091 [doi]
AB  - Background: The number of effective evidence-based treatment options for patients 
      with Tourette syndrome (TS) is limited. Emerging evidence shows cannabinoids as 
      promising for the treatment of tics. Objectives: To compare the efficacy and 
      tolerability of single doses of three vaporized medical cannabis products and 
      placebo in reducing tics in adults with TS. Methods: In a randomized, 
      double-blind, crossover design, each participant received a vaporized single 
      0.25 g dose of Delta(9)-tetrahydrocannabinol (THC) 10%, THC/cannabidiol (CBD) 9%/9%, 
      CBD 13%, and placebo at 2-week intervals. Our primary outcome was the Modified 
      Rush Video-Based Tic Rating Scale (MRVTRS), taken at baseline and at 0.5, 1, 2, 
      3, and 5 h after dose administration. Secondary measures included the Premonitory 
      Urge for Tics Scale (PUTS), Subjective Units of Distress Scale (SUDS), and 
      Clinical Global Impression-Improvement (CGI-I). Correlations between outcomes and 
      cannabinoid plasma levels were calculated. Tolerability measures included 
      open-ended and specific questions about adverse events (AEs). Results: Twelve 
      adult patients with TS were randomized, with nine completing the study. There was 
      no statistically significant effect of product on the MRVTRS. However, there was 
      a significant effect of THC 10%, and to a lesser extent THC/CBD 9%9%, versus 
      placebo on the PUTS, SUDS, and CGI-I. As well, there were significant 
      correlations between plasma levels of THC and its metabolites, but not CBD, with 
      MRVTRS, PUTS, and SUDS measures. There were more AEs from all cannabis products 
      relative to placebo, and more AEs from THC 10% versus other cannabis products, 
      particularly cognitive and psychomotor effects. Most participants correctly 
      identified whether they had received cannabis or placebo. Conclusions: In this 
      pilot randomized controlled trial of cannabis for tics in TS, there was no 
      statistically significant difference on the MRVTRS for any of the cannabis 
      products, although the THC 10% product was significantly better than placebo on 
      the secondary outcome measures. Also, THC and metabolite plasma levels correlated 
      with improvement on all measures. The THC 10% product resulted in the most AEs. 
      ClinicalTrials.gov ID: NCT03247244.
FAU - Abi-Jaoude, Elia
AU  - Abi-Jaoude E
AUID- ORCID: 0000-0002-2448-9758
AD  - Department of Psychiatry, The Hospital for Sick Children, University of Toronto, 
      Toronto, Ontario, Canada.
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Bhikram, Tracy
AU  - Bhikram T
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Parveen, Ferdous
AU  - Parveen F
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Levenbach, Jody
AU  - Levenbach J
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Lafreniere-Roula, Myriam
AU  - Lafreniere-Roula M
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Sandor, Paul
AU  - Sandor P
AD  - Department of Psychiatry, University Health Network, University of Toronto, 
      Toronto, Ontario, Canada.
AD  - Youthdale Treatment Centers, Toronto, Ontario, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT03247244
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20220830
PL  - United States
TA  - Cannabis Cannabinoid Res
JT  - Cannabis and cannabinoid research
JID - 101684827
RN  - 19GBJ60SN5 (Cannabidiol)
RN  - 0 (Cannabinoid Receptor Agonists)
RN  - 7J8897W37S (Dronabinol)
RN  - 0 (Hallucinogens)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Cannabidiol/adverse effects
MH  - Cannabinoid Receptor Agonists/adverse effects
MH  - *Cannabis/adverse effects
MH  - Cross-Over Studies
MH  - Dronabinol/adverse effects
MH  - Hallucinogens
MH  - *Tics/drug therapy
MH  - *Tourette Syndrome/drug therapy
OTO - NOTNLM
OT  - Tourette syndrome
OT  - cannabidiol
OT  - cannabis
OT  - randomized controlled trial
OT  - tics
OT  - Delta9-tetrahydrocannabinol
EDAT- 2022/08/31 06:00
MHDA- 2023/10/23 12:43
CRDT- 2022/08/30 10:06
PHST- 2023/10/23 12:43 [medline]
PHST- 2022/08/31 06:00 [pubmed]
PHST- 2022/08/30 10:06 [entrez]
AID - 10.1089/can.2022.0091 [doi]
PST - ppublish
SO  - Cannabis Cannabinoid Res. 2023 Oct;8(5):835-845. doi: 10.1089/can.2022.0091. Epub 
      2022 Aug 30.