Single center experience with medical cannabis in Gilles de la Tourette syndrome.

INTRODUCTION: Patients with Gilles de la Tourette syndrome (GTS) experience reduced function and impaired quality of life. The current medical treatments for this syndrome can cause significant side effects and offer partial symptomatic relief. In a few small trials medical cannabis (MC) has been suggested to offer symptomatic relief with a relatively benign side effect profile. We conducted a real-life assessment of clinical benefit and adverse effects of chronic MC treatment among patients with GTS. METHODS: GTS patients treated with MC were interviewed via phone regarding treatment efficacy and side effect profile from chronic MC consumption. Global efficacy was rated on a Likert scale of 1-5 and side effects of treatment were recorded. RESULTS: Forty-Two GTS patients (33 males, mean age 34.5) were interviewed for this study. The total global impression score of efficacy was 3.85 out of a total 5 possible points. Patients reported during the free discussion part of the interview about reduction in tic severity, better sleep and improved mood as positive effects of MC. Thirty-eight patients reported any kind of benefit from treatment while 10 patients with more than one year of consumption elected to stop treatment with MC for various reasons including severe side effects as psychosis in one patient. CONCLUSION: MC seems to hold promise in the treatment of GTS as it demonstrated high subjective satisfaction by most patients however not without side effects and should be further investigated as a treatment option for this syndrome.

Medical Cannabis in Parkinson Disease: Real-Life Patients' Experience.

BACKGROUND: The use of medical cannabis (MC) is controversial. Support for its benefits is based on small clinical series. OBJECTIVE: The aim of this study was to report the results of a standardized interview study that retrospectively assessed the effects of MC on symptoms of Parkinson disease (PD) and its adverse effects in patients treated for at least 3 months. METHODS: The survey used telephone interviews using a structured questionnaire based on subjective global impressions of change for various parkinsonian symptoms and yes/no questions on adverse effects. RESULTS: Forty-seven nondemented patients with PD (40 men) participated. Their mean age was 64.2 ± 10.8 years, mean disease duration was 10.8 ± 8.3 years, median Hoehn and Yahr (H&Y) was stage III. The duration of MC use was 19.1 ± 17.0 months, and the mean daily dose was 0.9 ± 0.5 g. The delivery of MC was mainly by smoking cigarettes (38 cases, 80.9%). Effect size (r) improvement for falls was 0.89, 0.73 for pain relief, 0.64 for depression, 0.64 for tremor, 0.62 for muscle stiffness, and 0.60 for sleep. The most frequently reported adverse effects from MC were cough (34.9%) in those who used MC by smoking and confusion and hallucinations (reported by 17% each) causing 5 patients (10.6%) to stop treatment. CONCLUSIONS: Medical cannabis was found to improve symptoms of PD in the initial stages of treatment and did not cause major adverse effects in this pilot, 2-center, retrospective survey. The extent of use and the reported effects lend support to further development of safer and more effective drugs derived from Cannabis sativa.