Evaluating the Efficacy of Cannabis-based Medicines in Managing Tourette Syndrome: A Comprehensive Meta-analysis and Systematic Review
Ibrahim Serag1, Mostafa Hossam El din Moawad2, Hossam Tharwat Ali3, Mona Mahmoud Elsakka4, Sally Shayeb5, Islam Nadim6, Mohamed Abouzid7, Khalid Sarhan1, Mohamed A. Alsaied1, Ahmed Negida8
1Faculty of Medicine, Mansoura University, 22.Faculty of Pharmacy Clinical Department, Alexandria University, Alexandria, Egypt, 3Qena Faculty of Medicine, South Valley University, Qena, Egypt, 4Faculty of Pharmacy, Damanhour University, Damanhour, Egypt, 5Faculty of Public Health, Al-Quds University, Jerusalem, Palestine., 6Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt, 7Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, 8Virginia Commonwealth University
Objective:
In our systematic review and meta-analysis, we aim to assess the effectiveness of cannabis and cannabinoids in the treatment of Tourette Syndrome
Background:
Tourette Syndrome is a neurodevelopmental and behavioral disorder that is characterized by motor and phonic tics. The condition's prevalence is between 0.3 and 0.7% among children with a poorly understood pathophysiology. It involves structural and functional changes in corticosteroid circuits and neurochemical imbalances. Although there is no cure for Tourette Syndrome, cannabis offers a perfect solution for controlling tics through its action on the endogenous cannabinoid system
Design/Methods:
Following the PRISMA guidelines, we conducted a systematic review and meta-analysis. We included clinical trials and cohort studies investigating the efficacy of cannabis or cannabinoids in the treatment of Tourette Syndrome. We searched databases such as PubMed, Cochrane, Scopus, and Web of Sciences until December 2023. Data extraction focused on baseline characteristics of included studies and efficacy outcomes, including scores on the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale (PUTS), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). We conducted the analysis using RevMan software.
Results:
In total, 357 articles were identified, with nine studies included in the systematic review and 3 in the meta-analysis. These studies involved 401 adult Tourette's Syndrome patients treated with cannabis. YGTSS reveals a significant reduction in total scores (MD = -23.71, 95% CI [-43.86 to -3.55], P = 0.02), PUTS reveals a significant decrease in scores (MD = -5.36, 95% CI [-8.46 to -2.27], P = 0.0007) and Y-BOCS reveals no significant difference in score reduction (MD = -6.22, 95% CI [-12.68 to 0.23], P = 0.06).
Conclusions:
The present study suggests favorable and potentially effective results with cannabinoids in reducing the severity of tics and premonitory urges and increasing quality of life. Larger studies with more representative samples are needed.
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