Cannabis for tic control: a systematic review and meta-analysis of its efficacy in Tourette syndrome management
Govind Singh Mann a 1 , Ahmed Farid Gadelmawla b , Ali Dway c , Fathima Hayathi Fayaz d , Eleni Asfaw Kebede e , Nandha Kumar Varadharaj d , Ayesha Akram f , Aneeza Khan g , Uchechi Blessing Azuwike h , Bharath Kanumuri Sampangi i , Oluwaseun Adeolu Ogundijo j
- a
- Department of Neurology, Sant Parmanand Hospital, Delhi, India
- b
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
- c
- Faculty of Medicine, Al-Andalus University for Medical Sciences, Tartus,Syria
- d
- Vitebsk State Medical University, Belarus
- e
- College of Health Sciences, Addis Ababa University,Ethiopia
- f
- Gujranwala Medical College, Gujranwala, Pakistan
- g
- Al-Tibri Medical College, Pakistan
- h
- Faculty of Medicine, University of Novi Sad, Serbia
- i
- Chettinad Academy of Research and Education, Chettinad Health and Research Institute, Chettinad School of Pharmaceutical Sciences, Kelambakkam, Tamil Nadu, India
- j
- Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Nigeria
Affiliationer
Abstract
Background
Tourette syndrome (TS) involves motor and vocal tics, often with obsessive–compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD). Cannabis-based medicines (CBMs) are a potential therapy due to their interaction with the endocannabinoid system, potentially reducing tics and associated symptoms. Compared to antipsychotics, CBMs may offer improved tolerability and fewer side effects. Although evidence is limited, emerging studies suggest their potential to improve quality of life in TS. This review was registered with PROSPERO (CRD420251088633).
Aim
To evaluate the effectiveness of CBMs in treating TS.
Methods
We systematically searched PubMed, Google Scholar, ScienceDirect, and the Cochrane Collaboration Database for cohort studies and randomized controlled trials (RCTs) up to July 2, 2025. Data extraction included study characteristics and efficacy outcomes measured by the Yale Global Tic Severity Scale (YGTSS) and Premonitory Urge for Tics Scale (PUTS). Meta-analysis using Review Manager 5.4 compared pre- and post-treatment scores using mean difference (MD) and 95% confidence intervals (CI).
Results
From 1,105 screened articles, eight studies met inclusion criteria for the review, and seven were included in the meta-analysis, involving 306 adult TS patients. CBMs significantly reduced YGTSS scores (MD = − 13.29, 95% CI [−21.67 to − 4.91], P = 0.002) and PUTS scores (MD = − 4.09, 95% CI [−7.24 to − 0.93], P = 0.01).
Conclusion
CBMs show promising potential in reducing tics and premonitory urges in TS. Larger, placebo-controlled trials are needed to confirm efficacy, ensure safety, and optimize dosing.
Keywords
Cannabinoids; Tourette syndrome; Tics; Endocannabinoid system
