Müller-Vahl K R, Koblenz A, Jöbges M, Kolbe H, Emrich H M, Schneider U
Department of Clinical Psychiatry and Psychotherapy, Medical School Hannover, Germany.
Pharmacopsychiatry. 2001 Jan;34(1):19-24. doi: 10.1055/s-2001-15191.
Previous studies have suggested that marijuana (cannabis sativa) and delta-9-tetrahydrocannabinol (delta9-THC), the major psychoactive ingredient of marijuana, are effective in the therapy of tics and associated behavioral disorders in Tourette Syndrome (TS). Because there is also evidence that cannabis sativa may cause cognitive impairment in healthy users, we performed a randomized double-blind placebo-controlled crossover trial for delta9-THC in 12 adult TS patients to investigate whether treatment of TS with a single dose of delta9-THC at 5.0 to 10.0 mg causes significant side effects on neuropsychological performance. Using a variety of neuropsychological tests, we found no significant differences after treatment with delta9-THC compared to placebo treatment in verbal and visual memory, reaction time, intelligence, sustained attention, divided attention, vigilance, or mood. Only when using the Symptom Checklist 90-R (SCL-90-R) did our data provide evidence for a deterioration of obsessive-compulsive behavior (OCB) and a trend towards an increase in phobic anxiety. However, these results should be interpreted with caution as SCL-90-R has known limitations on measuring OCB. We suggest that the increase in phobic anxiety is mainly due to the fact that a single-dose treatment rules out the possibility of administering the dosage slowly. In contrast to results obtained from healthy marijuana users, a single-dose treatment with delta9-THC in patients suffering from TS does not cause cognitive impairment. We therefore suggest that further investigations should concentrate on the effects of a longer-term therapy of TS with delta9-THC.
先前的研究表明，大麻（ Cannabis sativa ）及其主要精神活性成分 Δ9 - 四氢大麻酚（ Δ9 - THC ）对治疗抽动秽语综合征（TS）中的抽动及相关行为障碍有效。由于也有证据表明 Cannabis sativa 可能会对健康使用者造成认知损害，我们对12名成年TS患者进行了一项关于 Δ9 - THC 的随机双盲安慰剂对照交叉试验，以调查单剂量5.0至10.0毫克的 Δ9 - THC 治疗TS是否会对神经心理表现产生显著副作用。通过各种神经心理测试，我们发现与安慰剂治疗相比， Δ9 - THC 治疗后在言语和视觉记忆、反应时间、智力、持续注意力、分散注意力、警觉性或情绪方面没有显著差异。只有在使用症状自评量表90修订版（SCL - 90 - R）时，我们的数据才为强迫行为（OCB）的恶化以及恐惧焦虑增加的趋势提供了证据。然而，这些结果应谨慎解释，因为SCL - 90 - R在测量OCB方面存在已知局限性。我们认为恐惧焦虑的增加主要是由于单剂量治疗排除了缓慢给药的可能性。与健康大麻使用者的结果不同，TS患者单剂量使用 Δ9 - THC 治疗不会导致认知损害。因此，我们建议进一步的研究应集中在 Δ9 - THC 对TS进行长期治疗的效果上。
