What is Tourette syndrome?
In the U.S., about 1 out of 160 children will knowingly suffer from Tourette syndrome. And about 1 out of 100 children around the world suffer from some kind of tic disorder. While Tourette’s will affect all ethnicities equally, more boys are diagnosed with the condition than girls: About three to four more times boys are diagnosed with Tourette’s than girls.
Many agree this is because boys are also most likely to be diagnosed with hyperactivity. This may well mean that many girls may have undiagnosed hyperactivity and/or some kind of tic condition.
Tourette’s is a condition symptomized by involuntary tics. These can be sounds or motor motions – which include muscular movements and/or facial motions. Typically, a diagnosis of Tourette’s will include at least a couple of motor tics in combination with at least one sound tic occurring at least a couple of times over the past year.
Sound or vocal tics can include shouts, hoots, throat clearing, snuffling, heckling, cursing and other sounds or words. Motor tics include jerks, shakes, bobbles, facial expressions, jaw clenching and other motions that occur at random moments – in private or public locations.
The most known Tourette’s symptom is cursing in public – but many with Tourette’s do not curse at all. And for many, Tourette’s is not detected, because the tics can occur infrequently and/or may not be particularly embarrassing.
Tourette’s will often arise between five and seven years old and will sometimes be a lifelong condition. For many, however, the condition will resolve itself by age 18. While this is good news for some, the suffering and embarrassment during those interim years often produces significant trauma and social isolation for the child.
Genetic or environmental causes – even possibly streptococcus infections – have been linked to Tourette’s.
Today most cases of Tourette’s are treated with multiple antipsychotic and antidepressant drugs. These can have a variety of side effects. These include interfering with puberty, aggression and other problems. We’ll discuss one of these drugs in a moment.
Are there any safer herbal medicines that can treat Tourette’s syndrome?
Chinese herbal medicine treats Tourette’s
A Phase III Clinical Study published in the Journal of Child Psychology and Psychiatry – the journal of the Association for Child and Adolescent Mental Health – demonstrates an herbal treatment for Tourette’s.
The researchers tested a formulation of 11 herbs that have been utilized for centuries for a variety of nervous system and brain function conditions. The formula has been called 5-Ling Granule. The 5-Ling Granule formulation is designed to resolve involuntary tics, along with reducing agitation and hyperactivity. The herbs in the formula in combination or separately have been used to help produce tranquility, and halt nervousness and fidgetiness. See below for the formula.
The researchers tested a total of 603 Tourette’s patients, who were between the ages of five and 18 years old. They were randomly divided into three treatment groups. One group of 363 patients was given 15 to 22.5 grams per day of the 5-Ling Granule
formula. Another group of 123 patients was given 200 to 400 milligrams per day of the drug Tiapride. (Tiapride is an antipsychotic dopamine antagonist pharmaceutical often used to treat Tourette’s). And finally, a group of 117 patients were given a placebo.
Herbal treatment works in eight weeks
The patients were examined using the Yale Global Tic Severity Scale (YGTSS). They were also measured for Total Tic Scores (TTS) as well as other tic-related conditions. The researchers also measured the incidence of adverse events among all three groups.
The research found that the 5-Ling Granule herbal formulation reduced tics and tic impairment significantly and performed better than the Tiapride drug and the placebo. The 5-Ling Granule formula reduced tics and tic symptoms in 74 percent of the patients treated. This compared with 68 percent of those taking the Tiapride drug.
The 5-Ling Granule herbal formulation reduced both motor and sound tics among the children. Improvements were seen as early as two weeks into the treatment.
Drug produces more side effects
The Tiapride drug patients experienced significantly more adverse effects compared to the TCM herbal formulation. The researchers found that the patients who took the herbal medicine experienced significantly less fatigue, sleep disturbance, headache and dizziness compared to those who took the Tiapride drug.
To give you an idea of the rate of adverse responses, 26 percent of the Tiapride group reported at least one adverse reaction. This compares to 13.8 percent among the 5-Ling Granule group and 12 percent among the placebo group that reported some kind of side effect. In other words, the number of adverse effects reported from the herbal medicine was only marginally higher than the number reported by the placebo group.
Other adverse side effects besides the ones mentioned above that can occur with Tiapride according to the drug data include the breakdown of muscle tissue (called rhabdomyolysis), heart abnormalities, hormonal changes that impair puberty, and an increased risk of breast cancer.
What is the 5-Ling Granule?
The table below gives the specific percentages and weights of each herb in the formula. As you can see by the description of each, each herb is used clinically in Traditional Chinese Medicine.
| English and Chinese name | Raw weight (g) | % | Empirical use in TCM clinical practice and putative pharmacological properties |
|---|---|---|---|
| Radix Paeoniae Alba (Bai-Shao) | 3.23 | 12.9 | (a) Alleviate muscle tension, spasm, and pain; (b) subdue emotional hyperactivity and agitation. |
| Rhizoma Gastrodiae (Tian-Ma) | 2.35 | 9.4 | (a) Has anticonvulsive, neuroprotective, and antihypertensive potential; (b) modulate bone-muscle strength; (c) protect memory loss. |
| Fructus Tribuli (Ji-Li) | 2.78 | 11.1 | (a) Improve depression and agitation; (b) enhance blood circulation: (c) sharpen vision. |
| Ramulus Uncariae cum Uncis (Gou-Teng) | 2.90 | 11.6 | (a) Has anticonvulsive and antihypertensive properties for hypertension-related vertigo and restlessness. |
| Lucid Ganoderma (Ling-Zhi) | 2.15 | 8.6 | (a) Used as a sedative and tranquilizer for dizziness and insomnia occurred with neurasthenia and hypertension; (b) has tonic effects for fatigue and debility. |
| Caulis Polygoni Multiflori (Shou-Wu-Teng) | 2.08 | 8.3 | (a) Tranquilize nervousness, insomnia, and dreamfulness; (b) enhance blood circulation and alleviate limb pain. |
| Semen Ziziphi Spinosae (Suan-Zao-Ren) | 2.08 | 8.3 | (a) Used as a sedative and tranquilizer for fidgetiness, insomnia and palpitation; (b) Used as anhidrotic for spontaneous perspiration and night sweating. |
| Fructus Schisandrae Chinensis (Wu-Wei-Zi) | 2.08 | 8.3 | (a) Has sedative effects for insomnia and neurasthenia; (b) reduce night sweating and seminal emission. |
| Fructus Gardeniae (Zhi-Zi) | 2.05 | 8.2 | (a) Has sedative effects for convulsion, fidgetiness and insomnia; (b) has anti-infective and antipyretic effects. |
| Rhizoma Arisaematis cum bile (Dan-Nan-Xing) | 1.90 | 7.6 | (a) Has anticonvulsive effects for epilepsy and tetanus; (b) has expectorant effect for cough with profuse and thin phlegm. |
| Radix Scutellariae (Huang-Qin) | 1.43 | 5.7 | (a) Calm mood restlessness occurred with hypertension and fever; (b) Has anti-inflammatory effects against infection-caused enteritis, dysentery and skin lesions. |
| In total | 25.00 | 100 |
How can I get the 5-Ling Granule?
This is a tricky one. The 5-Ling Granule formulation is made by Tasly Pharmaceuticals, Inc. Like many Chinese herbal medicines, I could not find the product online, nor on their website. You may find out more by contacting the company directly.
Another solution would be to show this formulation to an acupuncturist. Acupuncturists can often special order Chinese formulations from manufacturers. Many acupuncturists can also blend up such a formula in their office. Some might even adjust the formula to make it specific to the patient.
Another way of getting a similar formula made is through a Chinese herbal medicine pharmacist. Some compounding pharmacies also specialize in Chinese herbal formulations. They may also be able to stock or obtain Tasly’s product.
REFERENCES:
Zheng Y, Zhang ZJ, Han XM, Ding Y, Chen YY, Wang XF, Wei XW, Wang MJ, Cheng Y, Nie ZH, Zhao M, Zheng XX. A proprietary herbal medicine (5-Ling Granule) for Tourette syndrome: a randomized controlled trial. J Child Psychol Psychiatry. 2015 Jun 13. doi: 10.1111/jcpp.12432.