This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders.
Using Magnesium for Treating Tourette’s Syndrome? by Kayla Ethridge
As classified under Tic Disorders in the DSM-5, Tourette Disorder is a neurological condition presenting in both multiple motor or vocal tics. Tics are described as sudden, rapid, recurrent, nonrhythmic motor movement or vocalizations. One individual can have various tic symptoms over time and they wax and wane in frequency and they can be tic free from weeks to months, but the criterion overall is that the tics have persisted more than 1 year since the first tic onset. Tics are not limited to a certain muscle group or vocalization, but tics such as eye blinking and throat clearing are common across patient populations. Tics are generally experienced as involuntary and the individual appears to have no control over the presentation of tics, but tics can be voluntarily suppressed for varying lengths of time.
A person’s tics are as unique as they are as an individual. Tics can either be simple or complex. Simple motor tics are of short duration (i.e., milliseconds) and can include eye blinking, shoulder shrugging and extension of the extremities. Simple vocal tics include throat clearing, sniffing, and grunting. Complex tics on the other hand last longer in duration (i.e., seconds) and often include a combination of simple and complex tics at once. The complex tics are categorized by copropraxia, echopraxia, palilalia, echolalia, and coprolalia.
- Copropraxia: appear to be purposeful, and are sudden, tic-like vulgar sexual or obscene gesture
- Echopraxia: is a mirror phenomenon of tic-like imitation of someone else’s movements
- Palilalia: complex vocal tics that include repeating one’s own sounds or words
- Echolalia: complex vocal tics that include repeating the last-heard word or phrase
- Coprolalia: Uttering socially unacceptable words, including obscenities, or ethnic, racial, or religious slurs.
It is important to note that these tics are abrupt, sharp bark or grunt utterances and lacks in similarity to inappropriate speech observed in human interactions. This tic is the most commonly known due to its portrayal in the media, but is the rarest symptom affecting a tiny percentage of the population.
When people with Tourette’s describe what their tics feel like you will get a wide variety of answers. The most common explanation of the sensation of having a tic is having an urge, more specifically a somatic sensation prior to the tic and then a feeling of tension reduction following the expression of the tic.
There are many things that can effect tic symptoms. Severity of tics depend on the emotional state of the individual with Tourette’s. They can be worsened by anxiety, excitement, and exhaustion and appear to be better during calm, focused activities. The environment plays a role on tics as well causing an individual observing a gesture or a sound in another person may result in a new tic for an individual with Tourette’s. The risk is that people may perceive this tic as intentional and purposeful. Lastly, genetics and environmental factors influence tic symptoms expression and severity. It has been identified that there is is a link between genetics and Tourette’s Disorder. Risks related with child birth that can cause complication for tics are older paternal age, lower birth weight, and maternal smoking during pregnancy. These complications are highly associated with worse tic severity.
Although there is no cure for Tourette’s Disorder, there are a wide range of treatments available to help manage the tics to avoid interference with school, work, or social life. Many of these forms of management include medical treatments for tics include neuroleptic blockers of dopamine receptors and neuroleptic medications that come with a high price to pay of aversive side effects. Along with medical treatment, educational behavioral therapy such as Comprehensive Behavior Intervention Tics (CBIT) and exposure and response prevention therapy (ERP) can achieve improvement with symptomology. Some investigators have explored using Botulinum Toxin (BOTOX) injections as a form of treatment that decreases both the tic frequency and the urge to tic. When all else fails, deep brain stimulation (DBS) is recommended that involves placing the tip of a very fine wire into the targeted area of the brain. The wire then runs up through a small hole in the skull under the scalp down to a device implanted in the collarbone. It acts as a pacemaker for the brain.
Many of these treatment options are extensive and complex forms of management for Tourette’s. One of the simplest approaches for improving the symptoms of Tourette’s Disorder is often over looked; Magnesium. A new therapeutic approach to Tourette Syndrome symptoms is the benefit gained from oral administration of magnesium and vitamin B6 for Tourette’s symptoms. This therapeutic approach to Tourette’s Disorder is based on the hypothesis that there is a deficit of vitamins, or reduction of their activity which aggravates this pathology and often provokes more severe symptoms.
Magnesium plays an important role and not just for individuals with Tourette’s Disorder. Magnesium is often associated with the primary mineral for your heart and bones, but there is an extensive list of benefits Magnesium does for the body. Researchers have discovered 3,751 magnesium binding sites on human proteins. This alone, indicates that Magnesium plays a large role in human health and disease and it is greatly underestimated. In the human body Magnesium is found in more than 300 different enzymes in your body and is a large contributor to your body’s detoxification processes, and can prevent damage from environmental chemicals, heavy metals, and other toxins. Aside from heart and bone health and preventing from toxicity, Magnesium is necessary for activating muscles and nerves, creating energy in your body by activating adenosine triphosphate (ATP), and helping digest proteins, carbohydrates, as well as fats. It also serves as a building block for RNA and DNA synthesis and acts as a precursor for neurotransmitters like Serotonin.
Having a Magnesium deficiency can trigger and cause many conditions such as anxiety and panic attacks, depression, insomnia, musculoskeletal conditions, nerve problems, and the list goes on and on. You can boost magnesium intake by taking magnesium supplements, using topical magnesium oils, or something as simple as changing your diet to include more magnesium rich foods. Magnesium can be found in a variety of animal and plant products. To name a few foods packed with magnesium are nuts, beans, green leafy vegetables, and whole grains.
A new study of the effectiveness and safety of magnesium and vitamin B6 in Spain used a placebo study to determine the effects of magnesium and vitamin B6 on the tic symptoms of 10 patients over a three-month period of time. They found an improvement of 50% in the mean total number of tics between the individuals given the Magnesium and Vitamin B6 from those who were given the placebo. Outside of clinical testing, many parent’s with children living with tics express their experiences to support anecdotal evidence of Magnesium helping their children and the severity and frequency of their tics.
Overall, there are many methods of treating tics in Tourette’s Disorder and even though there is not a cure for the disorder, any form of treatment that improves the tics and quality of life is worth looking into. Tourette’s and tics are as unique as an individual themselves and not all treatments will work for everyone. Magnesium may not be the solution for all cases concerning Tourette’s, but the overall anecdotal evidence along with the (small) empirical research suggests that magnesium may be a good place to start.