Efficacy and Safety of Gemlapodect (NOE-105) in Adults and Adolescents With Tourette Syndrome

Inclusion Criteria:

1. Initially, patients aged 18 years onwards, at the time of signing the ICF form.Adolescents aged 12 years and older at the time of signing the ICF/informed assentform will be eligible for inclusion after completion of a sentinel cohort of adults.

2. Moderate to severe Tourette Syndrome as defined by DSM-5 diagnostic criteria andTS-CGI-S ≥ 4.

3. Treatment naive or previously treated patients in need of treatment alternative asper investigators judgement.

4. Patients must discontinue all medications used to treat TS for at least 14 daysprior to randomization. Other psychotropic drugs, including stimulants, will beallowed provided they have been stable for at least 30 days prior to randomizationand are expected to remain stable for the duration of the study.

5. BMI within the range 18 to 35 kg/m2 (inclusive).

6. Women of childbearing potential should only be included after a confirmed menstrualperiod and a negative highly sensitive urine or serum pregnancy test. Contraceptiveuse should be consistent with local regulations regarding the methods ofcontraception for those participating in clinical studies.

7. Capable of giving signed informed consent or consent from their legalrepresentative.

8. Fluency in the language of the investigator, study staff, and the ICF/informedassent form when applicable.

Exclusion Criteria:

1. Any medical condition which, in the opinion of the investigator, could interferewith study procedures including but not limited to functional tic-like disorder,secondary tic symptoms accompanied by late-onset tics, Huntington's chorea,malignant TS, neuroacanthocytosis, autism, and history of known intellectualdisability that would affect patient's ability to comply with study procedures.

2. Current active diagnosis of severe anxiety, bipolar disorder, schizophrenia, majordepressive disorder (MDD,), or Parkinson's disease. Patients with a history of MDDon selective serotonin reuptake inhibitors treatment stable for at least a month mayparticipate in the study.

3. A history of severe traumatic brain injury or stroke.

4. Any unstable medical conditions, severe symptoms, or clinically significantabnormalities on screening test/examinations, including uncontrolled seizuredisorders, which, in the investigator's judgment, will put them at a risk of majorAE during this trial, or will interfere with safety and efficacy assessments.

5. Are undergoing active CBT (including but not limited to comprehensive behavioralintervention for tics, exposure and response prevention, relaxation training) duringthe last 28 days before the planned date of randomization and until the end of thetrial. Patients willing to discontinue their CBT over this period are eligible toenroll in the study.

6. Known DSM-5 diagnosis of substance abuse or dependence.

7. Active suicidal ideation or behavior.

8. Use of prescribed or recreational cannabinoids during the study are prohibited.Prescribed cannabinoids include Epidiolex® (cannabidiol), Marinol® /Syndros® (dronabinol), and Cesamet® (nabilone). These medications will be discontinued duringthe Screening period. Study participants prescribed cannabinoids for seizuredisorders are not eligible for study participation. Recreational cannabinoids,regardless of their form of intake, which include tetrahydrocannabinol and/orcannabidiol, are prohibited.

9. Strong inhibitors and inducers of CYP3A4 are prohibited during the study.

10. Neurostimulation/deep brain stimulation for TS.

11. Participation in another clinical study with a study intervention administered inthe last 30 days.

12. Patients with a known hypersensitivity to gemlapodect or any of the excipients ofthe product

13. Positive urine drug screen for cannabis, cocaine, or nonprescribed opiates.

14. The person is an employee or family member of an employee of the Sponsor,Investigator, or study site personnel.

15. Judgment by the investigator that the patient should not participate in the study ifthe patient is unlikely to comply with study procedures, restrictions, andrequirements.

16. Previous randomization in the present study.

17. The person is currently committed to an institution by virtue of an order issuedeither by the judicial or the administrative authorities