Synthetic Cannabinoid Treatment Shows Improvement in Agitation in People with Alzheimer's

Results of a randomized, double-blind clinical trial suggest that nabilone — a synthetic cannabinoid — may be effective in treating agitation in people with Alzheimer's disease. "Agitation, including verbal or physical outbursts, general emotional distress, restlessness, pacing, is one of the most common behavioral changes associated with Alzheimer's as it progresses, and can be a significant cause of caregiver stress," said Krista L. Lanctôt, PhD, Senior Scientist at Sunnybrook Health Sciences Centre and Professor of Psychiatry and Pharmacology/Toxicology at the University of Toronto.

Lanctôt and colleagues investigated the potential benefits of nabilone for adults with moderate to severe Alzheimer's dementia with clinically significant agitation. Over the 14-week trial duration, 39 participants (77 percent male, average age 87) received nabilone in capsule form (mean therapeutic dose=1.6 +/- .5 mg) for six weeks, followed by six weeks of placebo, with one week between each treatment period. In addition to measuring agitation, the researchers assessed overall behavioral symptoms, memory, physical changes and safety. They found that:

• Agitation improved significantly in those taking nabilone, compared to placebo, as measured by the Cohen-Mansfield Agitation Inventory (p=0.003).
• Nabilone also significantly improved overall behavioral symptoms, compared to placebo, as measured by the Neuropsychiatric Inventory (p=0.004).

The researchers also observed small benefits in cognition and nutrition during the study. More people in the study experienced sedation on nabilone (45 percent) compared to placebo (16 percent).

"Currently prescribed treatments for agitation in Alzheimer's do not work in everybody, and when they do work the effect is small and they increase risk of harmful side effects, including increased risk of death. As a result, there is an urgent need for safer medication options," said Lanctôt. "These findings suggest that nabilone may be an effective treatment for agitation; however, the risk of sedation must be carefully monitored. A larger clinical trial would allow us to confirm our findings regarding how effective and safe nabilone is in the treatment of agitation for Alzheimer's."

Note: Marijuana is not approved by the FDA for the treatment or management of Alzheimer's disease or other dementias. As medical marijuana use becomes more common, it is important to point out that much about its use in people with Alzheimer's or other dementias is unknown.

Marijuana is, essentially, an untested drug in Alzheimer's. There is currently no robust, consistent clinical trial data supporting the use of marijuana for treatment of Alzheimer's disease dementia — nor for related issues. The Alzheimer's Association believes that more research in this area is needed.

This article has been republished from materials provided by AAIC 2018. Note: material may have been edited for length and content. For further information, please contact the cited source.