The myths and facts of cannabis and dementia

Cannabinoids, the chemical chemicals in cannabis responsible for its therapeutic and recreational characteristics, have been studied by scientists and medical professionals over the last decade. Cannabinoids’ potential to calm anxious feelings is one area of research.

Agitation is a known behavioral alteration in Alzheimer’s patients. Medications may be necessary for severe agitation that does not respond to non-drug techniques, although everyone believes that non-drug methods should be tried first. Unfortunately, many of the current drugs used to treat this sort of behavior come with very dangerous side effects. Unfortunately, the most effective drugs are also the ones that may cause stroke and even death.

However, cannabinoids interact differently with the body, making them potentially safer and more effective for treating agitation. It’s believed that certain of these impacts may even assist prevent brain cell death.

However, there has been a lack of research on the efficacy of cannabis as a therapy for Alzheimer’s disease. Cannabinoids may not have the same impact on an Alzheimer’s disease brain as they do on a healthy brain, thus further research is needed. Cannabinoids, for instance, have been shown to have a soothing impact in healthy individuals, but they may have the opposite effect in those with Alzheimer’s disease.

My team at Sunnybrook Research Institute has begun investigating this further using seed money from the Alzheimer’s Drug Discovery Foundation and the Alzheimer Society Research Program.

We administered nabilone, a synthetic cannabinoid used to treat agitation and/or violence, to a group of persons with moderate to severe Alzheimer’s disease over a period of 14 weeks. Currently, Nabilone is the only drug licensed in Canada to alleviate nausea and vomiting caused by chemotherapy.

We want to see whether nabilone can decrease agitation without generating the main adverse effects associated with other drugs by comparing its effects to those of a placebo.

Also contributing to anger and violence in patients with severe Alzheimer’s disease are pain and weight loss. We also monitored changes in pain and appetite in trial participants because these symptoms have been shown to improve with cannabinoids.

After this, what do we know better?
Nabilone not only decreased agitation considerably as compared to the placebo group, but it also improved behavioral symptoms generally. One of the most prevalent negative effects was a drowsier feeling. Our next step is to test our hypotheses in a larger population to ensure the highest levels of safety and effectiveness.

We advise doctors, persons with dementia, and their families that more research is needed before we can prescribe cannabis to treat agitation, but we believe this study will pave the way for further studies on the use of cannabinoids to treat symptoms of Alzheimer’s disease. More research is needed to confirm our results and examine potential cannabis side effects, such as drowsiness and memory loss.

More study is needed to shed light on the pros and cons of medicinal cannabis and to back up well-informed laws, guidelines, and standards. This will allow us to devote more time and energy on improving the quality of life for individuals with dementia, rather than just focusing on preventing negative behaviors.

Krista Lanctôt, PhD, is a professor at the University of Toronto’s Department of Psychiatry and Department of Pharmacology and Toxicology, and a senior scientist at Sunnybrook Health Sciences Centre’s Hurvitz Brain Sciences Research Program. With the help of a biomedical grant from the Alzheimer Society Research Program, she conducted a pilot research on the use of cannabis in the treatment of behavioral abnormalities associated with Alzheimer’s disease.