Helps using cannabis oil with dementia

Cannabis hardly calms people with dementia

NIJMEGEN. The irritability and bustle of many dementia sufferers pose major problems for carers and relatives.

While there are enough non-pharmacological approaches to alleviate neuropsychiatric symptoms, there is often a lack of time, staff, or simply the knowledge and will to do so.

On the other hand, non-pharmacological procedures are often insufficient for severe agitation and restlessness. Neuroleptics should rightly not be prescribed to such patients on a permanent basis, but approved medicinal alternatives are sought in vain.

After all, the problem has now been recognized - there are now a number of studies with dementia patients with behavioral problems, mostly with preparations that are already used for other indications. Initial studies with analgesics suggest a certain benefit.

Patients became calmer - even with placebo

This brought Dutch geriatricians to Dr. Geke van den Elsen from the University of Nijmegen came up with the idea of ​​starting a therapy attempt with the cannabis active ingredient tetrahydrocannabinol (THC). THC - at least in low doses - has an analgesic and sedating effect with a very favorable risk profile.

Smaller studies in dementia patients seemed to suggest a positive influence on behavior, write the doctors around van den Elsen.

They were able to recruit 50 dementia patients with moderate behavioral problems for their phase II study (Neurology 2015; 84 (23): 2338-2346). A value of at least 10 points according to the Neuropsychiatric Inventory (NPI) and problems such as agitation, aggression or motor restlessness were required for at least one month.

On average, the patients had moderate dementia with an MMSE value of 15 points, two-thirds had been diagnosed with Alzheimer's disease, and the remainder had vascular dementia or a mixed type. During the study period, 24 patients received 1.5 mg THC in tablet form three times a day. Intoxication begins with around 10 mg of orally ingested THC. 26 patients received placebo tablets.

After three weeks, the NPI in the group with THC had actually decreased significantly, from 37 to 28 points at the beginning. However, a similar decrease was also observed in the placebo group - from 36 to 24 points.

A look at the agitation and aggression subscales could not change the picture either: the values ​​fell slightly in both groups. No significant changes in quality of life or everyday skills could be detected on the corresponding scales. The only plus point: side effects were also not observed more frequently with THC than with placebo.

Dose too low

The results led the study authors to suspect that the dose was probably a little too low after all. "A psychoactive drug is hardly effective without side effects," they write, pondering new studies with significantly higher doses.

In addition, the pronounced placebo effect could have watered down the result. The Dutch doctors write that the increased attention paid to patients and the positive expectations of the nursing staff and relatives may have contributed to a significant reduction in behavioral problems.

And this indirectly proves once again the good effectiveness of non-pharmacological methods.