Cannabis, specifically its cannabinoids delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), has been a subject of interest in the medical community for its potential to manage behavioral symptoms associated with dementia. Currently, more than 55 million individuals worldwide are living with dementia, a term for several diseases that affect memory, thinking, and the ability to perform daily activities. There is no cure for dementia, however several therapies exist to help improve the quality of life by limiting associated symptoms. In this blog we will explore studies and trials that look at the effectiveness of cannabis in easing agitation, aggression, and weight loss in patients with dementia.
The Endocannabinoid System (ECS) and Dementia
To understand why cannabis might help with dementia, it may first help to look at the role of the Endocannabinoid System (ECS). This widespread signaling system throughout the body and brain is significant for regulating several physiological processes such as feeding behavior, anxiety, and stress response. The ECS consists mainly of cannabinoid receptors CB1 and CB2, endogenous cannabinoids anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and synthesizing enzymes. Aging appears to result in decreased binding site availability of CB1 receptors throughout the brain region, leading researchers to further analyze the ECS and how cannabinoid use may benefit neuropsychiatric disorders.
Endocannabinoid modulation may protect from damage to mitochondria, restore balance, prevent the death of nerve cells, and reduce reactive oxygen species. Both CBD and THC can modulate the ECS, therefore have the potential to provide therapeutic benefits for neurodegenerative diseases.
In simple terms, cannabis works with our body’s ECS to potentially keep cells healthy, maintain balance, and protect against harmful molecules. There is a possibility of helping people with dementia regain some memory and cognitive abilities. Understanding these basic ideas helps us see how cannabis might offer relief in the challenging situation of dementia.
Efficacy of Dronabinol for Dementia
Dronabinol, also called Marinol, is a man-made version of THC. It received approval by The United States Food and Drug Administration (FDA) in 1985 to help with weight loss from HIV/AIDS and nausea from chemotherapy when other treatments were ineffective. Since then, it has been studied for additional conditions, such as easing nausea in cancer and behavioral issues in dementia.
Due to FDA approval, Dronabinol is more easily accessible for clinical trials. For further details on the approval and conditions, you can visit the FDA’s official information on Marinol.
Dronabinol for Agitation and Aggressive Behavior (2014 Chart Review)
In 2014, a study with 40 dementia patients at McLean Hospital showed positive results using Dronabinol. Given at 7 milligrams (mg) per day, it led to a notable decrease in agitation, better overall clinical scores, improved sleep, and increased meal consumption. The side effects were mild and did not cause participants to stop the treatment. However, the study lacked a control group, and the benefits were common.
In 2016, a study compared a placebo to THC to understand the efficacy and safety of oral THC doses for neuropsychiatric symptoms. Researchers compared findings using the Neuropsychiatric Inventory (NPI) Questionnaire. Findings between the two groups were similar. Although the THC did not show any more improvement than the placebo, it was well tolerated by the vulnerable population observed, which supports future similar studies to take place that provide higher doses of THC.
Safety and Efficacy of Medical Cannabis Oil
In 2016, a small study in Israel looked at 11 Alzheimer’s patients with severe agitation. They tried medical cannabis oil, and it showed a big drop in scores measuring the severity of symptoms and dementia-related behaviors. Side effects were minimal, suggesting cannabis treatments could be helpful.
Prescription of a THC/CBD-Based Medication
In 2019, a small study in Geneva looked at 10 female dementia patients with dementia and severe behavioral symptoms. They used a THC/CBD medication, which led to a big drop in scores measuring behavioral problems. Caregivers noticed improvements in the patients’ quality of life, suggesting that cannabis treatments could enhance the well-being of people with dementia.
Terpenes: The Aromas of Healing
While CBD and THC get attention, other parts of the cannabis plant, like terpenes, are essential for therapeutic potential. Some terpenes, like B-caryophyllene have anti-inflammatory effects that may protect the brain. With its calming lavender scent, Linalool is being studied for its anti-anxiety and its anti-inflammatory actions are well known. Research has shown linalool’s benefits for depression, insomnia, decreasing neuropathic pain, and having neuroprotective effects. Pinene, responsible for the pine smell, has also been reported to have anti-inflammatory and neuroprotective effects. Research published in 2021 noted “linalool, pinene, and CBD could present a unique opportunity to discover novel medicines to treat psychiatric and neurological illnesses”.
Conclusion
Research on cannabis and dementia shows promise in handling behavioral symptoms. Positive results from studies, including reviews and trials, suggest cannabinoids may offer therapeutic benefits. As research continues, we expect to learn more about the right doses, forms, and ways to use them for personalized dementia care. Also, a holistic approach involving nutrition, exercise, sleep, stress management, stimulation, and detox may help address a wider range of symptoms affecting cognitive abilities.
Finding Support
There is a lot to consider when starting cannabinoid therapy, but, as always, a Realm of Caring care specialist is here to help with free one-on-one support to answer your questions. Contact us today by calling (719) 347-5400 or emailing info@realmofcaring.org.
