Cannabis-based Medications (CBMs) in patients with dementia

The majority of patients with dementia will develop psychological and behavioral issues such as agitation, delusion, and hallucination during the course of their disease. These symptoms are very important because they will impact the communication between patients and caregivers, interfere in providing optimum care to patients and impact the quality of life of patients and their caregivers.
Antipsychotic, antidepressants and anticonvulsants have been used for controlling these symptoms, however, the risk of side effects and drug-drug interactions, especially in elderly patients, is a great concern for clinicians.
There are anecdotal pieces of evidence that the use of Cannabis-Based Medications (CBMs) has resulted in controlling the behavioral and psychological symptoms, however, there is a lack of controlled studies to measure the clinical effectiveness and safety of CBMs in patients with dementia.
Prof. Broers and her colleagues measured the clinical outcomes and acceptability of CBM in severely demented patients in a prospective observational study in Geneva, Switzerland.
Ten demented female patients received CBM orally and were assessed at weeks 2, 4 and then every month. The researchers used a cannabis oil with a THC/CBD ratio of 1: 2 (11 mg THC/24 mg CBD). The average dose was7.6 mg THC/13.2 mg CBD daily after 2 weeks, 8.8 mg THC/17.6 mg CBD after 1 month, and 9.0 mg THC/18.0 mg CBD after 2 months.
Neuropsychiatric symptoms, Agitation Inventory score, and a behavior problem visual analog scale decreased by 40% after 2 months and the rigidity score by 50%. Half of the patients decreased or stopped other psychotropic medications. None of the patients had to stop any medication because of the side effect or drug-drug interaction and the effects lasted more than 2months.
This small study confirms the tolerability and effectiveness of CBMs in the management of behavioral and psychological issues, however, larger clinical studies in a more diverse population are needed. You can find the full-text of the study here.

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