Cannabis as a Beneficial Replacement Therapy for Psychotropic Drugs with Treating Neuropsychiatric Symptoms of Severe Alzheimer’s Dementia

BY MICHAEL C. PATTERSON

A recent study published by the US National Institutes of Health (NIH) and Frontiers of Psychiatry found that the use of a synthetic cannabinoid medicine (dronabinol) decreased Neuropsychiatric symptoms (NPs) in a clinical study of a female patient with severe Alzheimer’s Disease (AD).

The link to the study is here: Cannabinoid as Beneficial Replacement Therapy for Psychotropics to Treat Neuropsychiatric Symptoms in Severe Alzheimer’s Dementia: A Clinical Case Report (nih.gov)

Alzheimer’s Disease is a debilitating neurogenerative disease that affects approximately 17 percent of people in the world from ages 75-84. Neuropsychiatric symptoms (NPS) such as delusions, agitation, anxiety, and hallucinations are present in up to 95 percent of patient in all stages of dementia. As someone with a tremendous amount of experience as an occupational therapist working in an Alzheimer’s nursing home for 3 years and treating Alzheimer’s patients for over 20 years, I can tell you that it is one of the worst diseases for humanity I have ever encountered.

Currently, there is no prescription drug that has been approved specifically for the treatment of NPs. The clinical case study involved is from a female patient diagnosed with AD with continuous cognitive decline and dementia related behavioral symptoms. Between 2008 and 2019, the patient was examined every 6 months at the memory clinic of the Medical University in Innsbruck, Austria. During each visit, the patient’s cognitive state and pharmacological treatment were evaluated via the neuropsychiatric inventory (NPI). In 2018, the patient progressed to severe AD stage and presented with progressive NPs (anxiety, delusions, agitation, aggressive behavior, and suspected pain due to long immobility).

At this time, off label treatment with low-dose dronabinol (synthetic THC) was initiated. Once lowdose dronabinol use commenced, the patient’s emotional state improved, while disruptive behavior, aggression, and sedation decreased significantly. Furthermore, the patient was decreased from 6 psychotropic drugs to 3 after starting dronabinol due to no longer requiring the added psychotropic drugs.

Analysis

The results in this case study are consistent with anecdotal results seen in patients all over the world using THC or synthetic THC medical cannabis. There is evidence that cannabinoid therapy can break up amyloid plaques in the brain (which are caused by AD), and therefore decrease NPs of Alzheimer’s. Cannabis and cannabinoid therapy are becoming more mainstream within the medical community due to their extremely low side effects and positive results in relieving symptoms of many different diagnoses.

More research will continue to be done on AD using cannabinoid therapy. The early results are extremely positive, which can increase AD patient and caregiver physical and emotional health, increasing overall quality of life, and a decrease in AD related health care expenses related to severe AD (falls, fractures, decrease in polypharmacy by taking less prescription medication, 24/7 supervised care)

Medical Cannabis Does Not Create Cognitive Decline in Seniors

A recent study published in the September 2020 edition of the Drug and Alcohol Review, determined that the use of medical cannabis does not create a cognitive decline in senior citizens. The link to the study is here: https://onlinelibrary.wiley.com/doi/10.1111/dar.13171

The study was performed by Sharon R. Sznitman PhD, Senior Lecturer, Simon Vulfsons MD, Director, David Meiri PhD, Lecturer, Galit Weinstein PhD, Senior Lecturer at Israel’s Haifa University School of Public Health. The study included 125 cannabis users who were 50 years and older. Out of the 125 study participants, 63 had Israeli government permission to use cannabis and 62 did not have permission.

Each participant was put through a multitude of tests consisting of CogState computerized brief battery used to assess cognitive performance of psychomotor reaction, attention, working memory and new learning. Regression models and Bayesian t‐tests examined differences in cognitive performance in the two groups. Furthermore, the associations between medical cannabis use patterns (dosage, cannabinoid concentrations, length and frequency of use and hours since last use) with cognition were assessed among medical cannabis licensed patients.

Patients were tested before use of medical cannabis and after use of medical cannabis. The result of the study showed no detectable difference in cognitive ability before or after use of medical cannabis.

Dr. Sharon Sznitman and Dr. Galit Weinstein

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