Medical Cannabis Review Articles and Reports on Alzeimer's Disease
Cannabinoids in late-onset Alzheimer's disease
Ahmed AIA, van der Marck MA, van den Elsen GAH, Olde Rikkert M. Cannabinoids in late-onset Alzheimer’s disease. Clin Pharmacol Ther 2015;97:597-606.
Reviews research indicating therapies currently used in patients with late-onset Alzheimer’s disease and related neuropsychiatric symptoms are frequently ineffective. Describes in vitro and in vivo studies of cannabinoids as treatment. And discusses the four small open-label studies of dronabinol (synthetic THC) as treatment for dementia symptoms. Also has a section on cannabinoid pharmacokinetics in the elderly.
In vivo Evidence for Therapeutic Properties of Cannabidiol (CBD) for Alzheimer's Disease
Watts G and Karl T. In vivo evidence for therapeutic properties of cannabidiol (CBD) for Alzheimer’s disease. Front Pharmacol 2017 Feb 3;8:20. doi: 10.3389/phar.2017.00020. eCollection 2017. Review
Good, brief sections on current treatments of Alzheimer’s disease and CBD pharmacology. Detailed discussion of CBD effects in rat models of Alzheimer’s disease. Conclusion, “the studies discussed here provide promising preliminary data and the translation of this preclinical work into the clinical setting could be realized relatively quickly: CBD is readily available, appears to only have limited side effects, and is safe for human use.”
Cannabinoids for the treatment of agitation and aggression in Alzheimer's disease
Liu CS, Chau SA, Ruthirakuhan M, Lanctot KL. CNS Drugs 2015;29:615-623. Curr Neuropharmacol 2017;15:800-814.
A literature search produced six small studies of cannabinoids for treating agitation and/or aggression in dementia or Alzheimer’s disease, comprising a total of 67 completed participants. Four used dronabinol (synthetic THC) and two used nabilone (a synthetic THC analog). Three were placebo-controlled and one each of open-label pilot study, retrospective chart review, and single-patient case report. A significant portion of all participants had used or were using psychoactive medication to manage their symptoms. Results of the studies suggest benefit in reducing agitation and aggression, but definitive conclusions were limited by small sample sizes, short trial duration, and lack of placebo control in some of the studies. The authors discuss putative mechanisms supporting cannabinoid management of agitation and aggression in Alzheimer’s disease.
Pros and cons of medical cannabis use by people with chronic brain disorders
Suryadevara U, Bruijnzeel DM, Nuthi M, Jagnarine DA, Tandon R, Bruijnzeel AW. Pros and cons of medical cannabis use by people with chronic brain disorders. Curr Neuropharmacol 2017;15:800-814.
Literature review covering (fairly briefly) ALS, MS, Alzheimer’s disease, Parkinson’s disease, bipolar disorder, and schizophrenia. From the abstract, “In late stage Alzheimer’s patients, cannabis products may improve food intake, sleep quality, and diminish agitation.” The authors lay out concerns about potential for cannabis to cause cognitive dysfunction and to lead to dependence. Cognitive dysfunction has been demonstrated in numerous studies of recreational cannabis users, who are typically relatively young. Long-term cognitive dysfunction has been studied little in any population. Cannabis use disorder and withdrawal syndromes relatively common in recreational cannabis users, but the risk and relevance of these in older persons with dementia using medical cannabis products is not clear.
The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
A report published by the U.S. National Academies of Sciences, Engineering, and Medicine. 2017.
A rigorous review of relevant scientific research published since 1999, summarizing the current state of evidence regarding what is known about the health impacts of cannabis and cannabis-derived products, including effects related to therapeutic uses of cannabis and potential health risks related to certain cancers, diseases, mental health disorders, and injuries. Sections on evidence of therapeutic effects include: chronic pain, cancer treatment, chemotherapy-induced nausea and vomiting, anorexia and weight loss associated with HIV/AIDS, cancer-associated anorexia-cachexia syndrome, anorexia nervosa, irritable bowel syndrome, epilepsy, spasticity associated with multiple sclerosis or spinal cord injury, Tourette syndrome, amyotrophic lateral sclerosis, Huntington’s disease, Parkinson’s disease, dystonia, dementia, glaucoma, traumatic brain injury/intracerebral hemorrhage, substance addiction, anxiety, depression, sleep disorders, posttraumatic stress disorder, and schizophrenia and other psychoses. Chapters summarizing evidence of harms include: cancer, cardiometabolic risk, respiratory disease, immunity, injury and death, prenatal/perinatal/neonatal exposure, psychosocial, mental health, cannabis use problems, and abuse of other substances.