The hallmarks of Alzheimer’s and dementia-related conditions are memory and thinking problems. However, it is the behavioral and psychological symptoms of dementia, primarily agitation, anxiety, apathy, depression, wandering, hallucinations, and incontinence that prove the greatest challenges for caregivers. It is these “symptoms” that often lead to placement in assisted living or nursing homes. When left untreated, these symptoms accelerate decline and reduce the quality of life.
In the absence of drugs to halt the biological spread of the disease and general cognitive decline, researchers aim to discover drugs and treatments that can improve the quality of life of patients — and their caregivers. Several studies presented at the Alzheimer’s Association International Conference in Chicago on July 24th focused on just that. We reported on the recent success of light therapy, a non-drug treatment that targets balanced dementia sufferers circadian rhythms.
Another study revealed that results of a randomized, double-blind clinical trial suggest that nabilone — a synthetic cannabinoid — may be effective in treating agitation in people with Alzheimer’s disease. “Agitation, including verbal or physical outbursts, general emotional distress, restlessness, pacing, is one of the most common behavioral changes associated with Alzheimer’s as it progresses, and can be a significant cause of caregiver stress,” said Krista L. Lanctôt, PhD, Senior Scientist at Sunnybrook Health Sciences Centre and Professor of Psychiatry and Pharmacology/Toxicology at the University of Toronto, in a statement released by Alzheimer’s Association.
Lanctôt and colleagues investigated the potential benefits of nabilone for adults with moderate to severe Alzheimer’s dementia with clinically significant agitation. Over the 14-week trial duration, 39 participants received nabilone in capsule form for six weeks, followed by six weeks of placebo, with one week between each treatment period. In addition to measuring agitation, the researchers assessed overall behavioral symptoms, memory, physical changes and safety. They discovered that agitation improved significantly in those taking nabilone, compared to placebo. The administration of nabilone also significantly improved overall behavioral symptoms, compared to placebo. Researchers also observed small improvements in cognition and nutrition during the study. However, 45 % of the patients in the study experienced sedation while on nabilone compared to 16% of the placebo group.
“Currently prescribed treatments for agitation in Alzheimer’s do not work in everybody, and when they do work the effect is small and they increase risk of harmful side effects, including increased risk of death. As a result, there is an urgent need for safer medication options,” said Lanctôt. “These findings suggest that nabilone may be an effective treatment for agitation; however, the risk of sedation must be carefully monitored. A larger clinical trial would allow us to confirm our findings regarding how effective and safe nabilone is in the treatment of agitation for Alzheimer’s.”
It is of note that marijuana is not approved by the FDA for the treatment or management of Alzheimer’s disease or other dementias. As medical marijuana use becomes more common, it is important to be aware of the fact that much about its use in people with Alzheimer’s or other dementias is unknown. Marijuana is an untested drug in Alzheimer’s treatment. Currently there is no strong, consistent clinical trial data supporting the use of marijuana for treatment of Alzheimer’s disease dementia. The experts at the Alzheimer’s Association believes that more research in this area is needed.
Source: https://www.alz.org/aaic/releases_2018/AAIC18-Tues-non-cognitive-symptoms.asp