Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Apr 15;2009(2):CD007204.
doi: 10.1002/14651858.CD007204.pub2.

Cannabinoids for the treatment of dementia

Sarada Krishnan  1 , Ruth Cairns, Robert Howard
Affiliations

Cannabinoids for the treatment of dementia

Sarada Krishnan et al. Cochrane Database Syst Rev. .

Abstract

Background: Following the discovery of an endogenous cannabinoid system and the identification of specific cannabinoid receptors in the central nervous system, much work has been done to investigate the main effects of these compounds. There is increasing evidence that the cannabinoid system may regulate neurodegenerative processes such as excessive glutamate production, oxidative stress and neuroinflammation. Neurodegeneration is a feature common to the various types of dementia and this has led to interest in whether cannabinoids may be clinically useful in the treatment of people with dementia. Recent studies have also shown that cannabinoids may have more specific effects in interrupting the pathological process in Alzheimer's disease.

Objectives: To determine from available research whether cannabinoids are clinically effective in the treatment of dementia.

Search strategy: The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 11 April 2008 using the terms: cannabis or cannabinoid* or endocannabinoid* or cannabidiol or THC or CBD or dronabinol or delta-9-tetrahydrocannabinol or marijuana or marihuana or hashish. The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many clinical trials registries and grey literature sources.

Selection criteria: All double-blind and single (rater)-blind randomized placebo controlled trials assessing the efficacy of cannabinoids at any dose in the treatment of people with dementia.

Data collection and analysis: Two reviewers independently examined the retrieved studies for inclusion according to the selection criteria. They then independently assessed the methodological quality of selected trials and extracted data where possible.

Main results: Only one study met the inclusion criteria. The data in the study report were presented in such a way that they could not be extracted for further analysis and there was insufficient quantitative data to validate the results.

Authors' conclusions: This review finds no evidence that cannabinoids are effective in the improvement of disturbed behaviour in dementia or in the treatment of other symptoms of dementia. More randomized double-blind placebo controlled trials are needed to determine whether cannabinoids are clinically effective in the treatment of dementia.

PubMed Disclaimer

Conflict of interest statement

None known.

Update of

  • doi: 10.1002/14651858.CD007204

References

References to studies included in this review

Volicer 1997 {published data only}
    1. Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. Effects of dronabinol on anorexia and disturbed behaviour in patients with Alzheimer's Disease.. International Journal of Geriatric Psychiatry 1997;12:913‐919. - PubMed

References to studies excluded from this review

Walther 2006 {published data only}
    1. Walther S, Mahlberg R, Eichmann U, Kunz D. Delta‐9‐tetrahydrocannabinol for nighttime agitation in severe dementia.. Psychopharmacology 2006;185:524‐528. - PubMed

References to ongoing studies

Walther 2007 {unpublished data only}
    1. Walther S. Placebo‐controlled, randomised, double blind crossover trial on dronabinol, a cannabinoid‐1‐receptor agonist, for behavioral and circadian rhythm disturbances in dementia. Registration‐number 2007DR2217 (Swissmedic trial registry).

Additional references

APA 1994
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. Washington DC: American Psychiatric Press, 1994.
Baker 2003
    1. Baker D, Pryce G, Giovannoni G, Thompson AJ. The therapeutic potential of cannabis. The Lancet Neurology 2003;2:291‐8. - PubMed
Ballard 2006
    1. Ballard C, Waite J, Birks J. Atypical antipsychotics for aggression and psychosis in Alzheimer's disease. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD003476.pub2] - DOI - PMC - PubMed
Birks 2006
    1. Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD005593] - DOI - PMC - PubMed
Campbell 2007
    1. Campbell VA, Gowran A. Alzheimer's disease; taking the edge off with cannabinoids?. British Journal of Pharmacology 2007;152:655‐662. - PMC - PubMed
Chalmers 1983
    1. Chalmers TC, Celano P, Sacks HS, Smith H Jr. Bias in treatment assignment in controlled clinical trials. New England Journal of Medicine 1983;309:1358‐61. - PubMed
Cohen‐Mansfield 1989
    1. Cohen‐Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. Journal of Gerontology 1989;44:M77‐M84. - PubMed
Ehrhart 2005
    1. Ehrhart J, Obergon D, Mori T, Hou H, Sun N, Bai Y, Klein T, Fernandez F, Tan J, Shytle RD. Stimulation of CB2 suppresses microglial activation. Journal of Neuroinflammation 2005;2:29. - PMC - PubMed
Eubanks 2006
    1. Eubanks LM, Rogers CJ, Beuscher AE 4th, Koob GF, Olson AJ, Dickerson TJ, et al. A molecular link between the active component of marijuana and Alzheimer's disease pathology. Molecular Pharmaceutics 2006;3:773‐7. - PMC - PubMed
FDA 2005
    1. Centre for Drug Evaluation and Research. FDA public health advisory: deaths with antipsychotics in elderly patients with behavioural disturbances. FDA April 2005.
Grinspoon 1993
    1. Grinspoon L, Bakalar JB. Marihuana, the forbidden medicine. New Haven, CT: Yale University Press, 1993.
Grundy 2002
    1. Grundy RI. The therapeutic potential of the cannabinoids in neuroprotection. Expert Opinion on Investigational Drugs 2002;11:1365‐74. - PubMed
Hampson 1998
    1. Hampson AJ, Grimaldi M, Axelrod J, Wink D. Cannabidiol and delta‐9‐tetrahydrocannabinol are neuroprotective antioxidants. Proceedings of the National Academy of Sciences 1998;95:8268‐73. - PMC - PubMed
Howard 2007
    1. Howard RJ, Juszczak E, Ballard CG, Bentham P, Brown RG, Bullock R, et al. Donepezil for the treatment of agitation in Alzheimer's disease. New England Journal of Medicine 2007;357:1382‐92. - PubMed
Howlett 2002
    1. Howlett AC, Barth F, Bonner T, Cabral G, Casellas P, Devane WA, et al. International Union of Pharmacology XXVII. Classification of cannabinoid receptors. Pharmacological Reviews 2002;54:161‐202. - PubMed
Iversen 2000
    1. Iversen LL. The science of marijuana. Oxford: Oxford University Press, 2000.
Lawton 1996
    1. Lawton MP, Haitsma K, Klapper J. Observed affect in nursing home residents with Alzheimer's disease. Journals of Gerontology. Series B, Psychological sciences and social sciences 1996;51B:P3‐P14. - PubMed
Lowin 2001
    1. Lowin A, Knapp M, McCrone P. Alzheimer's disease in the UK: comparative evidence on cost of illness and volume of health services research funding. International Journal of Geriatric Psychiatry 2001;16:1143‐8. - PubMed
Matsuda 1990
    1. Matsuda LA, Lolait SJ, Brownstein MJ, Young AC, Bonner T. Structure of a cannabinoid receptor and functional expression of the cloned cDNA. Nature 1990;346:561‐4. - PubMed
McKhann 1984
    1. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's Disease: Report of the NINCDS‐ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939‐44. - PubMed
MHRA 2004
    1. Medicines and Healthcare Products Regulatory Agency. New advice issued on risperidone and olanzepine. MHRA March 2004.
Nagayama 1999
    1. Nagayama T, Sinor AD, Simon RP, Chen J, Graham SH, Jin K, et al. Cannabinoids and neuroprotection in global and focal cerebral ischaemia and in neuronal cultures. Journal of Neuroscience 1999;19:2987‐95. - PMC - PubMed
Onaivi 2006
    1. Onaivi ES. Neuropsychological evidence for the functional presence and expression of cannabinoid CB2 receptors in the brain. Neuropsychobiology 2006;54:231‐246. - PubMed
Rabins 1982
    1. Rabins PV, Mace NL, Lucas MJ. The impact of dementia on the family. Journal of the American Medical Society 1982;248:333‐5. - PubMed
Ramirez 2005
    1. Ramirez BG, Blazquez C, Gomez del Pulgar T, Guzman M, Ceballos M. Prevention of Alzheimer's disease pathology by cannabinoids: neuroprotection mediated by blockade of microglial activation. The Journal of Neuroscience 2005;25:1904‐13. - PMC - PubMed
Schneider 2005
    1. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta‐analysis of randomized placebo‐controlled trials. Journal of the American Medical Association 2005;294:1934‐43. - PubMed
Schneider 2006
    1. Schneider LS, Dagerman KS, Insel P. Efficacy and adverse effects of atypical antipsychotics for dementia: meta‐analysis of randomized placebo‐controlled trials. American Journal of Geriatric Psychiatry 2006;14:191‐210. - PubMed
Schulz 1995
    1. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408‐12. - PubMed
Shen 1998
    1. Shen M, Thayer SA. Cannabinoid receptor agonists protect cultured rat hippocampal neurons from excitotoxicity. Molecular Pharmacology 1998;54:459‐62. - PubMed
Steele 1990
    1. Steele C, Rovner B, Chase GA, Folstein M. Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. American Journal of Psychiatry 1990;147:1049‐51. - PubMed
Van Sickle 2005
    1. Sickle MD, Duncan M, Kingsley PJ, Mouihate A, Urbani P, Mackie K, et al. Identification and functional characterization of brainstem cannabinoid CB2 receptors. Science 2005;310:329‐332. - PubMed
Volicer 1997
    1. Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. Effects of dronabinol on anorexia and disturbed behaviour in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry 1997;12:913‐9. - PubMed
Walther 2006
    1. Walther S, Mahlberg R, Eichmann U, Kunz D. Delta‐9‐tetrahydrocannabinol for nighttime agitation in severe dementia. Psychopharmacology 2006;185:524‐8. - PubMed
WHO 1993
    1. World Health Organisation. The ICD‐10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organisation, 1993.

Publication types

MeSH terms