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. 2023 Dec 7;4(1):326-333.
doi: 10.1089/pmr.2023.0024. eCollection 2023.

Impact of Low-Dose Dronabinol Therapy on Cognitive Function in Cancer Patients Receiving Palliative Care: A Case-Series Intervention Study

Ditte Buchwald  1   2 , Casper Schmidt  2 , Dorte Buchwald  1   3 , Kristina Iris Winter  1   3 , Ivan Bo Nielsen  3 , Kirsten Klostergaard  1 , Dorte Melgaard  1   2 , Steen K Fagerberg  1 , Peter Derek Christian Leutscher  1   3
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Impact of Low-Dose Dronabinol Therapy on Cognitive Function in Cancer Patients Receiving Palliative Care: A Case-Series Intervention Study

Ditte Buchwald et al. Palliat Med Rep. .

Abstract

Background: Cannabis may offer therapeutic benefits to patients with advanced cancer not responding adequately to conventional palliative treatment. However, tolerability is a major concern. Cognitive function is a potential adverse reaction to tetrahydrocannabinol containing regimens. The aim of this study was to test cognitive function in patients being prescribed dronabinol as an adjuvant palliative therapy.

Methods: Adult patients with advanced cancer and severe related pain refractory to conventional palliative treatment were included in this case-series study. Patients were examined at baseline in conjunction with initiation of dronabinol therapy and at a two-week follow-up using three selected Wechsler's adult intelligence scale III neurocognitive tests: Processing Speed Index (PSI), Perceptual Organization Index (POI), and Working Memory Index (WMI). Patients were also assessed using pain visual analog scale, Major Depression Inventory, and Brief Fatigue Inventory.

Results: Eight patients consented to take part in the study. Two patients discontinued dronabinol therapy, one due to a complaint of dizziness and another critical progression of cancer disease, respectively. The remaining six patients were successfully treated with a daily dosage of 12.5 mg dronabinol (p = 0.039). PSI (p = 0.020), POI (p = 0.034.), and WMI (p = 0.039).

Conclusions: Cognitive function improved in this group of patients with advanced cancer in conjunction with low-dose dronabinol therapy. The cause is likely multifactorial including reported relief of cancer-associated symptoms. Further clinical investigation is required.

Keywords: cancer; cognitive impairment; medical cannabis; pain management; sleep disturbances.

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Conflict of interest statement

The authors do not have potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations related to this article.

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