A new treatment for agitation and aggression in patients with Alzheimer's

Annual Report 2019-20

Can cannabinoids help alleviate the suffering caused by agitation and aggression?

Agitation and aggression are common symptoms experienced by those with Alzheimer's disease. These symptoms can be physically dangerous, lead to premature institutionalization, and have a major impact on their quality of life experienced by patients and their care partners.

Existing treatments are only moderately effective, and some commonly used treatments also have serious side-effects, including higher mortality rates. An effective, safe treatment for agitation would be a major step forward.

Dr. Krista Lanctôt and Dr. Nathan Herrmann realized that cannabinoids may provide this new avenue of treatment. Cannabinoids canc alm a paitent while providing anti-inflammatory and antioxidant effects to the brain. With the legalization of marijuana, the medical uses of cannabinoids can now be explored.

“When speaking to our patients’ and their care partners, we were surprised to learn how many of our patients had tried taking cannabinoids for a variety of symptoms, including pain, sleep and anxiety,” says Dr. Herrmann “And this was almost totally in the absence of evidence for efficacy and safety of these drugs in Alzheimer's patients!”

THC and cannabidiol (CBD) are both major components of marijuana. They have the potential to treat Alzheimer's disease by reducing anxiety and inflammation. But there are risks, as cannabinoids may induce psychotic symptoms, somnolence, and memory loss.

The team is now exploring the whether nabilone (a synthetic version of THC) and CBD are effective in treating agitation in Alzheimer’s patients, and whether the benefits of the treatment outweigh the risks.

“Our recent nabilone trial provided the first evidence in a randomized control trial that nabilone could be beneficial. With the support of the Alzheimer's Drug Discovery Foundation, we will launch a larger multicentre trial, comparing nabilone to a placebo, and also evaluating cannabidiol, which will provide key information to prescribers, care partners, and patients,” says Dr. Lanctôt.

Time will tell if the study supports the continued use of these medications, providing us with important information that will shape future treatments.