Scientists are going to use a CBD/THC oral spray Sativex to treat dementia patients in the first major trial in the UK. The study is led by researchers at King’s College London and funded by Alzheimer’s Research UK.
CBD products are gaining popularity at a rapid pace, mainly due to the number of conditions potentially alleviated by this compound.
Hemp and CBD oil were federally legalized with the 2018 Farm Bill, but scientists have been researching cannabidiol and its potential benefits for many years prior to the cannabis boom.
4. Lewy Bodies Dementia
In this article, I’ll dive specifically into the potential application of CBD for dementia and the collateral damage it does to individuals suffering from this disease.
Buying CBD oil online is also more convenient. You can easily check the reputation of your potential supplier. Always make sure that your manufacturer uses organic hemp, makes its products with CO2 extraction, and posts testing results from 3rd-party laboratory screening.
But if you prefer other forms of administration, Royal CBD offers convenient soft gel capsules (25 mg of CBD per piece) and isolate-based gummies (10 mg of CBD per count). These forms may not have the fastest onset but are easier to dose and take on the go.
If you’re using this supplement for dementia, it’s important to find something clean and as high quality as possible — preferably in a higher potency.
We used a medication with a natural cannabis extract, with a THC/CBD ratio of 1: 2. Compared to other studies, we used a higher dosage, with an average of 9 mg THC daily after 2 months versus 2–5 mg in most studies (7 mg in one study) . Other studies used pure, often synthetic, THC medications; we hypothesize that a natural cannabis extract might be better tolerated and/or that CBD adds to the overall positive effects on behavior. Still, compared to the average doses used in multiple sclerosis patients (average 7 puffs of nabiximol per day corresponding to 17 mg THC/34 mg CBD), doses were low, but our patients were older (almost 80 years). We privileged the cannabis oil for different reasons: oromucosal spray is difficult to administer in demented patients, and the cannabis tincture (with alcohol) seemed to cause oral ulcers in 3 patients. Cannabis oil has to be given with some oil-rich food; after having tried out different food options, the nurses found that putting the drops on a small piece of chocolate cake was the best administration option.
Background: Dementia is increasing worldwide. No effective medication is currently available for the treatment of the underlying disease and accompanying behavioral symptoms. Cannabinoids might have a beneficial effect, but clinical studies with (low-dose) synthetic THC have not been conclusive. Objective: To test the acceptability, practical aspects, and clinical outcomes of the introduction of a THC/CBD-based oral medication in severely demented patients in a specialized nursing home in Geneva. Methods: This was a prospective observational study. Results: Ten female demented patients with severe behavior problems received oral medication with on average 7.6 mg THC/13.2 mg CBD daily after 2 weeks, 8.8 mg THC/17.6 mg CBD after 1 month, and 9.0 mg THC/18.0 mg CBD after 2 months. The THC/CBD-based oil was preferred. Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory score, and a behavior problem visual analog scale decreased by 40% after 2 months, rigidity score by 50%. Half of the patients decreased or stopped other psychotropic medications. The staff appreciated the decrease in rigidity, making daily care and transfers easier, the improved direct contact with the patients, the improvement in behavior, and the decrease in constipation with less opioids. There was no withholding of the medication for reasons of side effects, and the effects persisted after 2 months. Conclusions: An oral cannabis extract with THC/CBD, in higher dosages than in other studies, was well tolerated and greatly improved behavior problems, rigidity, and daily care in severely demented patients.
© 2019 The Author(s) Published by S. Karger AG, Basel
Dementia is a syndrome characterized by a deterioration in memory, thinking, behavior, and autonomy in daily life activities. According to the World Health Organization , there were around 50 million persons worldwide suffering from dementia in 2017, and this number is increasing with the global aging of the population in most countries. Dementia has different causes, but Alzheimer disease is the most common form (two-thirds of cases). Approximately 5 out of 6 patients with dementia will develop behavioral and psychological symptoms of dementia (BPSD) during the course of the disease. These disturbances, namely agitation, depression, delusions, and hallucinations, are strongly correlated with each other. Currently, the options for treating BPSD include pharmacological and nonpharmacological therapies. Psychotropic medications are often used to reduce the frequency and severity of BPSD, but in the majority of patients, they provide only modest symptom control and important side effects . The interest of cannabinoids in Alzhei mer disease and other forms of dementia has increased first as neuroprotective drugs in animal studies. Indeed, some studies suggest a potential beneficial effect of CB1 and CB2 receptor agonists on reducing harmful β-amyloid peptide action and tau phosphorylation seen in Alzheimer disease as well as increasing intrinsic brain repair mechanisms . Several clinical trials, conducted in patients with severe dementia and BPSD, with one randomized study giving up to 4.5 mg THC daily, demonstrated that this can be safely administered to patients with dementia, but did not demonstrate any effect on BPSD [4-6]. Recent studies suggest that medications combining THC and CBD might have benefits over pure (synthetic) THC preparations .
The authors have no conflicts of interest to declare.
The study setting, “Les Tilleuls” in Geneva, is a nursing home specialized in the care of elderly with severe dementia. The staff includes nurses, nurse-aids, an appointed family doctor, and a psychiatrist. The psychiatrist met with the legal representatives of potential patients to get permission for the prescription of cannabinoid-based medication (from the Federal Office of Public Health) and the participation in the study. He was also responsible for the prescriptions of cannabinoid-based and other psychotropic medications.
In Switzerland various cannabinoid-based medications are available, in specialized pharmacies, with an authorization of the Federal Office of Public Health, for a specific patient, indication, and medication and for a limited duration (6 months at the time of the study). Available medications are nabiximol (oromucosal spray with THC/CBD in equal amounts), dronabinol solution (pure THC), cannabis tincture (11 mg THC/22 mg CBD), and cannabis oil (11 mg THC/24 mg CBD). At the start of the study we decided to use the cannabis tincture, since the nurses had the experience of difficulties in administering the oromucosal nabiximol spray (patient biting on the tip or moving her head so the spraying was random).
Products containing more than 0.2% THC are not legally available in the UK.
THC is the main component of cannabis that invokes feelings of sociability, happiness or relaxation.
What is Cannabidiol (CBD)?
Whilst the studies in the laboratory show some promise, we need to understand the wider effects that these components have before we can know whether they have any effect – positive or negative – on the development of Alzheimer’s in people.
Research does suggest that high concentrations of CBD oil could be useful for managing some of the symptoms of dementia such as agitation and anxiety.
It is also important to note that the researchers in these studies have used high concentrations of CBD oil that may not be available to buy. These studies have also been short term so we still don’t know what the long term effects of using CBD oil might be.