Can Cannabis Help Dementia?

Overview

Cannabis has been used to treat diseases for thousands of years. When it comes to cannabis treatment for dementia, clinical research is limited, though there is evidence to suggest that patients can benefit from a short treatment with cannabinoids, and that cannabinoids may even prevent the progression of Alzheimer’s disease. Moreover, clinical trials do show cannabinoid-based treatment to be safe for people with dementia.

Choosing the right cannabis product for dementia can be challenging, as there are thousands of cannabis varieties out there. But judging by the scientific literature of different cannabinoids and terpenes, products with medium-high concentrations of CBD and medium-low concentrations of THC make sense as a starting point. Other compounds to look for are terpenes, specifically limonene, pinene, and beta caryophyllene, which show potential for dementia and may synergize with CBD and THC.

Medical Research on Dementia and Cannabis

Randomized clinical trials are tightly regulated and provide a high level of evidence, but they’re also time-consuming and resource-hungry. For this reason, researchers and physicians also use cohort studies and case reports to assess how effective a therapy may be. Several such studies point more clearly toward cannabinoids as effective treatments for dementia:

In 1997, a group from the US reported that patients with Alzheimer’s disease experienced increased appetite and a reduction of disturbed behavior after receiving a THC-based medication, Dronabinol, for six weeks.. Similar results were later reported in two patients with Alzheimer’s who were given a similar dose for only 14 days.
Several larger studies were conducted in the Netherlands in 2015 and 2017, where patients with different types of dementia received synthetic THC two or three times a day for periods between four days and 12 weeks. While these studies suggested that the treatment is safe in terms of unwanted side effects, there were no clinically significant improvements on a wide range of dementia symptoms.
In May 2019, a Canadian group tried to address some of these kinds of shortcomings. It revealed that a similar dose of synthetic THC was effective for the treatment of agitation in Alzheimer’s patients. Forty-five percent of patients in this study, however, experienced sedation, but not at levels that required them to stop the treatment.
In 2014, a cohort of 40 patients with different types of dementia was found to be less agitated and aggressive, and more rested after a higher dose of a synthetic THC than was used in clinical trials.
In 2016 , an Israeli team reported similar results from a group of 11 patients with Alzheimer’s, who were given medical marijuana oil (containing a similar dose of THC and varying amounts of CBD) at similar doses for 28 days.

In 2019, a hospital in Geneva found that a higher dose of oral cannabis extract with THC and CBD was tolerated well and greatly improved behavioral issues, muscle rigidity and daily care in 10 female patients with dementia.
In the UK, a large clinical trial on dementia patients is commencing in late 2019, and is expected to provide more robust evidence on the efficacy of cannabinoids in dementia treatment. The study would be the first to use a cannabis-based mouth spray containing THC and CBD (Nabiximols).
Finally, several anecdotal case reports of patients treated with varying doses of THC reported reductions in behavioral and psychological symptoms of dementia.

Still, according to a recent scientific review looking at the use of cannabinoids for symptoms of dementia, such preliminary results are encouraging. The studies involved people with different types of dementia, and this can mask meaningful effects. Furthermore, the use of relatively small doses of THC, along with other medications, makes it harder still to draw firm conclusions.

CBD and Dementia

Unfortunately, to date there have not been any clinical trials evaluating the therapeutic potential of CBD for dementia. But trials in animal labs and cell cultures show that CBD and THC/CBD combinations can reduce the production and accumulation of the harmful proteins and plaque, which cause neurodegeneration in Alzheimer’s disease.

In a number of studies, a short course of CBD treatment in mice was even found to reduce destruction of neurons in the hippocampus (an area of the brain involved in memory formation) and to promote the formation of new cells.

Beyond protecting neurons, CBD was also found to prevent the onset of impaired social recognition in adult lab mice with Alzheimer’s-like conditions. As the journal of Behavioural Pharmacology optimistically summarized, “CBD could well provide symptomatic relief and/or prevent disease progression for Alzheimer patients.”

A large clinical trial in Israel is currently running and is expected to terminate in mid-2020. This trial would be the first to employ a locally-engineered medical marijuana oil (Avidekel), the main ingredient of which is CBD.

How Cannabis Works on Dementia

The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.

The ECS has recently come on the radar for treatment of dementia symptoms. Cannabinoids of all types – internal, plant-derived and synthetic – can bind to the receptors in this system, and impact processes such as learning, memory, restful sleep and other cognitive functions, which are often impaired in dementia patients. With this understanding, researchers have examined whether manipulation of the endocannabinoid system can be used to alleviate dementia symptoms, or even slow the progression of the disease.

Using Cannabis for Dementia

Deciding which cannabis variety to use can be challenging. There are thousands of different cannabis varieties (aka strains) out there, each with its own unique chemical profile. And since most of the clinical research uses cannabinoid-based medications rather than whole plant products, you might need to implement some trial and error before you find your perfect fit. Many patients experience some frustration when going through the process of finding the right product and dose, and mitigating side effects.

There is indeed a lack of clinical research when it comes to cannabis and dementia, but you can narrow down the options by looking at the preclinical research on specific compounds, notably cannabinoids and terpenes. There is no definitive answer on the best cannabis treatment for dementia, but the best bet would be to try products with medium-to-high CBD concentrations, and medium-to-low THC concentrations.

When it comes to terpenes, as mentioned, clinical research is lacking, but based on preclinical data, limonene, pinene, and beta-caryophyllene all show potential benefits for dementia:

A recent study found that “High levels of limonene in food or medication are expected to help treat or prevent Alzheimer’s disease”.
A 2017 study suggests the “possible neuroprotective potentials of APN (Alpha-Pinene) for the management of dementia with learning and memory loss”.
A 2014 research suggests “Beta-caryophyllene as an attractive molecule for the development of new drugs with therapeutic potential for the treatment of Alzheimer’s disease”.