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Article Link:  https://www.karger.com/Article/FullText/515042

Medical Cannabis Cannabinoids 2021;4:43–60

https://doi.org/10.1159/000515042

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Alzheimer’s Disease and Cannabis

According to WHO, Alzheimer’s disease (AD) is portrayed by a dynamic decrease in psychological function. Promotion of AD is generously expanded among individuals matured 65 years or more, with a dynamic decrease in memory, thinking, language, and learning capacity. The promotion of AD ought to be separated from an ordinary age-related decrease in cognitive function, which is progressively slow and connected with less inability. Illness frequently begins with mild symptoms and finishes with serious brain damage [26].

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According to Alz­heimer’s association, 1 in 10 people of age above 65 years have Alzheimer’s dementia, as of 2019, and risk of it increases with age [27]. One of the main factors in Alz­heimer’s progression is the accumulation of beta-amyloid proteins in the patient. A randomized, double-blind clinical study at the University of Toronto suggested that nabilone, a synthetic cannabinoid, was effective in treating agitation and other behavioral symptoms of Alzheimer’s [28]. Medical cannabis oil containing THC as an add-on leads to a significant decrease in neurobehavioral symptoms such as delusions, agitation/aggression, irritability, apathy, sleep, and caregiver distress. Medical cannabis can help prevent or delay the onset of Alzheimer’s and slow the disease’s progression [29]. Furthermore, THC competitively represses the compound acetylcholinesterase and additionally prevents acetylcholinesterase-actuated amyloid β-peptide aggregation, the key neurotic marker of Alzheimer’s disease. Compared to present medications recommended for the treatment of Alzheimer’s disease, THC is an impressively predominant inhibitor of amyloid β-peptide aggregation [30].

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Nighttime agitation has been one of the major symptoms of severe dementia and has become the main problem for caregivers. In an open-label pilot study, 6 patients with severe dementia were treated with dronabinol, a pure isomer of THC, for 2 weeks. This investigation recommends that dronabinol could lessen nighttime agitation and motor activity in extremely demented patients. Hence, it creates the impression that dronabinol might be a safe new treatment alternative for behavioral and circadian disturbances in dementia [31]. Dronabinol treatment diminished the seriousness of disturbed behavior. Adverse reactions were observed more with dronabinol treatment as compared with placebo; adverse reaction included euphoria, somnolence, and tiredness, but it did not require discontinuation of the therapy. These results demonstrated that dronabinol is a promising novel therapeutic agent that may be significant for the treatment of anorexia just as to improve disturbed behavior in patients with AD [32].

 

Cannabinoid receptor agonist anandamide and noladin ether inhibit amyloid-peptide, which is responsible for neurodegenerative changes during Alzheimer’s. At very low concentration, nanomolar, anandamide, and noladin ether showed concentration-dependent inhibition of A peptide toxicity [33]. Behavioral disturbances in patients with dementia associated with Alzheimer’s have a significant therapeutic effect using dronabinol and perhaps other cannabinoids, thus it deserves further investigation to make the life of severely demented patients a bit lively and aid the caretakers as well [34].