A pilot study suggests that THC (dronabinol) may reduce agitation and lead to weight gain in patients suffering from Alzheimer's disease. The results were presented on 15 May at the annual meeting of the American Geriatrics Society.
The study examined nine patients with a mean age of 83 years. All patients met accepted criteria for possible Alzheimer's disease and had unsatisfactory control of their agitation. The Mini Mental State Examination (MMSE), a test used to measure a person's basic cognitive skills, and an assessment of activities of daily living were used to evaluate patients at the start of the study and at one month. Patients initially received 2x2.5 mg THC daily, which was increased up to a maximum of 2x5 mg/day. In addition, all patients were treated with atypical neuroleptics and at least four medications to control behaviour.
After one month agitation was significantly reduced in six patients. Three patients experienced an average increase on the MMSE of 1.2 points (baseline: 11 points). Functional improvement was observed in three patients. Prior to the study, all patients experienced weight loss due to anorexia. After THC treatment all patients had gained weight. No adverse events, such as falls, syncope (short-term faint), seizures or exacerbation of agitation or depression were reported.
"Our trial, although preliminary, suggest dronabinol may reduce agitation and improve appetite in patients with Alzheimer's disease, when traditional therapies are not successful," said Dr. Joshua Shua-Haim, lead investigator in the study and medical director of the Meridian Institute for Aging in Central New Jersey.
In 1997 Dr. Ladislav Volicer and colleagues already conducted a study in 15 patients with Alzheimer's disease who refused food. Eleven patients completed the 12 week cross-over trial of THC and placebo (six weeks of each treatment). The THC treatment resulted in substantial weight gains. Surprisingly, THC also decreased severity of disturbed behaviour. In 1999 Unimed, the marketer of the THC preparation Marinol, estimated that about 5- 10 percent of the drug's patient population consisted of Alzheimer's patients.
(Sources: PR Newswire of 15 May 2003; NORML of 29 May 2003; Volicer L, et al. Int J Geriatr Psychiatry 1997;12:913-9; Joy JE, Watson SJ, Benson JA (eds): Marijuana and Medicine: Assessing the Science Base. Institute of Medicine, National Academy Press, Washington DC 1999)
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