No evidence of benefit from cannabinoids in dementia

Clinical question: 
Are cannabinoids clinically effective in the treatment of dementia?
Bottom line: 
There was no evidence that cannabinoids are effective in the improvement of disturbed behaviour in dementia or in the treatment of other symptoms of dementia. Only 1 small study was included which was designed to focus on the effects of the cannabinoid dronabinol on anorexia in Alzheimer's disease. While improvement of anorexia is clearly an important outcome for patients and their carers, it was not a primary outcome of interest in this review. The study concluded that the cannabinoid dronabinol may be useful in the treatment of anorexia and to improve disturbed behaviour in people with Alzheimer's disease.
Caveat: 
Only 1 small study met the inclusion criteria. The lack of quantitative data and the unclear risk of bias in key domains of this study mean no useful conclusions can be drawn from this review.
Context: 
There is increasing evidence the cannabinoid system may regulate neurodegenerative processes, such as excessive glutamate production, oxidative stress and neuroinflammation. Neurodegeneration is a feature common to the various types of dementia and this has led to interest in whether cannabinoids may be clinically useful in the treatment of people with dementia. Recent studies have also shown cannabinoids may have more specific effects in interrupting the pathological process in Alzheimer's disease.
Review CD#: 
CD007204
PEARLS No: 
185
Date: 
July, 2009
Authored by: 
Brian R McAvoy