Citation

Ruthirakuhan M, Lanctôt KL, Vieira D, Herrmann N. J. Clin. Psychiatry 2019; 80(2): e18r12617.

Affiliation

Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Copyright

(Copyright © 2019, Physicians Postgraduate Press)

DOI

10.4088/JCP.18r12617

PMID

30753761

Abstract

OBJECTIVE: This meta-analysis investigated the efficacy of cannabinoids on agitation and aggression in patients with Alzheimer's disease (AD). DATA SOURCES: Electronic records up to August 2018 were searched from MEDLINE, EMBASE, and PsycINFO. Search terms included Alzheimer's disease, agitation, aggression, and cannabinoids. STUDY SELECTION: Double-blind, placebo-controlled studies investigating the effect of cannabinoids on agitation in patients with AD were included. Of the 1,336 records returned, 123 were reviewed and 6 (N = 251 participants) were included. DATA EXTRACTION: Data on demographics, study setting, trial length, intervention, outcomes, and dropouts were extracted.

RESULTS: There was no effect of cannabinoids as a group on agitation (standard mean difference: -0.69, P =.10), though there was significant heterogeneity (χ²₆ = 43.53, P <.00001, I² = 86%). There was a trend for greater difference in agitation with synthetic cannabinoids over tetrahydrocannabinol (χ²₁ = 3.05, P =.08). Cannabinoids had a larger effect on agitation with greater cognitive impairment (B = 0.27, t₆ = 2.93, P =.03). Cannabinoids did not change overall neuropsychiatric symptoms or body mass index (BMI). However, there was a significant difference in patients with a lower BMI compared to patients with a higher BMI (χ²₁ = 4.63, P =.03). Sedation was significantly greater with cannabinoids compared to placebo (risk ratio = 1.73, P =.04), but there were no differences in the occurrence of adverse events or dropouts due to an adverse event between treatment groups.

CONCLUSIONS: The efficacy of cannabinoids on agitation and aggression in patients with AD remains inconclusive, though there may be a signal for a potential benefit of synthetic cannabinoids. Safety should be closely monitored as cannabinoid treatment was associated with increased sedation.

© Copyright 2019 Physicians Postgraduate Press, Inc.

Language: en