Synthetic cannabinoid shows calming effect in treating agitation in Alzheimer’s patients
In the first clinical trial involving a synthetic cannabinoid for treatment of agitation in people with Alzheimer’s disease, researchers at Sunnybrook Health Sciences Centre have found nabilone can help to improve patients’ symptoms.
Nabilone can be prescribed in capsule form and is currently approved by Health Canada for the treatment of chemotherapy-induced nausea.
Sunnybrook researchers are presenting study results at the Alzheimer’s Association International Conference in Chicago on July 24.
“The current medical treatments for agitation in Alzheimer’s patients have only modest effects and are often associated with side effects, which for some drugs include risk of stroke and increased mortality rate,“ says Dr. Krista Lanctôt, principal investigator of the study and senior scientist at Sunnybrook. “While our research is still in the early stages, nabilone has the potential to be an alternative therapy to treat agitation without these serious side-effects.”
The 14-week, randomized, double blind clinical trial included 39 adults with moderate to severe Alzheimer’s dementia living in the community or in long-term care residences. They were given nabilone and placebo in a random order, and their agitation in each phase was compared.
The majority of the patients were male (77 per cent) and on average, were 87 years old. Agitation and overall behavioural symptoms were improved while taking nabilone compared to placebo. The most common side effect associated with nabilone was sedation.
“The findings of our study suggest that nabilone may have a calming effect and be an effective treatment for agitation in patients with Alzheimer’s,” says Dr. Nathan Herrmann, study co-principal investigator and Lewar Chair in Geriatric Psychiatry at Sunnybrook. “However, sedation should be closely monitored.”
One in five patients with Alzheimer’s disease experience severe agitation, which involves restlessness, general emotional distress, verbal or physical outbursts and aggression. In less than 15 years, the number of Canadians with Alzheimer’s disease and other dementias is expected to increase from 564,000 to 937,000.
The study was funded in part by the Alzheimer Society Research Program and the Alzheimer’s Drug Discovery Foundation.
“Finding new treatment options is vital in improving the quality of life for people with Alzheimer’s disease and their caregivers,” says Nalini Sen, director, research program, at the Alzheimer Society of Canada.
“The results of this research are very encouraging,” says Howard Fillit, MD, founding executive director and chief science officer of the Alzheimer’s Drug Discovery Foundation. “The use of synthetic cannabinoids is a novel approach in the treatment of agitation in patients with Alzheimer’s and fills a huge unmet medical need. There is great interest and excellent scientific rationale for the use of cannabinoids in Alzheimer’s that might include a disease modifying effect that can be tested in subsequent studies.”
Researchers say because cannabinoids have also been shown to help with pain and increase appetite, the goal is to conduct a larger study to confirm findings on agitations and determine if nabilone can also help to improve reduced appetite, and diminish pain, both of which contribute to decreased quality of life in agitated patients with Alzheimer’s.
Media contact
Jennifer Palisoc
Sunnybrook Health Sciences Centre
416-480-4040
jennifer.palisoc@sunnybrook.ca
