Joy, Janet E.; Stanley J. Watson, Jr.; John A. Benson, Jr., Eds. "The Medical Value of Marijuana and Related Substances," in Marijuana and Medicine: Assessing the Science Base. Washington, DC: Division of Neuroscience and Behavoiral Health, Institute of Medicine. 1999. 259 p.
Food refusal is a common problem in patients who suffer from Alzheimer's type dementia. The causes of anorexia in demented people are not known but may be a symptom of depression. Antidepressants improve eating in some but not all patients with severe dementia. Eleven Alzheimer's patients were treated for 12 weeks on an alternating schedule of dronabinol and placebo (six weeks of each treatment). The dronabinol treatment resulted in substantial weight gains and declines in disturbed behavior.(190) No serious side effects were observed. One patient had a seizure and was removed from the study, but the seizure was not necessarily caused by dronabinol. Recurrent seizures without any precipitating events occur in 20% of patients who have advanced dementia of Alzheimer's type.(189) Nevertheless, these results are encouraging enough to recommend further clinical research with cannabinoids.
The patients in the study discussed above were in long-term institutional care, and most were severely demented with impaired memory. Although short-term memory loss is a common side effect of THC in healthy patients, it was not a concern in this study. However, the effect of dronabinol on memory in Alzheimer's patients who are not as severely disturbed as those in the above study would be an important consideration.
Notes:
189 Volicer L, Smith S, Volicer BJ. 1995. Effect of seizures on progression of dementia of the Alzheimer type. Dementia 6:258—263.
190 Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. 1997. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry 12:913—919.
