Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review
Abstract Introduction Neuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires...
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| Format: | Article |
| Language: | English |
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Associação de Psiquiatria do Rio Grande do Sul
2021-12-01
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| Series: | Trends in Psychiatry and Psychotherapy |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892021000400243&tlng=en |
| _version_ | 1819243612268920832 |
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| author | Florindo Stella Leandro C. Lane Valiengo Vanessa J. R. de Paula Carlos Augusto de Mendonça Lima Orestes V. Forlenza |
| author_facet | Florindo Stella Leandro C. Lane Valiengo Vanessa J. R. de Paula Carlos Augusto de Mendonça Lima Orestes V. Forlenza |
| author_sort | Florindo Stella |
| collection | DOAJ |
| description | Abstract Introduction Neuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires combinations of pharmacological and non-pharmacological interventions. However, limited efficacy and a non-negligible incidence of adverse psychotropic drug events emphasize the need for novel therapeutic options. Objectives To review the evidence supporting use of medical cannabinoids for treatment of neuropsychiatric symptoms (NPS) of dementia. Methods We conducted a systematic review of the medical literature to examine scientific publications reporting use of medical cannabinoids for treatment of NPS. Medical Subject Headings (MeSH) were used to search for relevant publications and only papers reporting original clinical information were included. A secondary search was performed within selected publications to capture relevant citations that were not retrieved by the systematic review. The papers selected were categorized according to the level of evidence generated by the studies in relation to this clinical application, i.e. (1) controlled clinical trials; (2) open-label or observational studies; and (3) case reports. Results Fifteen publications with original clinical data were retrieved: five controlled clinical trials, three open-label/observational studies, and seven case reports. Most studies indicated that use of medical cannabinoids engendered favorable outcomes for treatment of NPS related to moderate and advanced stages of dementia, particularly agitation, aggressive behavior, sleep disorder, and sexual disinhibition. Conclusion Medical cannabinoids constitute a promising pharmacological approach to treatment of NPS with preliminary evidence of benefit in at least moderate to severe dementia. Controlled trials with longitudinal designs and larger samples are required to examine the long-term efficacy of these drugs in different types and stages of dementia, in addition to their adverse events and risk of interactions with other drugs. Many pharmacological details are yet to be determined, such as dosing, treatment duration, and concentrations of active compounds (e.g., cannabidiol [CBD]/ Δ9-tetrahydrocannabinol [THC] ratio) in commercial preparations of medical cannabinoids. |
| first_indexed | 2024-12-23T14:58:28Z |
| format | Article |
| id | doaj.art-25fa54af40c0482c9e09218663f83435 |
| institution | Directory Open Access Journal |
| issn | 2238-0019 |
| language | English |
| last_indexed | 2024-12-23T14:58:28Z |
| publishDate | 2021-12-01 |
| publisher | Associação de Psiquiatria do Rio Grande do Sul |
| record_format | Article |
| series | Trends in Psychiatry and Psychotherapy |
| spelling | doaj.art-25fa54af40c0482c9e09218663f834352022-12-21T17:42:42ZengAssociação de Psiquiatria do Rio Grande do SulTrends in Psychiatry and Psychotherapy2238-00192021-12-0143424325510.47626/2237-6089-2021-0288Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic reviewFlorindo Stellahttps://orcid.org/0000-0001-6052-7312Leandro C. Lane ValiengoVanessa J. R. de PaulaCarlos Augusto de Mendonça LimaOrestes V. ForlenzaAbstract Introduction Neuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires combinations of pharmacological and non-pharmacological interventions. However, limited efficacy and a non-negligible incidence of adverse psychotropic drug events emphasize the need for novel therapeutic options. Objectives To review the evidence supporting use of medical cannabinoids for treatment of neuropsychiatric symptoms (NPS) of dementia. Methods We conducted a systematic review of the medical literature to examine scientific publications reporting use of medical cannabinoids for treatment of NPS. Medical Subject Headings (MeSH) were used to search for relevant publications and only papers reporting original clinical information were included. A secondary search was performed within selected publications to capture relevant citations that were not retrieved by the systematic review. The papers selected were categorized according to the level of evidence generated by the studies in relation to this clinical application, i.e. (1) controlled clinical trials; (2) open-label or observational studies; and (3) case reports. Results Fifteen publications with original clinical data were retrieved: five controlled clinical trials, three open-label/observational studies, and seven case reports. Most studies indicated that use of medical cannabinoids engendered favorable outcomes for treatment of NPS related to moderate and advanced stages of dementia, particularly agitation, aggressive behavior, sleep disorder, and sexual disinhibition. Conclusion Medical cannabinoids constitute a promising pharmacological approach to treatment of NPS with preliminary evidence of benefit in at least moderate to severe dementia. Controlled trials with longitudinal designs and larger samples are required to examine the long-term efficacy of these drugs in different types and stages of dementia, in addition to their adverse events and risk of interactions with other drugs. Many pharmacological details are yet to be determined, such as dosing, treatment duration, and concentrations of active compounds (e.g., cannabidiol [CBD]/ Δ9-tetrahydrocannabinol [THC] ratio) in commercial preparations of medical cannabinoids.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892021000400243&tlng=enDementianeuropsychiatric symptomscannabidiolΔ9-tetrahydrocannabinoltreatment |
| spellingShingle | Florindo Stella Leandro C. Lane Valiengo Vanessa J. R. de Paula Carlos Augusto de Mendonça Lima Orestes V. Forlenza Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review Trends in Psychiatry and Psychotherapy Dementia neuropsychiatric symptoms cannabidiol Δ9-tetrahydrocannabinol treatment |
| title | Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review |
| title_full | Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review |
| title_fullStr | Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review |
| title_full_unstemmed | Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review |
| title_short | Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review |
| title_sort | medical cannabinoids for treatment of neuropsychiatric symptoms in dementia a systematic review |
| topic | Dementia neuropsychiatric symptoms cannabidiol Δ9-tetrahydrocannabinol treatment |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892021000400243&tlng=en |
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