On Risk analysis of the use of Cannabinoids compounds as therapy in Dementia
A Systematic literature review
DOI:
https://doi.org/10.56226/75Keywords:
Cannabinoids, Dementia, Risk, Safety, EffectivenessAbstract
Background: Nowadays dementia pharmaceutical treatment has an unfavourable risk-benefit relation. New therapeutic approaches’ adoption is need due to the high prevalence of this condition.
Objective: To evaluate the risk of using cannabinoids compounds as nonharmful therapeutic approach in dementia.
Methods: A systematic literature review based on PRISMA was performed. PubMed and Clinical Trials database were used to collect articles between 2012 and 2022. Cochrane and Consort instruments were used to evaluate the methodology quality and report quality of adverse effects.
Results: Tetrahydrocannabinol and Nabilone were associated to a moderate effectiveness in the symptomatology related with Dementia and to favourable safety and tolerability profiles.
Contributions for evidence-based care: Evidence obtained shows the importance of these two compounds as a new approach to dementia treatment.
References
Ahmed, A. I. A., van den Elsen, G. A. H., Colbers, A., Kramers, C., Burger, D. M., van der Marck, M. A., & Olde Rikkert, M. G. M. (2015). Safety, pharmacodynamics, and pharmacokinetics of multiple oral doses of delta-9-tetrahydrocannabinol in older persons with dementia. Psychopharmacology, 232(14), 2587-2595. https://doi.org/10.1007/s00213-015-3889-y
Ballard, C., & Corbett, A. (2013). Agitation and aggression in people with Alzheimer's disease. Curr Opin Psychiatry, 26(3), 252-259. https://doi.org/10.1097/YCO.0b013e32835f414b
Balter, R. E., & Haney, M. (2017). Chapter 85 - The Synthetic Analog of Δ9-Tetrahydrocannabinol (THC): Nabilone. Pharmacology and Clinical Application. In V. R. Preedy (Ed.), Handbook of Cannabis and Related Pathologies (pp. 821-827). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-12-800756-3.00099-5
Bouchard, R. W. (2007). Diagnostic Criteria of Dementia. Canadian Journal of Neurological Sciences, 34(S1), S11-SS18. https://doi.org/10.1017/S0317167100005497
Breijyeh, Z., & Karaman, R. (2020). Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. Molecules, 25(24). https://doi.org/ 10.3390/molecules25245789
Cabreira, V., & Massano, J. (2019). Parkinson’s Disease: Clinical Review and Update. Acta Médica Portuguesa, 32(10), 661-670. https://doi.org/10.20344/amp.11978
Chi, H., Chang, H.-Y., & Sang, T.-K. (2018). Neuronal Cell Death Mechanisms in Major Neurodegenerative Diseases. International Journal of Molecular Sciences, 19(10), 3082. https://doi.org/10.3390/ijms19103082
Cotter, V. T. (2007). The burden of dementia. American Journal of Managed Care, 13(8), 193-197.
de Almeida, C. M. O., Brito, M. M. C., Bosaipo, N. B., Pimentel, A. V., Tumas, V., Zuardi, A. W., . . . Eckeli, A. L. (2021). Cannabidiol for Rapid Eye Movement Sleep Behavior Disorder. Movement Disorders, 36(7), 1711-1715. https://doi.org/https://doi.org/10.1002/mds.28577
de Faria, S. M., de Morais Fabrício, D., Tumas, V., Castro, P. C., Ponti, M. A., Hallak, J. E. C., . . . Chagas, M. H. N. (2020). Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease. Journal of Psychopharmacology, 34(2), 189-196. https://doi.org/10.1177/0269881119895536
Direção Geral da Saúde, & Ministério da Saúde. (2011). Norma nº 053/2011, de 27 de dezembro de 2011 - Abordagem Terapêutica das Alterações Cognitivas. Direção Geral da Saúde, Ministério da Saúde. https://www.dgs.pt/directrizes-da-dgs/normas-ecirculares-normativas/norma-n-0532011-de-27122011-jpg.aspx
Herrmann, N., Ruthirakuhan, M., Gallagher, D., Verhoeff, N. P. L. G., Kiss, A., Black, S. E., & Lanctôt, K. L. (2019). Randomized Placebo-Controlled Trial of Nabilone for Agitation in Alzheimer's Disease. The American Journal of Geriatric Psychiatry, 27(11), 1161-1173. https://doi.org/https://doi.org/10.1016/j.jagp.2019.05.002
Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., . . . (editors). (2020). Cochrane Handbook for Systematic Reviews of Interventions version 6.3. Cochrane. www.training.cochrane.org/handbook.
Ioannidis, J. P. A., Evans, S. J. W., Gøtzsche, P. C., O'Neill, R. T., Altman, D. G., Schulz, K., & Moher, D. (2004). Better Reporting of Harms in Randomized Trials: An Extension of the CONSORT Statement. Annals of Internal Medicine, 141(10), 781-788. https://doi.org/10.7326/0003-4819-141-10-200411160-00009
Kovacs, G. G. (2018). Chapter 21 - Concepts and classification of neurodegenerative diseases. In G. G. Kovacs & I. Alafuzoff (Eds.), Handbook of Clinical Neurology (Vol. 145, pp. 301-307). Elsevier. https://doi.org/https://doi.org/10.1016/B978-0-12-802395-2.00021-3
Lemberger, L., Rubin, A., Wolen, R., DeSante, K., Rowe, H., Forney, R., & Pence, P. (1982). Pharmacokinetics, metabolism and drug-abuse potential of nabilone. Cancer Treatment Reviews, 9, 17-23. https://doi.org/https://doi.org/10.1016/S0305-7372(82)80031-5
López-Sendón Moreno, J. L., García Caldentey, J., Trigo Cubillo, P., Ruiz Romero, C., García Ribas, G., Alonso Arias, M. A. A., . . . García de Yébenes Prous, J. (2016). A double-blind, randomized, cross-over, placebo-controlled, pilot trial with Sativex in Huntington’s disease. Journal of Neurology, 263(7), 1390-1400. https://doi.org/10.1007/s00415-016-8145-9
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., . . . Altman, D. G. (2012). CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. International Journal of Surgery, 10(1), 28-55. https://doi.org/https://doi.org/10.1016/j.ijsu.2011.10.001
Mohiuddin, M. M., Mizubuti, G. B., Haroutounian, S., Smith, S. M., Rice, A. S. C., Campbell, F., . . . Gilron, I. (2020). Adherence to Consolidated Standards of Reporting Trials (CONSORT) Guidelines for Reporting Safety Outcomes in Trials of Medical Cannabis and Cannabis-based Medicines for Chronic Noncancer Pain: A Systematic Review. The Clinical Journal of Pain, 36(4). https://journals.lww.com/clinicalpain/fulltext/2020/04000/adherence_to_consolidated_standards_of_reporting.10.aspx
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., . . . Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/https:///doi.org/10.1136/bmj.n71
Peball, M., Krismer, F., Knaus, H.-G., Djamshidian, A., Werkmann, M., Carbone, F., . . . Collaborators of the Parkinson's Disease Working Group, I. (2020). Non-Motor Symptoms in Parkinson's Disease are Reduced by Nabilone. Annals of Neurology, 88(4), 712-722. https://doi.org/https://doi.org/10.1002/ana.25864
Peball, M., Werkmann, M., Ellmerer, P., Stolz, R., Valent, D., Knaus, H.-G., . . . Seppi, K. (2019). Nabilone for non-motor symptoms of Parkinson’s disease: a randomized placebo-controlled, double-blind, parallel-group, enriched enrolment randomized withdrawal study (The NMS-Nab Study). Journal of Neural Transmission, 126(8), 1061-1072. https://doi.org/10.1007/s00702-019-02021-z
Schneider, L. S., Dagerman, K. S., & Insel, P. (2005). Risk of Death With Atypical Antipsychotic Drug Treatment for DementiaMeta-analysis of Randomized Placebo-Controlled Trials. JAMA, 294(15), 1934-1943. https://doi.org/10.1001/jama.294.15.1934
Sherer, T. B., Chowdhury, S., Peabody, K., & Brooks, D. W. (2012). Overcoming obstacles in Parkinson's disease. Movement Disorders, 27(13), 1606-1611. https://doi.org/https://doi.org/10.1002/mds.25260
Soria Lopez, J. A., González, H. M., & Léger, G. C. (2019). Chapter 13 - Alzheimer's disease. In S. T. Dekosky & S. Asthana (Eds.), Handbook of Clinical Neurology (Vol. 167, pp. 231-255). Elsevier. https://doi.org/https://doi.org/10.1016/B978-0-12-804766-8.00013-3
Timler, A., Bulsara, C., Bulsara, M., Vickery, A., Smith, J., & Codde, J. (2020). Use of cannabinoid-based medicine among older residential care recipients diagnosed with dementia: study protocol for a double-blind randomised crossover trial. Trials, 21(1), 188. https://doi.org/10.1186/s13063-020-4085-x
Tisher, A., & Salardini, A. (2019). A Comprehensive Update on Treatment of Dementia. Semin Neurol, 39(02), 167-178. https://doi.org/10.1055/s-0039-1683408
van den Elsen, G. A. H., Ahmed, A. I. A., Kramers, C., Verkes, R. J., van der Marck, M. A., Rikkert, M. G. M. O., . . . Rosenberg, P., B. . (2015b). Tetrahydrocannabinol for neuropsychiatric symptoms in dementia. Neurology, 84(23), 2338. https://doi.org/10.1212/WNL.0000000000001675
van den Elsen, G. A. H., Ahmed, A. I. A., Lammers, M., Kramers, C., Verkes, R. J., van der Marck, M. A., & Rikkert, M. G. M. O. (2014). Efficacy and safety of medical cannabinoids in older subjects: A systematic review. Ageing Research Reviews, 14, 56-64. https://doi.org/https://doi.org/10.1016/j.arr.2014.01.007
van den Elsen, G. A. H., Ahmed, A. I. A., Verkes, R.-J., Feuth, T., van der Marck, M. A., & Olde Rikkert, M. G. M. (2015a). Tetrahydrocannabinol in Behavioral Disturbances in Dementia: A Crossover Randomized Controlled Trial. The American Journal of Geriatric Psychiatry, 23(12), 1214-1224. https://doi.org/https://doi.org/10.1016/j.jagp.2015.07.011
van den Elsen, G. A. H., Tobben, L., Ahmed, A. I. A., Verkes, R. J., Kramers, C., Marijnissen, R. M., . . . van der Marck, M. A. (2017). Effects of tetrahydrocannabinol on balance and gait in patients with dementia: A randomised controlled crossover trial. Journal of Psychopharmacology, 31(2), 184-191. https://doi.org/10.1177/0269881116665357
Vicente Forlenza, O., Cretaz, E., & Satler de Oliveira Diniz, B. (2008). O uso de antipsicóticos em pacientes com diagnóstico de demência The use of antipsychotics in patients with dementia. Rev Bras Psiquiatr., 30(3), 265-270. https://doi.org/https://doi.org/10.1590/S1516-44462008000300014
Wang, T., Collet, J.-P., Shapiro, S., & Ware, M. A. (2008). Adverse effects of medical cannabinoids: a systematic review. Canadian Medical Association Journal, 178(13), 1669. https://doi.org/10.1503/cmaj.071178
World Health Organization. (2018). Medication Without Harm. https://www.who.int/initiatives/medicationwithout-harm

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