Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University , Pathumthani, Thailand.
Stroke and Neurodegenerative Disease Research Unit, Thammasat University , Pathumthani, Thailand.
Clin Gerontol. 2021 Jan-Feb;44(1):16-24. doi: 10.1080/07317115.2020.1742832. Epub 2020 Mar 18.
: In the last decade, research has focused on developing novel medications for the treatment of dementia. Cannabinoids are one of the potential agents under investigation. The present study aimed to examine the evidence concerning the effectiveness of cannabinoids for the treatment of dementia. : We undertook a systematic review complying to PRISMA guidelines. Four databases were searched including Medline, Embase, Cochrane Library, and PsychINFO. : Five studies evaluated the use of cannabinoids for anorexia and agitation in dementia. One study used dronabinol 5 mg/day to target anorexic symptoms of dementia which positively impacted on weight. Results of two trials investigating the effectiveness of tetrahydrocannabinol (THC) 1.5-4.5 mg/day for the treatment of agitation indicated no significant differences between THC and placebo. The most recent trial reported significant improvement in agitation using nabilone at 1-2 mg/day. However, levels of evidence of these agents were rated as low and very low because of low sample size and methodology issues. No studies were available that investigated the use of cannabinoids to moderate cognitive symptoms in dementia. : Findings from a few robust randomized controlled trials suggest that nabilone might be useful for the treatment of agitation in patients with dementia, but there is no convincing evidence for THC. Additional studies are needed to further clarify and assess the benefits of these treatments. : There were no randomized controlled trials investigating the use of cannabinoids for the treatment of cognitive decline in dementia. Studies on THC reported no significant improvement in agitation. It may be too early to postulate that cannabinoids have any effect on dementia symptoms or their progression.
在过去的十年中，研究的重点一直放在开发治疗痴呆症的新型药物上。大麻素是正在研究的潜在药物之一。本研究旨在研究大麻素治疗痴呆症的疗效证据。
我们进行了一项符合 PRISMA 指南的系统评价。检索了四个数据库，包括 Medline、Embase、Cochrane 图书馆和 PsychINFO。
五项研究评估了大麻素在痴呆症厌食症和激越中的应用。一项研究使用大麻二酚 5 毫克/天来治疗痴呆症的厌食症状，这对体重有积极影响。两项试验研究大麻素（THC）1.5-4.5 毫克/天治疗激越的效果，结果表明 THC 与安慰剂之间无显著差异。最近的一项试验报告说，使用纳布隆 1-2 毫克/天治疗激越可显著改善。然而，由于样本量小和方法学问题，这些药物的证据水平被评为低和极低。没有研究调查大麻素用于缓解痴呆症认知症状的用途。
少数严格的随机对照试验的结果表明，纳布隆可能对治疗痴呆症患者的激越有用，但没有 THC 的令人信服的证据。需要进一步的研究来进一步澄清和评估这些治疗方法的益处。
没有研究调查大麻素治疗痴呆症认知下降的用途。关于 THC 的研究报告称，激越没有显著改善。现在推测大麻素对痴呆症症状或其进展有任何影响还为时过早。
