Navarro Cristian E, Pérez Juan C
School of Medicine, Universidad de Antioquia, Medellín, Colombia.
Grupo de Investigación E.S.E Hospital Emiro Quintero Cañizares, Ocaña, Colombia.
Med Cannabis Cannabinoids. 2024 Sep 12;7(1):160-170. doi: 10.1159/000541364. eCollection 2024 Jan-Dec.
Neuropsychiatric symptoms (NPS) may be disruptive and problematic for patients with Alzheimer's disease (AD) and for their caregivers. Cannabidiol (CBD) may be a safer alternative. The objective was to evaluate whether CBD-rich oil was effective, and safe in adults with NPS secondary to AD.
An open-label, prospective cohort, single-center study in patients with AD onset after the age of 65 with untreated NPS. A CBD-rich oil was administrated 0.1 mL sublingually every 8-12 h, up-titrated weekly. The primary outcome was to establish a reduction in the NPI-Q severity score of >30% at 12 weeks compared with the baseline. A value of <0.05 was statistically significant.
Between July 2020 and July 2023, 59 (93.5%) patients completed ≥3 months of follow-up. The patients were under treatment for a mean of 23.2 months, the median dose of CBD was 111 mg/day. The median NPI-Q severity and caregiver's distress scores at baseline were 24 and 29, respectively. At 3 months, the median NPI-Q severity score shifted to 12 ( < 0.001) and 14 ( < 0.001), respectively. The proportion of patients who achieved a reduction in the NPI-Q severity score of >30% was 94.9%, while a reduction of >50% was achieved by 54.2%. The improvement was maintained for up to 24 months.
This study shows that CBD-rich oil is an effective and safe therapy for treating NPS in AD patients, while also reducing the caregivers' distress.
神经精神症状（NPS）对于阿尔茨海默病（AD）患者及其照护者而言可能具有破坏性且会引发问题。大麻二酚（CBD）可能是一种更安全的替代方案。目的是评估富含CBD的油对患有继发于AD的NPS的成年人是否有效且安全。
一项针对65岁后发病且未治疗的NPS的AD患者的开放标签、前瞻性队列、单中心研究。给予富含CBD的油，每8 - 12小时舌下含服0.1 mL，每周递增剂量。主要结局是确定与基线相比，12周时神经精神症状问卷（NPI - Q）严重程度评分降低>30%。P值<0.05具有统计学意义。
在2020年7月至2023年7月期间，59名（93.5%）患者完成了≥3个月的随访。患者平均接受治疗23.2个月，CBD的中位剂量为111毫克/天。基线时NPI - Q严重程度和照护者痛苦评分的中位数分别为24和29。在3个月时，NPI - Q严重程度评分中位数分别降至12（P<0.001）和14（P<0.001）。NPI - Q严重程度评分降低>30%的患者比例为94.9%，降低>50%的患者比例为54.2%。这种改善持续了长达24个月。
本研究表明，富含CBD的油是治疗AD患者NPS的一种有效且安全的疗法，同时还能减轻照护者的痛苦。
