Amyloid-beta inhibits E-S Potentiation through suppression of cannabinoid receptor 1 dependent synaptic disinhibition

Objective: The management of agitation in dementia is a growing problem and conventional modes of intervention have limited efficacy. Synthetic Cannabinoids have been studied in other conditions like pain and multiple sclerosis. There is limited data available on their role in dementia. The authors aim to review the available literature and report on the efficacy of treatment with synthetic cannabinoids in two cases of dementia.

Method: Two cases of patients with severe dementia were reported on for the off label use of Nabilone for their symptoms of psychomotor agitation and aggression. Informed consent was obtained from the patients’ substitute decision makers. The Kensington Standardized Behavioural Assessment (KSBA) tool and family observations were used to evaluate the patients’ response to Nabilone treatment. The current literature was reviewed for the use of synthetic cannabinoids in the treatment of aggression in severe dementia.

Results: In the cases there was little improvement in the combined KSBA score after initiation of Nabilone, however there were improvements in the areas of aggressive and emotional behaviour . Families reported improvements in the patients after administration of Nabilone.

Conclusions: Nabilone improved psychomotor agitation, aggression and communication. There were no bedsores in any of the patients on Nabilone. This was an incidental finding.