New findings from a clinical trial suggest that dronabinol, an oral form of delta-9-tetrahydrocannabinol (THC), may offer relief for Alzheimer's disease patients suffering from severe agitation, a challenging symptom that significantly impacts both patients and their caregivers.
The THC-AD trial, presented at the 2024 Clinical Trials on Alzheimer's Disease (CTAD) conference in Madrid, evaluated 80 patients aged 60 to 95 years who experienced severe agitation related to Alzheimer's disease. The study administered 5 mg of dronabinol twice daily in a randomized, double-blind, placebo-controlled design.
Understanding Agitation in Alzheimer's Disease
"Agitation is a symptom—it's a syndrome. It doesn't tell us anything about etiology," explains Dr. Brent Forester, director of behavioral health at Tufts Medicine. "It could be the disease itself, the time of day, or even the way a loved one spoke to them in the morning. It could be as simple as someone assisting with bathing. This variability is what makes agitation so difficult to treat."
The complexity of agitation in Alzheimer's disease has historically made treatment challenging. Current standard treatments, particularly antipsychotics, have shown limited efficacy while carrying serious risks, including increased mortality and stroke-like events.
Promising Trial Results and Future Directions
Preliminary findings from the trial indicated meaningful improvements in agitation symptoms among patients receiving dronabinol treatment. The research team, led by Dr. Forester and Dr. Paul Rosenberg from Johns Hopkins University School of Medicine, emphasized that these results warrant further investigation into cannabinoid-based therapies for Alzheimer's-related agitation.
Clinical Implications and Research Challenges
Researchers acknowledge several challenges in studying agitation treatments, including the reliance on caregiver reports and rating scales for symptom assessment. As the availability of dispensary cannabinoids grows, there is an urgent need for evidence-based clinical guidelines to help healthcare providers navigate treatment options effectively.
The research team is now focusing on identifying predictors of treatment response to cannabinoid therapy, which could help optimize patient selection and treatment outcomes in future clinical applications.
