Intervention Review

Cannabinoids for the treatment of dementia

  1. Sarada Krishnan1,*,
  2. Ruth Cairns2,
  3. Robert Howard3

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 15 APR 2009

Assessed as up-to-date: 9 NOV 2008

DOI: 10.1002/14651858.CD007204.pub2


How to Cite

Krishnan S, Cairns R, Howard R. Cannabinoids for the treatment of dementia. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD007204. DOI: 10.1002/14651858.CD007204.pub2.

Author Information

  1. 1

    Maudsley Hospital, Mental Health of Older Adults, London, UK

  2. 2

    Institute of Psychiatry, Department of Psychological Medicine, London, UK

  3. 3

    Institute of Psychiatry, London, UK

*Sarada Krishnan, Mental Health of Older Adults, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK. S.Krishnan@iop.kcl.ac.uk. skrishnan@doctors.org.uk.

Publication History

  1. Publication Status: New
  2. Published Online: 15 APR 2009

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Following the discovery of an endogenous cannabinoid system and the identification of specific cannabinoid receptors in the central nervous system, much work has been done to investigate the main effects of these compounds. There is increasing evidence that the cannabinoid system may regulate neurodegenerative processes such as excessive glutamate production, oxidative stress and neuroinflammation. Neurodegeneration is a feature common to the various types of dementia and this has led to interest in whether cannabinoids may be clinically useful in the treatment of people with dementia. Recent studies have also shown that cannabinoids may have more specific effects in interrupting the pathological process in Alzheimer's disease.

Objectives

To determine from available research whether cannabinoids are clinically effective in the treatment of dementia.

Search methods

The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 11 April 2008 using the terms: cannabis or cannabinoid* or endocannabinoid*  or cannabidiol or THC or CBD or dronabinol or delta-9-tetrahydrocannabinol or marijuana  or marihuana or hashish. The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many clinical trials registries and grey literature sources.

Selection criteria

All double-blind and single (rater)-blind randomized placebo controlled trials assessing the efficacy of cannabinoids at any dose in the treatment of people with dementia.

Data collection and analysis

Two reviewers independently examined the retrieved studies for inclusion according to the selection criteria. They then independently assessed the methodological quality of selected trials and extracted data where possible.

Main results

Only one study met the inclusion criteria. The data in the study report were presented in such a way that they could not be extracted for further analysis and there was insufficient quantitative data to validate the results.

Authors' conclusions

This review finds no evidence that cannabinoids are effective in the improvement of disturbed behaviour in dementia or in the treatment of other symptoms of dementia. More randomized double-blind placebo controlled trials are needed to determine whether cannabinoids are clinically effective in the treatment of dementia.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

No evidence that cannabinoids are effective in the improvement of disturbed behaviour in dementia or in the treatment of other symptoms of dementia

Cannabinoids are compounds derived from the cannabis plant (Cannabis sativa). Laboratory studies have indicated that cannabinoids may regulate some of the processes that lead to neurodegeneration. This suggests that cannabinoids could be useful in the treatment of neurodegenerative dementias such as Alzheimer's disease. So far, only one small randomized controlled trial has assessed the efficacy of cannabinoids in the treatment of dementia. This study had poorly presented results and did not provide sufficient data to draw any useful conclusions.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

以Cannabinoids治療失智症

內生cannabinoid系統,及中樞神經系統中專一性的cannabinoid受器被發現之後,已有大量的研究工作來研究這些化合物的主要功效。 越來越多的證據顯示出cannabinoid系統可調控神經退化的過程,如:過量的glutamate的製造、氧化的壓力以及神經發炎。神經退化對於各式癡呆症係一常見的特徵,且這已引起眾人的關注,也就是是否cannabinoids可在臨床上對於治療癡呆症病人有所用處。 最近的研究也顯示cannabinoids可有更多專一性的效果中止阿茲海默症的病理進程。

目標

要由可供利用的研究中判定cannabinoids是否在臨床上對癡呆症的治療具有效益,因此進行了以下的研究。

搜尋策略

2008年4月11日在Cochrane Dementia and Cognitive Improvement Group(CDCIG)的 Specialized Register、The Cochrane Library、 MEDLINE、 EMBASE、 PsycINFO、 CINAHL 及 LILACS資料庫使用詞語: cannabis or cannabinoid* or endocannabinoid* or cannabidiol or THC or CBD or dronabinol or delta9tetrahydrocannabinol or marijuana or marihuana or hashish進行搜尋。這CDCIG Specialized Register資料庫不但含有由主要健康資料庫(The Cochrane Library、 MEDLINE、 EMBASE、 PsycINFO、 CINAHL、 LILACS)的記錄也包含許多進行中的臨床試驗資料庫及灰色文獻來源。

選擇標準

所有在任何劑量下評估cannabinoids治療癡呆症人們的雙盲及單(評估者)盲隨機安慰劑對照試驗評量了其效果。

資料收集與分析

兩位回顧者以根據選擇標準獨立地詳細查驗檢索到的研究以納入本回顧。接著他們獨立地評估選擇到的試驗方法學的品質,如果可能的話並摘錄數據。

主要結論

僅一項研究符合納入本回顧的標準。該研究中的資料所呈現的方式不恰當,使得其不能被摘錄,於是也就無法進行更深入的分析,且資料量不足以對這些結果進行確效。

作者結論

本文獻回顧發現並無證據顯示cannabinoids在改善癡呆症的紊亂行為或治療其他癡呆症的病徵時有功效。我們需要更多隨機雙盲安慰劑對照試驗,以判定cannabinoids是否在癡呆症的治療上具有臨床上的功效。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

Cannabinoids為衍生自the cannabis plant (Cannabis sativa)的化合物。實驗室中的研究已經指出cannabinoids可調節一些神經退化的過程。這暗示cannabinoids在治療神經退行性癡呆症如阿茲海默症時能有其功效。迄今為止,僅一小型隨機對照試驗已評估了cannabinoids在治療癡呆症時的功效。這項研究呈現的結果量少且不能提供足夠的資料來描述任何實際的結論。