“From Stigma to Solution” – Using THC Edibles for the Palliative Treatment of Aggression and Agitation in Dementia

Outcomes 1. Explain the detrimental effects of under-treated behavioral symptoms of dementia on patients and caregivers, and list the pros and cons of the current standard treatment of behavioral symptoms of dementia. 2. Understand current research supporting THC use for behavioral symptoms of dementia. Key Message THC from cannabis dispensaries shows promise in effectively managing neuropsychiatric symptoms (NPS) in dementia patients. Our preliminary study demonstrated high caregiver acceptance, substantial NPS improvement, and potential for reduced antipsychotic use. Ongoing research explores factors influencing THC efficacy, offering hope for better NPS management in dementia care. Abstract Neuropsychiatric symptoms (NPS) in dementia patients significantly contribute to poor quality of life, increased healthcare costs, and caregiver burden.1 Current management options primarily rely on nonpharmacologic strategies, including environmental modifications, as first-line interventions for NPS.2 However, these strategies often prove insufficient or logistically challenging, resulting in the utilization of antipsychotics with their associated substantial side effect profiles.3 One innovative avenue showing promise is the use of tetrahydrocannabinol (THC).4 In the preliminary phase of our study, we conducted a retrospective cohort study encompassing 50 patients diagnosed with dementia, all of whom were offered treatment with THC edibles obtained from cannabis dispensaries. Our results revealed substantial caregiver acceptance of dispensary-sourced THC (38/50, 76%) and subsequent high caregiver-reported improvements in NPS (30/38, 79%). Notably, very few adverse reactions (5/38, 13%) were reported in association with THC use, and a significant number of patients achieved reductions in or discontinuation of antipsychotic medications following THC treatment. Expanding upon these initial findings, the subsequent phase of our investigation seeks to explore the multifactorial aspects associated with THC's efficacy in managing NPS. Preliminary analyses have already identified a significant association (r = 0.014) between the type of dementia diagnosis and the determined efficacy of THC, with vascular dementia emerging as the most prevalent specific diagnosis. An ongoing open-label prospective study is currently utilizing quantitative measures to assess THC's effectiveness for agitation, aggression, and sleep cycle regulation, as well as investigating factors related to caregiver/patient acceptance of perceived 'natural treatments' like cannabis. These findings promise to provide a comprehensive understanding of THC's potential utility in addressing NPS in dementia patients, offering hope for improved quality of life for both patients and their caregivers. Keywords Disease specific management / Integrative Medicine