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 .
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 clinical ly 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 clinical ly effective in the treatment of dementia .
Donepezil for the treatment of agitation in Alzheimer's disease.
BACKGROUND Agitation is a common and distressing symptom in patients with Alzheimer 's disease .  Cholinesterase inhibitors improve cognitive outcomes in such patients , but the benefits of these drugs for behavioral disturbances are unclear . METHODS We r and omly assigned 272 patients with Alzheimer 's disease who had clinical ly significant agitation and no response to a brief psychosocial treatment program to receive 10 mg of donepezil per day ( 128 patients ) or placebo ( 131 patients ) for 12 weeks . The primary outcome was a change in the score on the Cohen-Mansfield Agitation Inventory ( CMAI ) ( on a scale of 29 to 203 , with higher scores indicating more agitation ) at 12 weeks . RESULTS There was no significant difference between the effects of donepezil and those of placebo on the basis of the change in CMAI scores from baseline to 12 weeks ( estimated mean difference in change [ the value for donepezil minus that for placebo ] , -0.06 ; 95 % confidence interval [ CI ] , -4.35 to 4.22 ) . Twenty-two of 108 patients ( 20.4 % ) in the placebo group and 22 of 113 ( 19.5 % ) in the donepezil group had a reduction of 30 % or greater in the CMAI score ( the value for donepezil minus that for placebo , -0.9 percentage point ; 95 % CI , -11.4 to 9.6 ) . There were also no significant differences between the placebo and donepezil groups in scores for the Neuropsychiatric Inventory , the Neuropsychiatric Inventory Caregiver Distress Scale , or the Clinician 's Global Impression of Change . CONCLUSIONS In this 12-week trial , donepezil was not more effective than placebo in treating agitation in patients with Alzheimer 's disease . ( Clinical Trials.gov number , NCT00142324 [ Clinical Trials.gov ] . )
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 .
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 clinical ly 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 clinical ly effective in the treatment of dementia .