←Dementia
Study register · detail Fallserie · Dementia · 2023

A Case Report of Treatment-Resistant Agitation in Dementia With Lewy Bodies: Medical Cannabis as an Alternative to Antipsychotics.

Ramm et al. ·Journal of palliative medicine Impact 1.0
Clear benefit GRADE Very low 5 citations
Samplen = 1 Pat.
Durationunclear
EndpointAgitation/behavior
Blindingn.a.
DesignFallserie
Cannabinoidthc
Routeoral
Key finding

In an 85-year-old patient with dementia with Lewy bodies, THC tincture led to rapid improvement of agitation after multiple antipsychotics had failed.

Summary

Case report n=1: 85-year-old man with Lewy body dementia and treatment-refractory aggression (multiple antipsychotic regimens failed). After starting THC tincture, rapid behavioral improvement, successful discharge home. THC as an alternative to antipsychotics for persistent dementia-associated agitation. Limited evidence from a single case.

P
Population85-year-old man with Lewy body dementia and treatment-refractory agitation, n=1
I
InterventionTHC tincture (oral administration), dose not specified
O
OutcomeRapid improvement in behavior after THC tincture; discharge home possible
Confidence in the evidence
Very low

The lowest GRADE level, the effect estimate remains uncertain.

Downgraded for
Imprecision
Quality profile
Sample size ★★★★★
Blinding —
Effect size Clear benefit
Citations / year ★★★★★
Authors
Ramm RM, Lerner ZI, Levy-Meeks GS, Burke RV, Raven MC, Song A, Glass MH
DOI 10.1089/jpm.2022.0343↗
Design: Fallserie
Share
Abstract
Palliative care teams are often consulted to assist in treating persistent dementia-related behavioral issues. Delta-9-tetrahydrocannabinol (THC) offers an alternative to traditional antipsychotic drugs in the long-term management of dementia with behavioral change. We present the case of an 85-year-old man with dementia with Lewy bodies with worsening aggression refractory to antipsychotic management. Multiple regimens of antipsychotics failed both in the outpatient and inpatient settings. After exhausting other options and in the setting of worsening agitation, a tincture of THC was prescribed. After starting THC tincture, the patient's behavior rapidly improved, and he was discharged home to the care of his spouse. The challenges of prescribing and obtaining THC are discussed.
Indication
Further studies on Dementia
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The impediment to action advances action. — Marcus Aurelius