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Can cannabis-based treatments help people?

Exploring the possibilities of cannabis-based treatments to control challenging behaviour The Sativex for the Treatment of Agitation in Dementia (STAND trial) will see Sativex peppermint-flavoured mouth spray tested in a Phase 2 clinical trial by King's College London with £300,000 of funding by Alzheimer’s Research UK. The charity is keen to explore the possibilities of cannabis-based treatments, especially for challenging behaviours, however they acknowledge taking cannabis “can involve risks including short-term memory and thinking problems, coordination difficulties and anxiety.” The trial is significant to those within the dementia community as nearly half of the 850,000 people living with dementia in the UK will experience symptoms of agitation or aggression, according to Alzheimer’s Research UK. For relatives and care workers, this can often be one of the most challenging aspects of the illness, both for the person with dementia and those caring for them.

A future alternative to antipsychotic medications? Professor Dag Aarsland, the lead researcher on the STAND trial, said: “While people most often associate Alzheimer’s disease with memory problems, this is just one aspect of a complex condition that can affect people in different ways. “Many people with Alzheimer’s can become agitated or aggressive, and this can pose difficulties for the person with the condition and those closest to them. “Current treatments for behavioural and psychiatric symptoms of dementia are very limited, and we desperately need to develop alternatives. Doctors sometimes prescribe anti-psychotic medications, and while these drugs can have important benefits, these need to be weighed against the risk of very serious side effects.” The STAND trial volunteers will take the medication for four weeks and researchers will compare the results from those taking Sativex and those taking a dummy drug. Professor Aarsland believes there are some important factors to consider with the STAND trial. He said: “One of the key questions the STAND trial will answer is whether it is practical to give someone with dementia a drug through a mouth spray when they may be exhibiting severe symptoms of agitation and aggression." There are 60 participants in the trial, but a larger study will take place if results are successful. Dr David Reynolds, chief scientific officer of Alzheimer’s Research UK, said: “While a major focus for dementia research is to develop drugs that slow or stop the progression of the physical diseases that cause dementia, what really matters is that a medicine benefits people’s day-to-day lives. “The STAND trial opens the door to a treatment that may help to alleviate an extremely challenging set of symptoms, and Alzheimer’s Research UK is extremely grateful to our supporters for making this important work possible.” Dr Reynolds confirmed that the health and wellbeing of participants will be closely monitored throughout the trial.

What does the Alzheimer Society think? While there is ongoing promising research on the effects of cannabis, there is currently no evidence that cannabis is useful for the treatment or prevention of Alzheimer’s disease. In fact, some research indicates that long-term use of cannabis may be harmful and result in memory problems.

Summary The search for new treatments to alleviate the problems associated with dementia must not compromise the heath and wellbeing of people who participate in the research. Even if the research alleviates some of the symptoms of agitation or aggression, we must still bear in mind the potential long-term effects of cannabis-based medicine. While Dr Reynolds is right to bring to our attention that to date the major focus for dementia research is the development of drugs that slow or stop the progression of the physical diseases. It seems important that we shift some of that focus to research into medicines that benefits people’s day-to-day lives. The Alzheimer Society seem to be voicing a word of caution. Drawing people’s attention to the fact that whist there is some promising ongoing research on the effects of cannabis, there is currently no evidence that cannabis is useful for the treatment or prevention of Alzheimer’s disease. Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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