Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T15:46:14.728Z Has data issue: false hasContentIssue false
  • English
  • Français

Study rationale and baseline data for pilot trial of dronabinol adjunctive treatment of agitation in Alzheimer’s dementia (THC-AD)

Published online by Cambridge University Press:  11 October 2021

Leah M. Cohen Open the ORCID record for Leah M. Cohen [Opens in a new window] ,
Eleanor Ash ,
John D. Outen ,
Ryan Vandrey ,
Halima Amjad ,
Marc Agronin ,
M. Haroon Burhanullah ,
Patricia Walsh ,
James M. Wilkins  and
Jeannie-Marie Leoutsakos
...Show all authors
Leah M. Cohen
Affiliation:
Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
Eleanor Ash
Affiliation:
Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
John D. Outen
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Ryan Vandrey
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Halima Amjad
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Marc Agronin
Affiliation:
Department of Mental Health and Clinical Research, Miami Jewish Health, Miami, FL, USA
M. Haroon Burhanullah
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Patricia Walsh
Affiliation:
Department of Psychiatry, North Shore Medical Center, Salem, MA, USA
James M. Wilkins
Affiliation:
Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA Harvard Medical School, Boston, MA, USA
Jeannie-Marie Leoutsakos
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Milap A. Nowrangi
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
David Harper
Affiliation:
Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA Harvard Medical School, Boston, MA, USA
Paul B. Rosenberg
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Brent P. Forester*
Affiliation:
Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA Harvard Medical School, Boston, MA, USA
*
Correspondence should be addressed to: Brent P. Forester, M.D., M.Sc., Division of Geriatric Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA. Office: 617-855-3622; Fax: 617-855-3246. Email: bforester@mclean.harvard.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Agitation is a common complication of Alzheimer’s dementia (Agit-AD) associated with substantial morbidity, high healthcare service utilization, and adverse emotional and physical impact on care partners. There are currently no FDA-approved pharmacological treatments for Agit-AD. We present the study design and baseline data for an ongoing multisite, three-week, double-blind, placebo-controlled, randomized clinical trial of dronabinol (synthetic tetrahydrocannabinol [THC]), titrated to a dose of 10 mg daily, in 80 participants to examine the safety and efficacy of dronabinol as an adjunctive treatment for Agit-AD. Preliminary findings for 44 participants enrolled thus far show a predominately female, white sample with advanced cognitive impairment (Mini Mental Status Examination mean 7.8) and agitation (Neuropsychiatric Inventory-Clinician Agitation subscale mean 14.1). Adjustments to study design in light of the COVID-19 pandemic are described. Findings from this study will provide guidance for the clinical utility of dronabinol for Agit-AD. ClinicalTrials.gov Identifier: NCT02792257.

Keywords

Alzheimer’s diseasedementiaagitationneuropsychiatric symptomsdrug trials
Type
Brief Report
Information
International Psychogeriatrics , First View , pp. 1 - 6
Copyright
© International Psychogeriatric Association 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cummings, J. et al. (2015). Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition. International Psychogeriatrics, 27, 7–17. doi: 10.1017/S1041610214001963 CrossRefGoogle ScholarPubMed
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer‘s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7, 263–269. doi: 10.1016/j.jalz.2011.03.005 CrossRefGoogle Scholar
Porsteinsson, A. P. et al. (2014). Effect of Citalopram on Agitation in Alzheimer Disease. JAMA, 311, 682–691. doi: 10.1001/jama.2014.93 CrossRefGoogle ScholarPubMed
Ruthirakuhan, M., Lanctot, K. L., Vieira, D. and Herrmann, N. (2019). Natural and Synthetic Cannabinoids for Agitation and Aggression in Alzheimer’s Disease: A Meta-Analysis. Journal of Clinical Psychiatry, 80. doi: 10.4088/JCP.18r12617.Google ScholarPubMed
Schneider, L. S., Dagerman, K. and Insel, P. S. (2006). Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. American Journal of Geriatric Psychiatry, 14, 191–210. doi: 10.1097/01.JGP.0000200589.01396.6d CrossRefGoogle ScholarPubMed
Scott, N. W., McPherson, G. C., Ramsay, C. R. and Campbell, M. K. (2002). The method of minimization for allocation to clinical trials. a review. Controlled Clinical Trials, 23, 662–674. doi: 10.1016/s0197-2456(02)00242-8 CrossRefGoogle ScholarPubMed
van den Elsen, G. A. H. et al. (2015). Tetrahydrocannabinol for neuropsychiatric symptoms in dementia: a randomized controlled trial. Neurology, 84, 2338–2346. doi: 10.1212/WNL.0000000000001675 CrossRefGoogle ScholarPubMed
Woodward, M. R., Harper, D. G., Stolyar, A., Forester, B. P. and Ellison, J. M. (2013). Dronabinol for the treatment of agitation and aggressive behavior in acutely hospitalized severely demented patients with noncognitive behavioral symptoms. American Journal of Geriatric Psychiatry, 22, 415–419. doi: 10.1016/j.jagp.2012.11.022 CrossRefGoogle ScholarPubMed