Nabilone treatment for severe behavioral problems in adults with intellectual and developmental disabilities: Protocol for a phase I open-label clinical trial

PLoS One. 2023 Apr 12;18(4):e0282114. doi: 10.1371/journal.pone.0282114. eCollection 2023.

Abstract

Severe behavioral problems (SBPs) are common contributors to morbidity and reduced quality of life for adults with intellectual and developmental disabilities (IDD) and their families. Current medications for SBPs show equivocal effectiveness and are associated with a high risk of side effects. New and safe treatments are urgently needed. While preliminary studies suggest that medical cannabinoids, particularly the synthetic cannabinoid nabilone, are plausible treatment options for SBPs in adults with IDD, data on the tolerability, safety and efficacy of nabilone in this population has never been investigated. Thus, we propose this first-ever Phase I pre-pilot open-label clinical trial to obtain preliminary data on the adherence, tolerability and safety profiles of nabilone in adults with IDD, and explore changes in SBPs pre- to post-treatment. We hypothesize that nabilone has favorable tolerability and safety profile for adults with IDD. The preliminary results will inform the next-stage pilot randomized controlled trials, followed by fully powered clinical trials eventually. This research helps fill the evidence gap in the use of cannabinoids in individuals with IDD to meet the needs of patients, families, and service providers.

Publication types

  • Clinical Trial Protocol
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cannabinoids* / adverse effects
  • Child
  • Clinical Trials, Phase I as Topic
  • Developmental Disabilities / chemically induced
  • Humans
  • Intellectual Disability* / complications
  • Problem Behavior*
  • Quality of Life

Substances

  • Cannabinoids
  • nabilone

Grants and funding

This project is funded by the CAMH Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario, and the University of Toronto Department of Psychiatry Excellence Funds. H-YL is supported by the Azrieli Adult Neurodevelopmental Centre at Centre for Addiction and Mental Health, and an Academic Scholar Award from the Department of Psychiatry, University of Toronto. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the protocol.