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

J Palliat Med. 2023 May;26(5):737-740. doi: 10.1089/jpm.2022.0343. Epub 2022 Dec 26.

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.

Keywords: dementia; medical cannabis; neurodegenerative disease.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antipsychotic Agents* / therapeutic use
  • Anxiety
  • Humans
  • Lewy Body Disease* / drug therapy
  • Male
  • Medical Marijuana* / therapeutic use

Substances

  • Antipsychotic Agents
  • Medical Marijuana