Evidence map›Paper›PMID 34374269›Full record

SynthesisTrends in psychiatry and psychotherapy

Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review.

Florindo Stella, Leandro C Lane Valiengo, Vanessa J R de Paula, Carlos Augusto de Mendonça Lima, Orestes V Forlenza

Open access · diamondAbstract readSystematic Review
In one paragraph

Synthesis in Trends in psychiatry and psychotherapy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Evidence synthesis of medical cannabis research: current challenges and opportunities.European archives of psychiatry and clinical neuroscience · 2025
    Review
  3. Review
  4. Article
  5. Review
  6. Medical cannabis and cannabinoids
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Florindo StellaLaboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Instituto Nacional de Biomarcadores em Neuropsiquiatria (InBion), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, SP, Brazil. Instituto de Biociências, Universidade Estadual Paulista (UNESP), Campus de Rio Claro, SP, Brazil.
Leandro C Lane ValiengoLaboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Instituto Nacional de Biomarcadores em Neuropsiquiatria (InBion), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, SP, Brazil.
Vanessa J R de PaulaLaboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Instituto Nacional de Biomarcadores em Neuropsiquiatria (InBion), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, SP, Brazil.
Carlos Augusto de Mendonça LimaSection of Old Age Psychiatry, World Psychiatric Association, Geneva, Switzerland.
Orestes V ForlenzaLaboratory of Neuroscience (LIM-27), Departamento e Instituto de Psiquiatria HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Instituto Nacional de Biomarcadores em Neuropsiquiatria (InBion), Conselho Nacional de Desenvolvimento Científico e Tecnológico, São Paulo, SP, Brazil.
Universidade de São Paulo · BRUniversidade Estadual Paulista (Unesp) · BRWorld Federation of Public Health Associations · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNeuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires combinations of pharmacological and non-pharmacological interventions. However, limited efficacy and a non-negligible incidence of adverse psychotropic drug events emphasize the need for novel therapeutic options.

objectivesTo review the evidence supporting use of medical cannabinoids for treatment of neuropsychiatric symptoms (NPS) of dementia.

methodsWe conducted a systematic review of the medical literature to examine scientific publications reporting use of medical cannabinoids for treatment of NPS. Medical Subject Headings (MeSH) were used to search for relevant publications and only papers reporting original clinical information were included. A secondary search was performed within selected publications to capture relevant citations that were not retrieved by the systematic review. The papers selected were categorized according to the level of evidence generated by the studies in relation to this clinical application, i.e. (1) controlled clinical trials; (2) open-label or observational studies; and (3) case reports.

resultsFifteen publications with original clinical data were retrieved: five controlled clinical trials, three open-label/observational studies, and seven case reports. Most studies indicated that use of medical cannabinoids engendered favorable outcomes for treatment of NPS related to moderate and advanced stages of dementia, particularly agitation, aggressive behavior, sleep disorder, and sexual disinhibition.

conclusionMedical cannabinoids constitute a promising pharmacological approach to treatment of NPS with preliminary evidence of benefit in at least moderate to severe dementia. Controlled trials with longitudinal designs and larger samples are required to examine the long-term efficacy of these drugs in different types and stages of dementia, in addition to their adverse events and risk of interactions with other drugs. Many pharmacological details are yet to be determined, such as dosing, treatment duration, and concentrations of active compounds (e.g., cannabidiol [CBD]/ Δ9-tetrahydrocannabinol [THC] ratio) in commercial preparations of medical cannabinoids.

Indexed as

CannabinoidsDementiaAggressionAnxietyHumansPsychotropic DrugsCannabinoidsPsychotropic DrugscannabidiolDementianeuropsychiatric symptomstreatmentΔ9-tetrahydrocannabinol

Identifiers

PMID34374269
PMCPMC8835388
OpenAlexW3183650046

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.