A placebo-controlled crossover design, with each treatment period lasting 6 weeks, was used to investigate effects of dronabinol in 15 patients with a diagnosis of probable Alzhemer's disease who were refusing food. Eleven patients completed both study periods; one patient who died of a heart attack 2 weeks before the end of the study was also included in the analysis. The study was terminated in 3 patients: one developed a grand mal seizure and 2 developed serious intercurrent infections. Body weight of study subjects increased more during the dronabinol treatment than during the placebo periods. Dronabinol treatment decreased severity of disturbed behavior and this effect persisted during the placebo period in patients who received dronabinol first. Adverse reactions observed more commonly during the dronabinol treatment than during placebo periods included euphoria, somnolence and tiredness, but did not require discontinuation of therapy. These results indicate that dronabinol is a promising novel therapeutic agent which may be useful not only for treatment of anorexia but also to improve disturbed behavior in patients with Alzheimer's disease.
Alzheimer's disease (AD) causes a steady loss of memory and a decline in the ability to care for oneself. Weight loss is an insidious, yet common, problem that requires intervention and supervision during all stages of the disease. In spite of swallowing difficulties, natural feeding techniques can be used to sustain demented individuals without the use of tube feeding. Mealtime independence that supports an adequate nutritional intake can be encouraged by a variety of environmental, behavioral, and physical strategies. Supplements and adjustments in the diet's texture and volume in response to chewing and swallowing difficulties can enhance food and fluid intake and help to maintain an established target weight. Strategies used to maintain nutritional status in AD may also be useful for individuals with other progressive dementias. It is important to consider the individual's comfort and dignity when making any team treatment decisions.
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