Lewy Body Dementia (LBD)

Lewy body dementia (LBD) is one of the most common causes of dementia, affecting over 1 million people in the United States alone. Symptoms tend to show up at age 50 or over, although someties younger people are affected by it. LBD tends to affect men slightly more than women. Symptoms of LBD, such as problems with movement, visual hallucinations, confusion, unpredictable changes in concentraion & alertness, difficulties with language & numbers, and changes in behavior and mood, are often mistaken for other brain diseases or psychiatric disorders. LBD is a progressive disease. Memory loss is also common, but not immediately apparent in the initial stages of LBD.

In LBD, there are abnormal deposits of a protein called alpha-synuclein in the brain. This accumulation of proteins are called “Lewy bodies” which, when they build up over time, can cause problems with the way in which your brain works.

Treatment for LBD includes:

• Acetylcholinesterase (AChE) inhibitors, such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Reminyl), which may help reduce hallucinations and confusion by increasing levels of a chemical called acetylcholine in the brain, improving the ability of the brain cells to send signals to each other.
• Memantine, which blocks glutamate production in the brain.
• Levodopa, which can help improve movement.
• Antidepressants
• Sedatives like clonazepam
• Antipsychotics like haloperidol
• Various kinds of therapy (occupational, physio, speech etc.)

Many of these medications can have severe side-effects.

When it comes to medical cannabis for the treatment of LBD (or indeed any type of dementia), there is limited evidence to suggest it may help. Medical cannabis “may be effective for treating agitation, disinhibition, irritability, aberrant motor behaviour, and nocturnal behaviour disorders as well as aberrant vocalization and resting care, which are neuropsychiatric symptoms associated with dementia. There was also limited evidence of improvement in rigidity and cognitive scores as assessed by Mini-Mental State Examination.” There is some other limited evidence confirming this, although medical cannabis may be more helpful (theoretically at least) for dementia associated with Alzheimer’s disease.

There is some suggestion that cannabidiol (CBD) may be useful as an antipsychotic, which would certainly be a useful addition (and alternative, even if only partially so) to the prescription drugs listed above. CBD has far fewer side-effects in comparison, although there are concerns about its interactions with other drugs and desensitization of liver enzymes like CYP 450.

Cannabinoids like CBD and CBG may also have neurogenic properties, meaning that they may be able to help grow new brain cells. This aspect could also help treat memory loss associated with various types of dementia, but there is no specific evidence to suggest that phytocannabinoids like CBD and CBG can have such an effect.

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