title: Efficacy and safety of medical cannabinoids in older subjects: a systematic review.
abstract: This systematic review aims to integrate the evidence on indications, efficacy, safety and pharmacokinetics of medical cannabinoids in older subjects. The literature search was conducted using PubMed, EMBASE, CINAHL and Cochrane Library. We selected controlled trials including solely older subjects (≥65 years) or reporting data on older subgroups. 105 (74%) papers, on controlled intervention trials, reported the inclusion of older subjects. Five studies reported data on older persons separately. These were randomized controlled trials, including in total 267 participants (mean age 47-78 years). Interventions were oral tetrahydrocannabinol (THC) (n=3) and oral THC combined with cannabidiol (n=2). The studies showed no efficacy on dyskinesia, breathlessness and chemotherapy induced nausea and vomiting. Two studies showed that THC might be useful in treatment of anorexia and behavioral symptoms in dementia. Adverse events were more common during cannabinoid treatment compared to the control treatment, and were most frequently sedation like symptoms. Although trials studying medical cannabinoids included older subjects, there is a lack of evidence of its use specifically in older patients. Adequately powered trials are needed to assess the efficacy and safety of cannabinoids in older subjects, as the potential symptomatic benefit is especially attractive in this age group.
authors: Radboud university medical center, Radboud Alzheimer Centre, Department of Geriatric Medicine, Nijmegen, The Netherlands. Electronic address: Geke.vandenElsen@radboudumc.nl.
authors: G A H
authors: GA
authors: van den Elsen
authors: Radboud university medical center, Radboud Alzheimer Centre, Department of Geriatric Medicine, Nijmegen, The Netherlands; Vincent van Gogh Institute, Department of Elderly, Venray, The Netherlands; Radboud university medical center, Department of Pharmacology and Toxicology, Nijmegen, The Netherlands. Electronic address: Amir.Ahmed@radboudumc.nl.
authors: A I A
authors: AI
authors: Ahmed
authors: Radboud university medical center, Radboud Alzheimer Centre, Department of Geriatric Medicine, Nijmegen, The Netherlands. Electronic address: Michiel.Lammers@radboudumc.nl.
authors: M
authors: M
authors: Lammers
authors: Radboud university medical center, Department of Pharmacology and Toxicology, Nijmegen, The Netherlands. Electronic address: Kees.Kramers@radboudumc.nl.
authors: C
authors: C
authors: Kramers
authors: Radboud university medical center, Department of Psychiatry, Nijmegen, The Netherlands. Electronic address: Robbert-Jan.Verkes@radboudumc.nl.
authors: R J
authors: RJ
authors: Verkes
authors: Radboud university medical center, Radboud Alzheimer Centre, Department of Geriatric Medicine, Nijmegen, The Netherlands. Electronic address: Marjolein.vanderMarck@radboudumc.nl.
authors: M A
authors: MA
authors: van der Marck
authors: Radboud university medical center, Radboud Alzheimer Centre, Department of Geriatric Medicine, Nijmegen, The Netherlands. Electronic address: Marcel.OldeRikkert@radboudumc.nl.
authors: M G M Olde
authors: MG
authors: Rikkert
mesh_terms: D000368:Aged; D002186:Cannabinoids / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D064086:Medical Marijuana / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D002186:Cannabinoids; D064086:Medical Marijuana