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Can Cannabis Reduce Anxiety or Fear in Dementia? 

Posted
Updated
ByMy Patient Advice
Author: Julia Sutton, MSc | Reviewed by: Dr. Clarissa Morton, PharmD

Anxiety and fear are common psychological symptoms in dementia, often exacerbating the burden of care for both patients and their families. These feelings can contribute to confusion, agitation, and aggressive behaviours, making the management of dementia more complex. With increasing interest in medical cannabis, particularly THC and CBD, researchers are exploring whether cannabis-based treatments can help alleviate anxiety and fear in individuals with dementia. While preliminary findings are promising, there is still a lack of robust evidence to support the routine use of cannabis for this purpose. 

Can medical cannabis be accessed legally for women’s health?

Anxiety and Fear in Dementia: What’s Going On? 

As dementia progresses, changes in the brain can affect how individuals process emotions and manage stress. The neurodegenerative processes, especially in areas like the amygdala (which controls emotional responses), may increase sensitivity to stressors, leading to heightened anxiety and fear. These symptoms, part of a group known as behavioural and psychological symptoms of dementia (BPSD), are often accompanied by agitation and aggression. 

According to NHS guidance on dementia, anxiety and fear in dementia can be managed with a combination of behavioural therapies, environmental adjustments, and medications such as antidepressants or anti-anxiety drugs. However, these medications come with potential side effects, and their effectiveness may diminish over time. 

How Might Cannabis Help? 

Cannabis compounds like THC and CBD interact with the brain’s endocannabinoid system, which plays a key role in regulating emotions, memory, and stress responses. 

  • THC, the psychoactive compound in cannabis, binds to CB1 receptors in the brain, particularly in areas that regulate emotion and stress, such as the amygdala and hippocampus. By activating these receptors, THC can help modulate emotional responses and reduce feelings of fear and anxiety. 
  • CBD, which is non-psychoactive, interacts with 5-HT1A receptors (serotonin receptors) and CB2 receptors, potentially helping reduce anxiety by modulating serotonin levels and lowering neuroinflammation. CBD has been shown to have calming effects in various conditions, including anxiety disorders, and may help stabilize mood and improve sleep. 

Recent studies have explored the potential of THC and CBD for anxiety in dementia patients, though results are still mixed. 

What Does Research Say? 

Several studies in the past few years have focused on the effects of cannabinoids on anxiety in dementia, with promising but inconclusive results. 

  • A 2024 study published in Frontiers in Aging Neuroscience (PubMed 36247984) examined the use of a THC: CBD oil formulation in patients with severe dementia. The study found improvements in anxiety and agitation after several weeks of treatment, suggesting that cannabinoids may help alleviate these symptoms. However, the study was small, and the authors called for further trials with larger sample sizes to confirm these findings. 
  • Pautex et al. (2022) conducted a prospective observational study in dementia patients using a daily dose of THC and CBD. The results showed a reduction in agitation and anxiety, with patients reporting improved sleep and emotional regulation after several months of treatment (PubMed 36247984). 
  • Another study, a 2023 systematic review published in Pain Medicine (PubMed 37293434), found that CBD-rich oils led to reductions in anxiety and improved mood in patients with dementia. While promising, the authors emphasized that the overall quality of evidence was low, and further research was needed to confirm the efficacy of cannabinoids for treating anxiety in dementia. 

Systematic Reviews and Meta-Analyses 

  • Kuharic et al. (2021) conducted a systematic review of 12 studies evaluating the effects of cannabinoids on anxiety and other BPSD symptoms in dementia. The review concluded that cannabinoids, particularly CBD, showed modest reductions in anxiety but cautioned that many of the studies were small, lacked control groups, or had short durations, limiting the reliability of the findings (PubMed 34532852). 
  • Broers et al. (2024), in an updated review, concluded that while CBD may help reduce anxiety and improve sleep, THC has mixed results, with some studies showing anxiety reduction and others showing increased agitation at higher doses (PubMed 38447959). 

What Are the Guidelines? 

Both NICE and the NHS have cautious positions when it comes to cannabis use in dementia care. 

  • According to NICE NG97, behavioural interventions and non-pharmacological approaches (such as cognitive stimulation therapy and structured routines) are the first-line treatments for anxiety and other BPSD symptoms in dementia. Medication, including anti-anxiety drugs, should only be prescribed if necessary. 
  • The NICE NG144 guidance on cannabis-based medicinal products (NICE NG144) states that cannabis-based products can be prescribed only by specialists, primarily for epilepsy, spasticity in MS, and chemotherapy-induced nausea, but are not recommended for dementia symptoms due to a lack of robust evidence for their effectiveness. 

Clinical Bottom Line 

  • CBD may help alleviate anxiety and improve mood in dementia patients by modulating serotonin and neuroinflammation. 
  • THC may also reduce anxiety but can cause sedation or increased agitation at higher doses. 
  • Evidence remains inconclusive; although initial studies suggest benefits, they are small and often poorly controlled. 
  • NICE and NHS advise against using cannabis outside of specialist care and clinical trials for dementia-related anxiety or fear. 
  • Non-drug interventions should be prioritised for managing anxiety in dementia. 

Educational Context: AlleviMed 

AlleviMed offers educational resources on the regulation and eligibility of medical cannabis in the UK. It helps explain how cannabis-based medicines are assessed and prescribed by the MHRA and Home Office but clarifies that they are not currently recommended for the treatment of dementia-related anxiety. AlleviMed focuses on providing up-to-date, evidence-based information regarding licensed cannabis products and their clinical use. 

Takeaway 

While CBD and THC show promise for reducing anxiety and fear in dementia, evidence is still limited. According to NHS and NICE guidelines, cannabis should not be used as a primary treatment for these symptoms until more definitive research supports its safety and efficacy. Non-drug interventions, such as routine care, environmental modifications, and cognitive therapies, remain the most effective and widely recommended strategies for managing anxiety in dementia care. Ongoing clinical trials will be crucial in determining whether cannabis can become a standard adjunctive treatment in dementia management. 

Julia Sutton, MSc
Author

Julia Sutton is a clinical psychologist with a Master’s in Clinical Psychology and experience providing psychological assessment and therapy to adolescents and adults. Skilled in CBT, client-centered therapy, and evidence-based interventions, she has worked with conditions including depression, anxiety, bipolar disorder, and conversion disorder. She also has experience in child psychology, conducting psycho-educational evaluations and developing tailored treatment plans to improve learning and well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

Dr. Clarissa Morton, PharmD
Reviewer

Dr. Clarissa Morton is a licensed pharmacist with a Doctor of Pharmacy degree and experience across hospital, community, and industrial pharmacy. She has worked in emergency, outpatient, and inpatient pharmacy settings, providing patient counseling, dispensing medications, and ensuring regulatory compliance. Alongside her pharmacy expertise, she has worked as a Support Plan & Risk Assessment (SPRA) officer and in medical coding, applying knowledge of medical terminology, EMIS, and SystmOne software to deliver accurate, compliant healthcare documentation. Her skills span medication safety, regulatory standards, healthcare data management, and statistical reporting.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewers's privacy. 

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