"My mom suffers from a form of dementia that causes her lots of anxiety and mood swings. She is on Xanax but her MD has now suggested she try marijuana products. However he feels he is not educated enough to suggest types or products. I know she won’t smoke or vape. Is there something she can add to her coffee or milk? High in THC or CBD? Edibles? Any advice would be greatly appreciated. "
I would be extremely cautious in the starting of any new psychoactive medicine in a patient with significant dementia. We have minimal experience using medicinal cannabis in this setting, and patients with cognitive disorders may react in unanticipated ways. I would certainly begin with very small doses of preparations absorbed from the mouth, not swallowed, which may provide effects in 10 minutes or so. CBD alone, being essentially without psychoactivity, might be considered to see if it provides noticeable calming or other benefit, but there is little science to guide the choice of preparation. While adding a small amount of THC to the CBD is sometimes very helpful for patients with anxiety, I’m not clear it will be appropriate in this situation, and without knowing the patient better it’s hard to give any recommendation other than extreme caution.