Table 2.

Practical management with cannabinoids in Parkinson’s and Alzheimer’s disease.

Neuropsychiatric Disorder	Potential (Off Label) Indication	Suggested Dose Regimen
Parkinson’s disease	Resistant tremor or dyskinesia	Starting dose: CBD (<0.3% THC) 5 mg once daily. Increase 5 mg every 3 days. Maximum dose: 20 mg twice a week.
	Resistant anxiety	Starting dose: CBD (<0.3% THC) 5 mg once daily. Increase 5 mg every 3 days. May split the dose in two or three intakes. Maximum dose: 90 mg twice a week (CBD monotherapy). 1 mg of THC can be initiated with CBD or after 20 mg of CBD without a positive effect. Increase THC to a maximum of 20 mg combined to a maximum of 40 mg of CBD.
	Agitation due psychosis partially treated with quetiapine or clozapine
	Persisted sleeping disturbance albeit treated with two first-line treatment	Starting dose: CBD (<0.3% THC) 5 mg at night. Increase 5 mg every 3 days. Maximum dose: 20 mg
Alzheimer’s disease	Persisting agitation or aggression besides non-pharmacologic and first-line drug treatment implemented	Starting dose: CBD (<0.3% THC) 5 mg once daily. Increase 5 mg every 3 days. May split the dose in two or three intakes. Maximum dose: 20 mg twice a week. 1 mg of THC can be initiated with CBD or after 20 mg of CBD without a positive effect. Increase THC to a maximum of 20 mg
	Major adverse event with first-line drug treatment for agitation, anxiety, or aggression
	Persisting anorexia albeit traditional treatment for dementia and exclusion of secondary causes	Starting dose: CBD (<0.3% THC) 5 mg once daily. Increase 5 mg every 3 days. Maximum dose: 10 mg twice daily

Note: CBD = cannabidiol; THC = delta-9-tetrahydrocannabinol.