Social History

Fiona is a 41-year-old mother of two who was diagnosed with Post Traumatic Stress Disorder after a significant road accident. She experienced severe anxiety which affected her ability to manage holding down a job as a casual university lecturer as well as juggling her young family. She also had difficulty with falling asleep of an evening and reported constantly feeling tired.

Medical History

When Fiona was diagnosed by her psychiatrist, she was first prescribed an anti-depressant  escitalopram 10mg and a benzodiazepine ozazepam 15mg. She reported limited improvement in her anxiety however no improvement in her sleep. She was unhappy about the weight gain she experienced with this medication and also experienced nausea and headaches.

Medical Management

Fiona was prescribed a whole plant extract CBD Oil 100 mg/mL, initiated on a dose of 50mg CBD oil daily. After 4 weeks she was stabilised at 100mg oil CBD per day. She reported significant improvement in falling asleep and an improvement in rating on the DASS-21 Depression Anxiety Stress Scale administered by the psychiatrist.

At Fiona’s 8 week review she raised concerns with the psychiatrist about ongoing cost of the medication. Her casual lecturing hours at the University had been reduced and indicated she would not be able to afford it long term.  Her psychiatrist suggest she consider another form of medical cannabis, a CBD micro bead housed within a gastro-resistant capsule. This gastro-resistant capsule protects the CBD micro beads from stomach acid allowing it to pass into the intestine where the CBD micro beads disperse and are absorbed into the blood and lymphatic system with increased bioavailability, minimising the impact of the first pass metabolism in the liver. Meaning a smaller dose is required by Fiona for the same impact and lower cost.

Her psychiatrist switched her prescription from 100mg/day oil to 50mg/day capsule with improved response. She continued on the medication and at her 4-week follow-up after the change, her psychiatrist readministered the DASS-21 and Fiona showed improvement on all ratings.

Fiona also reported feeling more able to manage situations that usually caused her stress and she did not note any adverse side effects.

Further Information

For further information about the Satipharm CBD 50 Advanced gelpell micro bead gastro-resistant capsule (Schedule 4, TGA Category 1) see https://satipharm.com/pages/healthcare-professional

Download the TGA factsheet on the Active Ingredient Categories for Medicinal Cannabis Products https://www.tga.gov.au/sites/default/files/active_ingredient_categories_for_medicinal_cannabis_products.pdf

References

Atsmon J, Heffetz D, Deutsch L, Deutsch F, Sacks H. Single-Dose Pharmacokinetics of Oral Cannabidiol Following Administration of PTL101: A New formulation based on Gelatin Matrix Pellets Technology. Clin Pharmacol Drug Dev. 2018 Sep;7(7):751-758

N.B. These products are not registered on the Australian Register of Therapeutic Goods (ARTG) and are only available to be prescribed through the TGA’s Special Access Scheme (SAS), the Authorised Prescriber Scheme (AP) or by clinical trial.