Social History

Zac is a 10-year-old boy in year 5 at his local school. He finds it hard to make friends at school and is often getting into trouble from his teachers for not paying attention. He reports often feeling itchy and needing to constantly fidget during class. He loves soccer and feels best about himself when he is on the soccer field.

Medical History

Zac was diagnosed with ADHD and Anxiety and his psychiatrist recommended a trial on anti-depressants and a stimulant. His parents were reluctant to try these medications on their young child and after much discussion the psychiatrist suggests a trial of medical cannabis.

Zac also has mild asthma and uses Ventolin approximately once every few months if he feels wheezy. This usually only occurs at soccer.

Medical Management

Zac was initially prescribed a CBD Oil solution starting at 40mg of CBD oil per day increasing over a two-week period to 120mg per day and was stabilised on this dosage.

At the 8-week review, Zac and his parents reported improved concentration and self-regulation. Zac called the medication his ‘focus medication’ and said that he was less itchy and more able to sit still. However, he hated the taste. His parents reported that his anxiety and dysregulation increased in the evenings and dosing was becoming difficult due to his strong aversion to the taste.

The psychiatrist suggested another formulation to address his aversion to the taste of the oil and which was negatively impacting his level of anxiety in the evenings. After reviewing the options Zac was prescribed a gastro-resistant capsule containing micro beads of CBD that absorbed in his intestine rather than his stomach, minimising the impact of the first pass metabolism in the liver. His dosage was reduced to a CBD 50mg capsule due to increased bioavailability.

Zac found these capsules easier to take and he showed a more stable regulated state throughout the day according to his parents. As a side benefit his parents noted an improvement in Zac’s sleep hygiene. There was also increased affordability due to the reduction in daily treatment required.

Further Information

See further information about the Satipharm CBD 50 Advanced gelpell micro bead gastro-resistant capsule (Schedule 4, TGA Category 1) 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.