Medicinal cannabis in children and adolescents with autism spectrum disorder: A scoping review

Fletcher, Sarah; Pawliuk, Colleen; Ip, Angie; Huh, Linda; Rassekh, Shahrad R.; Oberlander, Tim F.; Siden, Harold

doi:10.1111/cch.12909

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…The TGA provides Clinical Guidance documents to help support this process, but these are limited to indications deemed to have the highest quality evidence (chronic non-cancer pain; epilepsy; palliative care; chemotherapy-induced nausea and vomiting; and spasticity in multiple sclerosis) ( Therapeutic Goods Administration, 2017 ). Notably, there are no guidance documents for leading conditions in the current dataset such as anxiety ( Black et al, 2019 ), sleep disorders ( Suraev et al, 2020 ), ASD ( Fletcher et al, 2022 ), and PTSD ( Hindocha et al, 2020 ). These conditions, all which have >1,000 cumulative approvals, are characterized by ongoing uncertainty around MC efficacy and poor quality of available evidence.…”

Section: Discussionmentioning

confidence: 99%

Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years

et al. 2022

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A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to the Therapeutic Goods Administration (TGA–the federal regulator) for approval to prescribe a category of product to an individual patient suffering from a specific indication. The dataset collected by the TGA provides a unique opportunity to examine MC prescribing trends over time in the Australian population. Here we analysed this TGA SAS-B dataset since inception with respect to age, gender, product type (e.g., oil, flower, etc.), CBD content, indication treated, and prescriber location. Results are presented descriptively as well as being analysed using non-linear regression models. Relationship between variables were explored via correspondence analyses. Indications were classified with reference to the International Statistical Classification of Diseases and Related Health Problems (10th Revision). As of 31 August 2021, a total of 159,665 SAS-B approvals had been issued for MC products, 82.4% of were since January 2020. Leading indications for approvals were for pain, anxiety, and sleep disorders. Oil products were the most popular product type, while CBD-dominant products (≥98% CBD) accounted for 25.1% of total approvals. Approvals for flower products increased markedly during 2020–2021, as did approvals involving younger age groups (18–31 years old), male patients, and non-CBD dominant products. A disproportionate number of SAS-B MC applications (around 50%) came from HCPs in the state of Queensland. Associations between patient gender and age and/or indication with product type were found. For example, approvals for oil products were commonly associated with approvals for pain. While, overall prescribing increased dramatically over the last 2 years of analysis, stabilization of approval numbers is evident for some indications, such as pain. Current prescribing practices do not always reflect provided TGA guidance documents for MC prescribing. While acknowledging some limitations around the SAS-B dataset, it provides a unique and valuable resource with which to better understand current prescribing practices and utilisation of MC products within Australia.

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Section: Discussionmentioning

confidence: 99%

Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years

et al. 2022

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“…A study by Fletcher et al reports the usage of extracts with a high CBD low THC ratio with average CBD doses ranging from 1.8 to 6.45 mg/kg/day, similar to the range used in this case study [ 18 ]. The routine starting dose recommended for the adult patient is 5mg of CBD-predominant cannabinoid twice daily [ 19 ].…”

Section: Discussionmentioning

confidence: 77%

“…Successful drug delivery also depends on the individual’s physiology and the physicochemical properties of the drug, such as solubility, dissolution, stability, permeability, and metabolism. Since CBD is a highly lipophilic drug, when delivered orally in solution, it can precipitate in the gastrointestinal (GI) tract, resulting in an absorption rate slower than elimination [ 18 ]. Time to peak plasma concentration following oral delivery is slow for CBD (1-4 h), and the half-life of CBD was reported between 1.4 and 10.9 h after oromucosal spray [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Cannabidiol in Treatment of Autism Spectrum Disorder: A Case Study

Ma¹,

Platnick²,

Platnick³

2022

Cureus

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This case study aims to demonstrate the use of cannabidiol (CBD) with low-dose tetrahydrocannabinol (THC) in managing symptoms associated with autism spectrum disorder (ASD) to increase the overall quality of life for these individuals and their families. ASD is a neurodevelopmental disorder affecting cognitive development, behavior, social communication, and motor skills. Despite the increasing awareness of ASD, there is still a lack of safe and effective treatment options. The study includes a nine-year-old male patient who was diagnosed with nonverbal ASD. He exhibited emotional outbursts, inappropriate behaviors, and social deficits including challenges in communicating his needs with others. Since the patient was unable to attain independence at school and at home, his condition was a significant burden to his caregivers. The patient was treated with full-spectrum high CBD and low THC oil formulation, with each milliliter containing 20 mg of CBD and <1 mg of THC. CBD oil starting dose was 0.1ml twice daily, increased every three to four days to 0.5ml twice daily. Overall, the patient experienced a reduction in negative behaviors, including violent outbursts, self-injurious behaviors, and sleep disruptions. There was an improvement in social interactions, concentration, and emotional stability. A combination of high CBD and low-dose THC oil was demonstrated to be an effective treatment option for managing symptoms associated with autism, leading to a better quality of life for both the patient and the caregivers.

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“…A family member is defined as a person who identifies as related to a stroke survivor by blood, marriage, or through other familial involvement. The stroke survivors and/or family members will have to comprise at least 50% of the study population, in line with cut-offs used in prior scoping reviews, 23,24 and will have to be aged 18 years or over. The participants may be at any stage post-stroke.…”

Section: Inclusion Criteria Participantsmentioning

confidence: 99%

Information needs of stroke survivors and their family members regarding post-stroke cognition: a scoping review protocol

Hobden,

Demeyere

2023

JBI Evidence Synthesis

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Objective: The aim of this review is to map current evidence describing the information needs of stroke survivors and family members regarding cognition. Introduction: Managing cognitive changes is the most frequently reported unmet need among stroke survivors; hence, there is an urgent need to improve support for post-stroke cognitive impairment. While there is evidence that psychoeducation may help stroke survivors and their family members develop awareness about cognitive impairment and self-management strategies, it is unclear what information stroke survivors and their family members want to receive and how their needs change over time. Inclusion criteria: This review will consider peer-reviewed articles describing information needs relating to the following cognitive domains: memory, language, attention, executive function, praxis, and number processing. Stroke survivors and/or their family members must comprise at least 50% of the study population and must be aged at least 18 years. Quantitative, qualitative, and mixed methods studies will be included. Methods: The review will be conducted in line with the JBI methodology for scoping reviews. A full literature search will be conducted in MEDLINE (PubMed), PsycINFO (Ovid), Embase, CINAHL (EBSCOhost), and Scopus using a search strategy developed in consultation with an expert university librarian. Articles will be screened by title, abstract, and full text; then, data will be extracted by 2 independent reviewers. The reference lists of included articles will be hand-searched for additional material. Data analysis and reporting will involve qualitative (textual narrative synthesis) and quantitative (descriptive statistics) methods.

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Medicinal cannabis in children and adolescents with autism spectrum disorder: A scoping review

Cited by 9 publications

References 29 publications

Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years

Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years

Cannabidiol in Treatment of Autism Spectrum Disorder: A Case Study

Information needs of stroke survivors and their family members regarding post-stroke cognition: a scoping review protocol

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