The Efficacy Of Cannabidiol Adjunct To Standard Treatment In First Episode Psychosis In Young People
Funder
MRFF
Summary
More effective biological treatments in the early course of psychotic disorders are needed, specifically to improve
outcomes in people whose psychotic symptoms do not sufficiently improve within the first three months of
specialised treatment. This is indicated by a medical records audit from Orygen's early psychosis clinic which found
359 of 535 (67.1%) first episode psychosis (FEP) patients were prescribed a second antipsychotic. Of those on the
second antipsychotic, 60.7% (218 of 359) were sw ....More effective biological treatments in the early course of psychotic disorders are needed, specifically to improve
outcomes in people whose psychotic symptoms do not sufficiently improve within the first three months of
specialised treatment. This is indicated by a medical records audit from Orygen's early psychosis clinic which found
359 of 535 (67.1%) first episode psychosis (FEP) patients were prescribed a second antipsychotic. Of those on the
second antipsychotic, 60.7% (218 of 359) were switched to a third antipsychotic. This shows about two thirds of
youth with FEP experience a delay of several months before receiving effective antipsychotic treatment while
already being in the service.
In this study, we will test cannabidiol (CBD), a non-intoxicating compound of the Cannabis plant for the first time in
the early treatment phase of psychotic disorders. Since the therapeutic action of CBD does not appear to depend
on dopamine receptor antagonism, this agent may represent a new class of treatment for FEP patients when
treatment with conventional antipsychotic medication as sole antipsychotic agent has a low success rate.
Specifically, we aim to test whether CBD can improve the relatively low response rate to a second or third trial of
antipsychotic medication in 16- to 25-year-olds FEP patients while receiving state-of-the-art care in a specialised
early psychosis program.
Patients and study design: Randomised controlled trial (RCT) – 200 FEP patients (100 per arm) with insufficient
clinical improvement after 6-12 weeks in the service, who consequently are switched to a second or third
antipsychotic medication, as per treatment guidelines.
Intervention: CBD (per oral) – dose of 1000mg per day (fixed schedule) for 12 weeks.
Primary outcome: Change of positive psychotic symptoms on the Positive and Negative Syndrome Scale (PANSS)
at 12 weeks.
Partners: Orygen; headspace; Lambert Initiative for Cannabinoid Therapeutics, University of SydneyRead moreRead less
Defining And Measuring 'whole-of-self' Affirming Care To Evaluate A Multidisciplinary, Patient-centred, And Sustainable Model Of Care For Trans Young People Experiencing Intersectional Disadvantage: Work Package 2
Funder
MRFF
Summary
In 2022, a multidisciplinary, person-centred, specialised gender service for trans and gender diverse TGD young people aged 12-25 was established within an existing youth mental health service (Orygen). The service was co-designed with people with lived experience, and 70% of team members have lived experience. The service provides care to TGD young people from: 1) five headspace Centres (integrated primary care services) in culturally diverse north-western suburbs of Melbourne; and 2) the Victo ....In 2022, a multidisciplinary, person-centred, specialised gender service for trans and gender diverse TGD young people aged 12-25 was established within an existing youth mental health service (Orygen). The service was co-designed with people with lived experience, and 70% of team members have lived experience. The service provides care to TGD young people from: 1) five headspace Centres (integrated primary care services) in culturally diverse north-western suburbs of Melbourne; and 2) the Victorian state-wide waitlist of Australia's first paediatric gender clinic at the Royal Children's Hospital.
This application is related to a boarder study that aims to evaluate the effectiveness of the Orygen gender service by measuring the degree to which it meets the needs of TDGY from historically disadvantaged groups. For services to be effective, TDG young people need to be able to safely share all parts of their identity (e.g., gender, culture, neurodiversity). For this to happen, services must provide 'whole-of-self' affirming care. We will use a co-design approach informed by implementation science with mixed methods to: 1) obtain consensus on what constitutes 'whole-of-self affirming care' and develop a novel patient reported experience measure and fidelity checklist and 2) evaluate the implementation and effectiveness of Orygen's service.
This application relates to the co-evaluation of the Orygen Service to determine effectiveness at delivering WOSAC and improving wellbeing, psychological distress, functioning, and service satisfaction. Our project will establish a strong evidence base to improve the clinical care and health outcomes for young trans and gender diverse people to reduce mental health disparities. Read moreRead less