Convulsions Associated with the Use of a Synthetic Cannabinoid Product

Abstract

Introduction Clinical presentations following the use of various "spice" or synthetic cannabinoids have included agitation, anxiety, emesis, hallucinations, psychosis, tachycardia, and unresponsiveness. Convulsions were described in a one report although there was not laboratory confirmation for synthetic cannabinoids. In another published report laboratory confirmation for a synthetic cannabinoid was done in which the patient manifested activity that was interpreted as a possible convulsion. Case Report We describe a patient who had two witnessed generalized convulsions soon after smoking a "spice" product that we later confirmed to have four different synthetic cannabinoids. Discussion Convulsions have only rarely been associated with marijuana exposures. Recreational use of synthetic cannabinoids is a very recent phenomenon and there is a very limited, albeit burgeoning, literature detailing the associated complications including convulsions we have reported here. The absence of anticonvulsant phytocannabinoids in spice products could potentially be one of multiple unknown mechanisms contributing to convulsions.

Chronic exposure to cannabinoids during adolescence causes long‐lasting behavioral deficits in adult mice

“…Adolescent rodents display slower desensitization of CB1 receptors following chronic treatment with WIN than adults (Abush and Akirav, 2012), and this fact might confer vulnerability to turn into long‐lasting effects. The current use of more potent CB1 agonists, such as the many synthetic cannabinoids found in the so‐called spice drugs (Brents et al , 2011; Schneir et al , 2012), which have potency and efficacy higher than THC and comparable to WIN, the drug used in the present study, might lead to even more dramatic consequences.…”

“…Long‐lasting cognitive impairments are in fact the most prominent effects after chronic THC consumption during adulthood in humans (for review, see Hoch et al 2015). Such impairments might be more serious following the use of synthetic cannabinoids, which are several fold more potent than THC in activating its receptors in the brain, have become very popular in recent years and whose consequences later in life have not been investigated yet (Brents et al , 2011; Schneir et al , 2012). …”

A Common Source Outbreak of Severe Delirium Associated with Exposure to the Novel Synthetic Cannabinoid ADB-PINACA

“…Reports of cases and outbreaks of unpredicted, severe toxicity have increased as the number of SCs introduced to the market has risen. Seizures are one of the most common unpredictable toxicities reported after SC exposure (4)(5)(6)(7)(8)(9)(10). Chest pain and cardiovascular toxicity after SC use have also been reported (11,12).…”

Structure–activity relationships of synthetic cannabinoid designer drug RCS-4 and its regioisomers and C4 homologues

“…Like the principal bioactive component of cannabis, D 9 -tetrahydrocannabinol (D 9 -THC, 3), many SCs exert agonist activities at both cannabinoid receptor subtypes (CB 1 and CB 2 receptors), with psychoactivity attributed to CB 1 activation [3]. Unlike D 9 -THC, SC intoxication is associated with severe acute toxicity, including myocardial infarction and seizure [4][5][6][7][8][9][10][11].…”