Marijuana Intoxication Presenting as Seizure - Comment

Tilelli, John A.; Spack, Lawrence

doi:10.1097/01.pec.0000204831.96139.52

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…Several preclinical studies indicate that both THC and CBD have anticonvulsant properties, with better results for CBD 43,44 . Some trials reported efficacy of cannabis varieties with high level of CBD in treating epilepsy, 43 whereas case series of seizure have been published in the setting of cannabis intoxication 45–47 and animal data have shown proconvulsive properties of THC 48,49 . Regarding the 9 cases of coma, it should be noted that concomitant alcohol use was reported for 6 and was unknown in the other 3.…”

Section: Discussionmentioning

confidence: 99%

Adverse events of recreational cannabis use reported to the French addictovigilance network (2012–2017)

Bouquet

Pain

Eiden

et al. 2021

Brit J Clinical Pharma

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Aims To describe the adverse events (AEs) of recreational cannabis use in France between 2012 and 2017. Methods AEs related to recreational cannabis use, alone or in combination with alcohol and/or tobacco reported to the French Addictovigilance Network were analysed (excluding cannabidiol and synthetic cannabinoids). Results Reporting of AEs tripled between 2012 (n = 179, 6.3%, 95% confidence interval [CI] = 5.4–7.2) and 2017 (n = 562, 10.1%, 95% CI = 9.3–10.9), reaching 2217 cases. They concerned mainly men (76.4%) and users aged between 18 and 34 years (18–25: 30.9%; 26–34: 26.3%, range: 12–84 years). Cannabis was mainly inhaled (71.6%) and exposure was most often chronic (64.2%). Many types of AEs were reported: psychiatric (51.2%), neurological (15.6%), cardiac (7.8%) and gastrointestinal (7.7%), including unexpected AEs (n = 34, 1.1%). The most common effect was dependence, ranging from 10.1% (95% CI = 7.9–12.3) to 20.3% (95% CI = 17.3–23.2) over the study period. Cannabinoid hyperemesis syndrome (n = 87, 2.8%) emerged from 2015. Deaths accounted for 0.2% of all AEs (4 men and 3 women aged on average 35 years). A chronic pattern of cannabis use was reported in 4 of them (intracranial hypertension in the context of lung cancer, suicide, cerebral haematoma, neonatal death with concomitant chronic alcohol use), while in the other cases the toxicological analysis identified cannabis use (ruptured aneurysm and unknown aetiology). Conclusion This study showed a multitude of AEs related to recreational cannabis use, including unexpected AEs and deaths. It highlights the problem of dependence and the emergence of cannabinoid hyperemesis syndrome.

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Section: Discussionmentioning

confidence: 99%

Adverse events of recreational cannabis use reported to the French addictovigilance network (2012–2017)

Bouquet

Pain

Eiden

et al. 2021

Brit J Clinical Pharma

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“…To our knowledge, there is only one report of a seizure after marijuana intoxication, which occurred in a 2‐year‐old girl . However, it was doubtful that the seizure was caused by cannabis alone .…”

Section: Discussionmentioning

confidence: 99%

Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings

et al. 2012

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There appears to have been an increase in use of the extremely potent synthetic cannabinoids JWH-122 and JWH-210. Acute toxic symptoms associated with their use are also reported after intake of high doses of cannabis, but agitation, seizures, hypertension, emesis and hypokalaemia seem to be characteristic to the synthetic cannabinoids, which are high-affinity and high-efficacy agonists of the CB(1) receptor. Thus, these effects are due probably to a strong CB(1) receptor stimulation.

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“…26,27 However, the selective CB1 antagonist, rimonabant induced seizures in animal models. 28 It is possible that the patient experienced seizures through a dose-response mechanism.…”

Section: Discussionmentioning

confidence: 99%

Severe Toxicity Following Synthetic Cannabinoid Ingestion

Lapoint¹,

James²,

Moran³

et al. 2011

Clinical Toxicology

190

138

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Objective To report a case of seizures and supraventricular tachycardia (SVT) following confirmed synthetic cannabinoid ingestion. Background Despite widespread use of legal synthetic cannabinoids, reports of serious toxicity following confirmed use of synthetic cannabinoids are rare. We report severe toxicity including seizures following intentional ingestion of the synthetic cannabinoid JWH-018 and detail confirmation by laboratory analysis. Case Report A healthy 48 year old man had a generalized seizure within thirty minutes of ingesting an ethanol mixture containing a white powder he purchased from the Internet in an attempt to get high. Seizures recurred and abated with lorazepam. Initial vital signs were: pulse, 106/min; BP, 140/88 mmHg; respirations, 22/min; temperature, 37.7 °C. A noncontrast computed tomography of the brain and EEG were negative, and serum chemistry values were normal. The blood ethanol concentration was 3.8 mg/dL and the CPK 2,649 U/L. Urine drug screening by EMIT was negative for common drugs of abuse, including tetrahydrocannabinol. On hospital day 1, he developed medically refractory SVT. The patient had no further complications and was discharged in his normal state of health 10 days after admission. The original powder was confirmed by gas chromatography mass spectrometry to be JWH-018, and a primary JWH-018 metabolite was detected in the patient’s urine (200 nM) using liquid chromatography tandem mass spectrometry. Discussion Synthetic cannabinoids are legal in many parts of the world and easily obtained over the Internet. Data on human toxicity are limited and real-time confirmatory testing is unavailable to clinicians. The potential for toxicity exists for users mistakenly associating the dose and side effect profiles of synthetic cannabinoids to those of marijuana. Conclusion Ingestion of JWH-018 can produce seizures and tachyarrhythmias. Clinicians, lawmakers, and the general public need to be aware of the potential for toxicity associated with synthetic cannabinoid use.

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Marijuana Intoxication Presenting as Seizure - Comment

Cited by 9 publications

References 12 publications

Adverse events of recreational cannabis use reported to the French addictovigilance network (2012–2017)

Adverse events of recreational cannabis use reported to the French addictovigilance network (2012–2017)

Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings

Severe Toxicity Following Synthetic Cannabinoid Ingestion

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