can cbd cause serotonin syndrome

Can cbd cause serotonin syndrome

Acute or chronic pain is known to exhaust serotonin levels.

The effects:

Seven days of treatment with CBD reduced mechanical allodynia, decreased anxiety-like behavior, and normalized 5-HT activity.

Pumping up tryptophan does not juice serotonin levels to the point of serotonin syndrome.

Like we said, with serotonin, it’s all about balance.

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Let’s look at what research shows but understand, I can attest to how bad serotonin syndrome is first hand.

A 16-year-old male took “a hit from a dab pen” while on the bus to school. He developed altered mental status and was transported to the ED. On arrival he was mildly obtunded, Glasgow Coma Score was 13 (three for eye-opening response, four verbal response, and six motor response). Vital signs were recorded as blood pressure 152/86 mmHg, pulse 116 bpm, oral temperature 98.6° F and 100% pulse oximetry on room air. Physical exam showed dilated pupils to five mm, tachycardia, and rigidity of the lower extremities with non-sustained clonus in the legs bilaterally. Lab results were normal with the exception of a drug screen positive for THC. This patient slowly improved over six hours of observation in the ED and was discharged home.

Section Editor: Rick A. McPheeters, DO

Case 1

As more states legalize marijuana, the potential of marijuana abuse could lead to an increase in the number of emergency department (ED) visits. We describe two patients who presented to the ED with dilated pupils, rigidity in both lower extremities, and clonus in both feet after inhaling the vapor of a highly potent form of marijuana. Serotonin syndrome diagnosis was initially considered in the differential diagnosis. Ultimately, high-potency marijuana abuse was the final diagnosis. Therefore, marijuana toxicity should be considered in ED patients who present with signs and symptoms similar to that of serotonin syndrome.

CONCLUSION

Serotonin syndrome and marijuana abuse are recognizable conditions encountered in the practice of emergency medicine.

Can cbd cause serotonin syndrome

People who take Epidiolex for epilepsy are more likely to develop abnormal liver enzymes, as well as sleepiness and other symptoms, if they are also using valproic acid to control seizures.

Dr. Patel worries in particular about any side effects or interactions that result in dizziness and may increase the risk of falls in the elderly. For example, using the antidepressant fluoxetine together with cannabis products can increase dizziness and drowsiness.

A huge number of medications, including CBD, are broken down by the same large family of liver enzymes, called CYP450.

If I stick with a CBD cream, does that reduce the risk of drug interactions?

“If you fill all of your medications at the same pharmacy, your pharmacist will be able to assess for drug interactions for all of them, regardless of who prescribed them. You should still let the pharmacist know about over-the-counter medications, herbs, and supplements — including CBD — that you don’t get through the pharmacy. It is important to bring the CBD product to your doctor and pharmacist so they can check the amount of CBD and other ingredients it contains,” says Dr. Bemben.

CBD (cannabidiol) is seemingly everywhere, with oils, tinctures, pills, chocolates, gummy bears, and creams available all over the internet, at national drugstore chains, and perhaps at your local farmer’s market — even if you don’t live in a state where medical or recreational marijuana is legal.

“The manufacturer of Epidiolex was asked by the FDA to conduct more drug-drug interaction studies, so we will learn more about CBD’s interactions with other drugs in the future,” says Dr. Bemben.

Are there some people who should stay away from CBD?

CBD inhibits some enzymes in this family. This makes them break down certain drugs more slowly, which could potentially increase side effects unless your doctor adjusts the dose. On the other hand, CBD induces other enzymes in this family, which speeds the breakdown of certain drugs so they may potentially be less effective unless the dose is increased.

Rheumatologists are always on the alert for liver problems that may result from arthritis medications, and that includes CBD as well as NSAIDs and methotrexate.