Drug-Drug Interactions Between Cannabidiol and Lithium

Drug-Drug Interactions Between Cannabidiol and Lithium

Epidiolex ® (Cannabidiol- CBD) is approved for epilepsy associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients over 2 years of age. Common side effects include somnolence and diarrhea. Recent studies have demonstrated interactions between cannabidiol and several other ant...

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Main Authors: Rani K. Singh MD, Brittany Dillon DNP, David A. Tatum DO, Katherine C. Van Poppel MD, Daniel J. Bonthius MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2020-08-01
Series:Child Neurology Open
Online Access:https://doi.org/10.1177/2329048X20947896
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spelling doaj-8f9d6c04d01843e48dcc98d9bd2b6e1a2020-11-25T04:01:41ZengSAGE PublishingChild Neurology Open2329-048X2020-08-01710.1177/2329048X20947896Drug-Drug Interactions Between Cannabidiol and LithiumRani K. Singh MD0Brittany Dillon DNP1David A. Tatum DO2Katherine C. Van Poppel MD3Daniel J. Bonthius MD, PhD4 Division of Pediatric Neurology, Department of Pediatrics, Atrium Health/Levine Children’s Hospital, Concord, NC, USA Division of Pediatric Neurology, Department of Pediatrics, Atrium Health/Levine Children’s Hospital, Concord, NC, USA Child and Adolescent Psychiatry, Atrium Health/Levine Children’s Hospital, Charlotte, NC, USA Division of Pediatric Neurology, Department of Pediatrics, Atrium Health/Levine Children’s Hospital, Concord, NC, USA Division of Pediatric Neurology, Department of Pediatrics, Atrium Health/Levine Children’s Hospital, Concord, NC, USAEpidiolex ® (Cannabidiol- CBD) is approved for epilepsy associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients over 2 years of age. Common side effects include somnolence and diarrhea. Recent studies have demonstrated interactions between cannabidiol and several other antiseizure medications. However, little is known regarding interactions between cannabidiol and other classes of medications. We discuss an autistic patient with LGS and significant psychiatric comorbidities who was being treated with multiple antiseizure and psychiatric medications, including lithium, when CBD was added to his medical regimen. Several weeks after initiating CBD therapy, he developed hypersomnolence, ataxia and decreased oral intake and was found to have lithium toxicity. Lithium was discontinued and his symptoms resolved. He remains on CBD and 2 other antiseizure medications, seizure-free with improved behavior. We review mechanisms of action and pharmacokinetics of CBD and discuss possible explanations for lithium toxicity in this patient.https://doi.org/10.1177/2329048X20947896
collection DOAJ
language English
format Article
sources DOAJ
author Rani K. Singh MD
Brittany Dillon DNP
David A. Tatum DO
Katherine C. Van Poppel MD
Daniel J. Bonthius MD, PhD
spellingShingle Rani K. Singh MD
Brittany Dillon DNP
David A. Tatum DO
Katherine C. Van Poppel MD
Daniel J. Bonthius MD, PhD
Drug-Drug Interactions Between Cannabidiol and Lithium
Child Neurology Open
author_facet Rani K. Singh MD
Brittany Dillon DNP
David A. Tatum DO
Katherine C. Van Poppel MD
Daniel J. Bonthius MD, PhD
author_sort Rani K. Singh MD
title Drug-Drug Interactions Between Cannabidiol and Lithium
title_short Drug-Drug Interactions Between Cannabidiol and Lithium
title_full Drug-Drug Interactions Between Cannabidiol and Lithium
title_fullStr Drug-Drug Interactions Between Cannabidiol and Lithium
title_full_unstemmed Drug-Drug Interactions Between Cannabidiol and Lithium
title_sort drug-drug interactions between cannabidiol and lithium
publisher SAGE Publishing
series Child Neurology Open
issn 2329-048X
publishDate 2020-08-01
description Epidiolex ® (Cannabidiol- CBD) is approved for epilepsy associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients over 2 years of age. Common side effects include somnolence and diarrhea. Recent studies have demonstrated interactions between cannabidiol and several other antiseizure medications. However, little is known regarding interactions between cannabidiol and other classes of medications. We discuss an autistic patient with LGS and significant psychiatric comorbidities who was being treated with multiple antiseizure and psychiatric medications, including lithium, when CBD was added to his medical regimen. Several weeks after initiating CBD therapy, he developed hypersomnolence, ataxia and decreased oral intake and was found to have lithium toxicity. Lithium was discontinued and his symptoms resolved. He remains on CBD and 2 other antiseizure medications, seizure-free with improved behavior. We review mechanisms of action and pharmacokinetics of CBD and discuss possible explanations for lithium toxicity in this patient.
url https://doi.org/10.1177/2329048X20947896
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