1. Drug-Drug Interactions Between Cannabidiol and Lithium
- Author
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Brittany Dillon, Katherine C Van Poppel, Daniel J. Bonthius, Rani K. Singh, and David A Tatum
- Subjects
Drug ,medicine.medical_specialty ,Ataxia ,Lithium (medication) ,media_common.quotation_subject ,autism ,Case Report ,030226 pharmacology & pharmacy ,lcsh:RC346-429 ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Dravet syndrome ,Internal medicine ,medicine ,antiepileptic drugs ,lcsh:Neurology. Diseases of the nervous system ,media_common ,behavior ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,General Medicine ,medicine.disease ,digestive system diseases ,Regimen ,pediatric ,epilepsy ,medicine.symptom ,business ,antiseizure drugs ,Cannabidiol ,030217 neurology & neurosurgery ,Somnolence ,medicine.drug - Abstract
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.
- Published
- 2020
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