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Drug-Drug Interactions Between Cannabidiol and Lithium
Rani K Singh1, Brittany Dillon1, David A Tatum2
1Division of Pediatric Neurology, Department of Pediatrics, Atrium Health/Levine Children's Hospital, Concord, NC, USA.
Child Neurology Open
|August 28, 2020
Summary
Cannabidiol (CBD) may interact with lithium, a psychiatric medication. A patient with epilepsy experienced lithium toxicity after starting CBD, highlighting potential drug interactions beyond antiseizure medications.
Area of Science:
- Neuropharmacology
- Clinical Toxicology
Background:
- Epidiolex (Cannabidiol - CBD) is FDA-approved for epilepsy in Dravet syndrome and Lennox-Gastaut syndrome.
- CBD interactions with antiseizure medications are documented, but interactions with other drug classes remain under-researched.
Observation:
- A case study involving an autistic patient with Lennox-Gastaut syndrome and psychiatric comorbidities who was on multiple medications, including lithium.
- CBD was initiated for seizure control in this patient.
Findings:
- The patient developed hypersomnolence, ataxia, and decreased oral intake weeks after starting CBD.
- Laboratory results revealed lithium toxicity, which resolved after discontinuing lithium.
- The patient remained seizure-free on CBD and other antiseizure medications with improved behavior.
Implications:
- This case suggests a potential drug interaction between cannabidiol and lithium, necessitating careful monitoring.
- Further research into CBD's pharmacokinetic and pharmacodynamic interactions with non-antiseizure medications is warranted.
- Understanding these interactions is crucial for managing patients with complex comorbidities on multiple pharmacotherapies.
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