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Case Reports
. 2020 Aug 13:7:2329048X20947896.
doi: 10.1177/2329048X20947896. eCollection 2020 Jan-Dec.

Drug-Drug Interactions Between Cannabidiol and Lithium

Rani K Singh  1 , Brittany Dillon  1 , David A Tatum  2 , Katherine C Van Poppel  1 , Daniel J Bonthius  1
Affiliations
Case Reports

Drug-Drug Interactions Between Cannabidiol and Lithium

Rani K Singh et al. Child Neurol Open. .

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.

Keywords: antiepileptic drugs; antiseizure drugs; autism; behavior; epilepsy; pediatric.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. EPIDIOLEX® (cannabidiol) oral solution [US Prescribing Information]. Greenwich Biosciences Inc; 2018.
    1. Devinsky O, Cilio MR, Cross JH, et al. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014;55(6):791–802. - PMC - PubMed
    1. Devinsky O, Cross JH, Laux L, et al. Cannabidiol in Dravet syndrome Study Group. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med. 2017;376(21):2011–2020. - PubMed
    1. Devinsky O, Marsh E, Friedman D, et al. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol. 2016;15(4):270–278. - PubMed
    1. Devinsky O, Patel AD, Cross JH, et al. Effect of cannabidiol on drop seizures in the Lennox–Gastaut syndrome. N Engl J Med. 2018;378(20):1888–1897. - PubMed

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