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Pot & Effexor caused seratonin syndrome!

I'm currently on SSRI and if understand correctly from above post, then it is dangerous to combaine any ssri and cannabis? I have turned down many mdma pill's due to my ssri use, but now cannabis? That can't be true, but reading Bilzor post then it seems so.

So do this applie to other ssri's too?
 
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Bump, I find this a little disturbing. I always thought the combination of Cannabis and SSRI's was "realitivly" harmless (knowing full well there is no such thing as risk free drug use) If cannabis is indeed a seratonin uptake inhibiter, then this could lead to serious complications if your on SSRI´s I would guess. Am I right?
 
Bigger pupils is (probably) a result of of more noradrenaline. The peripheral blockade of dopamine (and probably noradrenaline) uptake transporters will lead to more peripheral noradrenaline and hence bigger pupils.
 
Bump, Cannabis contains a wide range of flavonoids, it could be a possibility that one or several of these flavonoids are responsible for a type of MAO inhibition, which is ofcourse pretty bad in combination with SSRI's..
 
i was on the same dose of Effexor (75mg) as the guy in the experience report over the summer, smoked multiple bowls every day for the entire time i was on the medication (it made me want to smoke even more than i already did), and never experienced anything like that. i did however notice that effexor made my high considerably more intense and energetic -- i could smoke all day and not feel burnt out for the longest time. once in awhile i would get a headache after smoking, but it was pretty mild and i don't know if this was even caused by the effexor, could have very well been from allergies and whatnot.

anyways, i'm finally off effexor and doing better. i hated that drug. the only reason i took it for as long as i did was because i feared the withdrawal symptoms. eventually just weaned myself off it gradually without my psychiatrist's permission because i was sick of being on it.
 
I've just done a '20 questions' on my wife regarding this, and after reading the report on Erowid, she said that she's seen a couple of similar cases in the Toxbase database; apparently venlafaxine on its own can cause QT prolongation. The cannabis had most probably increased the tachycardia, which in combination with QT prolongation can lead to a situation where the blood isn't being pumped efficiently, leading to the build up of carbon dioxide described.

Basically, it's the combination of venlafaxine, anoxia and a high partial pressure of carbon dioxide that resulted in the convulsions, and although the cannabis may have contributed to the tachycardia, it's mainly due to the venlafaxine in combination with the extremes of blood gases observed.
In none of the cases that my wife's encountered has the condition been attributed to serotonin syndrome.

tests came back and showed nothing more than a small amount of THC in his bloodstream, and nominal amounts in the urine which was to be expected. There was no other substances showing in the drug screening other than cannabinoids and venlafaxine

The situation BilZ0r described (THC inhibiting reuptake of serotonin) would require a plasma concentration of 1uM; that corresponds to the equivalent of smoking 4g of 10% THC weed (figures calculated from here ), yet the report states that there was only a small amount of THC detected.

The most likely explanation (again according to the mrs) is that he had an underlying minor heart condition that responded to cannabis induced tachycardia in combination with the QT prolongation from the venlafaxine.


The reason she knew about it was that I was prescribed venlafaxine a couple of years ago for SAD, and am fond of the odd smoke (or dozen!), so she checked at work in case there were any potential complications (she works for the NPIS).

Bottom line Effexor + THC + undiagnosed (minor) heart condition is the most likely cause, not serotonin syndrome.
 
yeah, that makes sense, none-the less venlafaxine has caused shit loads of serotonin syndrome cases, and I really doubt your weed amount calculations... in this study, subjects smoked cannabis containing approx 34mg THC and got a blood peak of 140µg/L (~0.5µM), that, in combination with some of the pharmacokinetics from this paper, gives me a linear dose to plasma relationship (r-square=0.9874), where peak plasma(µM) = 0.0158 x THC dose (mg), so from that a 1µM plasma peak can come from a 63mg dose of inhalled (smoked) THC. From a 10% THC strain, that's just over half a gram of bud.
 
then plants yielding joints from such a source might have an available 75mg dose and could result in rapid attainment of plasma concentrations above 300 ng/mL

so 75 mg of THC in a joint equates to plasma concn of 300ng/ml

300ng/ml = 300ug/l, and as THC has a RMM of 314

then 75mg of THC in joint give concn of (about) 1umol/l = 1uM

if 10 percent THC then 75mg of THC is contained in 750mg of cannabis

Oops! don't know what happened in the calculation there, but yeah 3/4 of a gram of 10 percent bud would give 1uM plasma level.

That's still a pretty steep spliff though (10 from a quarter oz of average Amsterdam weed. Even entrys into the cannabis cup rarely get above 20 percent THC), and the report does say that he had fairly low levels of THC in blood and urine when tested.

So despite my attrocious maths, it doesn't seem like the THC level would have gotten near 1uM, pretty much ruling out any significant 5HT reuptake inhibition.

When I did take the venlafaxine I was prescribed, it was a pretty unpleasant drug to take without any interactions (lots of anxiety and sympathetic type activity), and with cannabis, it didn't take much to feel like it could progress into a panic attack type situation.


PS I've looked at my figures, and I'd got that it was equivalent to 1.5g of 5 percent weed, then it just goes sideways and the figures become a tad deranged * worries about signs of pre-senile dementia! *
 
Don't forget about 75% of the THC is destroyed when you're smoking a joint due to pyrolysis, sidestream smoke and bad absorption, coming from here.

The bioavailability of THC, i.e. the amount of THC in a given dose that makes it to general circulation, varies dramatically depending on the method of delivery. When THC is delivered intraveneously (a bioavailability of 100%), it produces effects at only 0.06mg/kg (Ohlsson et al, 1980). Intravenous doses of 5mg can produce peak plasma concentrations of greater than 400 µg/L (Kelley and Jones, 1992). The amount of THC in a cigarette is typically between about 10 and 100mg of THC. A single, high potency (10% THC by weight) cannabis cigarette weighing one gram contains 100mg of THC. Half or more of this THC is lost in sidestream smoke that is never delivered to the lungs (Perez-Reyes, 1990). Experiments using a smoking machine show that depending on puff volume and puff interval, as little as 16-19% of the THC present in the cigarette may be delivered as mainstream smoke, while as much as 69% is transferred to mainstream smoke if the cigarette is smoked in a single puff with no loss via sidestream smoke (Davis et al, 1984). About 30% of THC is assumed to be destroyed by pyrolysis. More THC is lost due to incomplete absorption of inhaled doses in the lungs. Actual bioavailability via a cigarette, i.e. the percentage of THC in the cigarette that is delivered to general circulation, ranges from 10 to 35%, and varies according to puff volume, breathhold duration, and depth of inhalation (Grotenhermen, p. 331). More experienced users tend to achieve higher levels. This appears to be due to different smoking behaviors in experienced users, since plasma levels and AUC values are about the same for heavy and light users following intravenous THC administration (Ohlsson et al, 1982). Bioavailability is higher (45% in one case) with pipes, which reduces loss via sidestream smoke (Agurell and Leander, 1971).
 
The website I took the figures from took that into account; it was working on 25 percent of the dose actually getting into the persons body. The 75mg=300ng/ml figure was after taking all other factors into consideration (very nice of them!).

It is a pretty inefficient way of taking the drug isn't it? And that's without taking into account things like, are you a person that starts talking, and forgets to keep taking a toke off the spliff (something I'm guilty of).

Vapourizers are definitley woth the effort of making or buying
 
Yeah, my calculations took that into account, the equation was total THC in cannabis to peak blood.

But yeah, I have no idea how much weed the guy smoked, I'd be interested to see what the actual urinary THC-COOH was, and how long that was after smoking.
 
When i was on 225mg of efexor per day i could smoke a gram of good dutch grass or hash and not have any problem with "serotonin syndrome". I have had several other occasions of less and more severe "serotonin syndrome" (well you can never measure the amount of serotonin in your brain whilst puking your guts out so i think many people are quick to use that term without knowing exactly what lead to the incident. Aslo mild forms arent alway's life threatening. Not to say its not potentially dangerous), but never from cannabis alone.
 
woah.. this is news to me.

i've used MJ and been on 300 mg of Effexor and haven't felt SS.

i wonder why it happened for this guy..
 
i took effexor too... the first week i was on effexor i smoked pot twice, both times after i smoked a bowl i super high then had to take one hell of a shit, after i shit i totally lost my high :( i stopped smoking for like 2 weeks untill that passed
 
Blowmonkey said:
Don't forget about 75% of the THC is destroyed when you're smoking a joint due to pyrolysis, sidestream smoke and bad absorption, coming from here.

but if you read the norml studies, they basically say the unfiltered joint has the best performance, when you factor in thc/cbn : tar ratio, though they imply a good vap could be better (heat gun, no water filtration), yet still producing 10x more tar than cannabinoids

http://www.maps.org/news-letters/v06n3/06359mj1.html

i know its a vastly different high, whether that is a different thc : cbn ratio or the various other chemicals and carcinogens (and possibly lack of O2) produced by combustion, there is no denying one burns your throat more than the other


back to the thread though, i took zoloft for about 6 months, felt like a zombie, could barely string a sentence together and everyone i knew hated it and wanted me off, weed had absolutely no effect, yet i kept smoking it, far as i can tell, no resultant SS
 
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