Chronic Synthetic Marijuana Use: A Case of First-Onset Seizures as a Withdrawal Symptom
A 44-year-old male with no known past medical history but a known history of daily synthetic marijuana use presented to the emergency department after two witnessed seizures. The patient was admitted to the neurology service, where he was worked up with an MRI with epilepsy protocol and an EEG. During admission, the patient was admitted to daily synthetic marijuana use. He did note that he had started to decrease the amount of mojo he used daily in an attempt to stop. His last use was at 9 am the day of his admission. He was trying to decrease his use; his girlfriend of difficulty word-finding noted periods. Synthetic marijuana (SM) or “mojo” use has been increasing in the past decade for two reasons; It is considered an herbal product and has been legal. A withdrawal syndrome of SM use has been characterized chiefly as tachycardia, irritation, anxiety, and mood swings. These withdrawal symptoms are usually seen with chronic use. Some early results in the literature also show that SM use can lead to functional and structural neuronal changes. This manuscript discusses a case of a first on-set seizure as a possible withdrawal symptom in chronic SM use.
1. Vera L, Bernstein K, Lee S. Historical and Current Perspectives of Synthetic Marijuana: Critical Review. J Addict Nurs. 2020;31(2):85-91. doi:10.1097/JAN.0000000000000333
2. Nacca N, Vatti D, Sullivan R, Sud P, Su M, Marraffa J. The synthetic cannabinoid withdrawal syndrome. J Addict Med. 2013;7(4):296-298. doi:10.1097/ADM.0b013e31828e1881
3. Cohen K, Weinstein AM. Synthetic and Non-synthetic Cannabinoid Drugs and Their Adverse Effects-A Review From Public Health Prospective. Front Public Health. 2018;6. doi:10.3389/fpubh.2018.00162
4. Zorlu N, Angelique Di Biase M, Kalayc CC, et al. Abnormal white matter integrity in synthetic cannabinoid users. Eur Neuropsychopharmacol. 2016;26(11):1818-1825. doi:10.1016/j.euroneuro.2016.08.015
5. Rominger A, Cumming P, Xiong G, et al. Effects of acute detoxification of the herbal blend “Spice Gold” on dopamine D2/3 receptor availability: a [18F]fallypride PET study. Eur Neuropsychopharmacol. 2013;23(11):1606-1610. doi:10.1016/j.euroneuro.2013.01.009
6. Drummer OH, Gerostamoulos D, Woodford NW. Cannabis as a cause of death: A review. Forensic Sci Int. 2019;298:298-306. doi:10.1016/j.forsciint.2019.03.007
7. Breivogel CS, Wells JR, Jonas A, et al. Comparison of the Neurotoxic and Seizure-Inducing Effects of Synthetic and Endogenous Cannabinoids with Δ9-Tetrahydrocannabinol. Cannabis Cannabinoid Res. 2020;5(1):32-41. doi:10.1089/can.2019.0003
8. Schifano F, Orsolini L, Duccio Papanti G, Corkery JM. Novel psychoactive substances of interest for psychiatry. World Psychiatry. 2015;14(1):15-26. doi:10.1002/wps.20174
9. Schneir AB, Baumbacher T. Convulsions Associated with the Use of a Synthetic Cannabinoid Product. doi:10.1007/s13181-011-0182-2
10. Havenon A de, Chin B, Thomas KC, Afra P. The Secret “Spice”: An Undetectable Toxic Cause of Seizure. Neurohospitalist. 2011;1(4):182-186. doi:10.1177/1941874411417977
11. Tofighi B, Lee JD. Internet highs-seizures after consumption of synthetic cannabinoids purchased online. J Addict Med. 2012;6(3):240-241. doi:10.1097/ADM.0b013e3182619004