The problem with marijuana is that many people think of only a plant when they think of marijuana, not the psychoactive compounds it contains and how they interact with their medications. That's where people get hurt. Prior to being prescribed marijuana, I was given 300mg of Gabapentin at a pain clinic. I didn't think to ask my pharmacist about potential interactions with marijuana because, like many people, I didn't understand the potentially harmful effects of marijuana. That night, I took them together because I was nauseous and in a lot of pain. That was the start of the most horrifying experience of my entire life.
I went to bed, feeling much better, and I woke a few hours later to find my heart racing and body jerking each time feeling as if I was being shocked. I tried to make it stop, but, I couldn't, and, when it finally did, I was completely paralyzed and started hallucinating. I somehow yelled out for my mom, and, hearing how scared I was, she came running to my room. I did the best I could to tell her with great difficulty what I was experiencing. I blacked out and woke up to myself thrashing around again with my mom trying to change my pants, saying I had peed in my bed. I knew something was terribly wrong, and, at that point I asked her to take me to the hospital, but, being a nurse, she thought I was just having a bad reaction to the Gabapentin and that she would take care of me until it wore off. I stopped the Gabapentin and was physically fine, but had a lot of mood swings for several days afterwards. This happened two more times without the Gabapentin, and I was having a very difficult time waking up in the morning, so, I asked my primary doctor for an antidepressant that wouldn't make me sleepy. She prescribed me a low dose of an SSRI, called Zoloft, and, a week later, my gastroenterologist gave me a low dose of Tramadol. Tramadol is notoriously bad with antidepressants, especially SSRI's, but it doesn't usually cause much of a problem if both are used at a low dose.
I took those two medications and marijuana fairly close together one morning because I was in quite a bit of pain. An hour later, I experienced the same problem as before, except with the worst headache of my life, worsening abdominal pain, vomiting, and diarrhoea. This time my parents rushed me to the hospital, knowing that something was terribly wrong. I was either unconscious or sedated for the majority of my stay (about a week), and I vaguely remember my parents calling a priest from our parish to administer my last rites because my care team wasn't sure if I would be able to pull through because my blood pressure was fluctuating wildly, indicating that there was damage to my central nervous system. It turns out that I had something called Serotonin Syndrome, which is where serotonin receptors are overstimulated by high electrical activity and dump way too much serotonin into their synapses. If the neuron on the other side of the synapse isn't able to absorb enough of the serotonin, the myelin sheath around the synapse ruptures, resulting in the chemical messengers being disbursed and only randomly hitting the other neuron.
Most people recover from this within 48hrs of stopping the offending drugs with the help of IV fluids, Ativan, and a vitamin B complex. My care team said that the reason my case was so severe was because the CBD in the marijuana oil increased the potency of both drugs. It has also been found to stimulate the 5HT-1A serotonin receptor.
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