Relation between Acute Administration of Synthetic Cannabinoids and Induction of Epileptic Seizures

Abstract

he increasing use of Synthetic Cannabinoids has reached serious levels and this trend is likely to continue as the composition of the formulations is often changed to bypass legal restrictions and to achieve different effects for the user. Also, due to wide availability, cheapness and ease of access. Synthetic cannabinoids began to be marketed through supermarkets and internet since 2004 in Europe. And according to official data synthetic cannabinoids had a 17-fold increase in three years (EMCDDA, 2014). Lifetime prevalence of synthetic cannabinoid use was found as 8.1-16.8% at follow-up studies (Hu et al., 2011). As a result, synthetic cannabinoid use has become a common health problem in the whole world that could be associated with physical and psychiatric complications either with acute or long term use. The variability and adverse outcomes associated with the use of synthetic cannabinoids are likely a result of multiple different chemical compounds, different dosage used and different affinity on receptor targets. Proper assessment of the negative hazards complicating synthetic cannabinoid use will contribute to the development of effective intervention programs. Based on that, this study was conducted to evaluate occurrence of seizures as one of the possible neurological complications to synthetic cannabinoid use. Forty (40) male patients were included in this study and compared with 40 healthy controls matched for age and sex. Their age ranges between 16-60 years. The study took place from January 2019 till June 2020. All subjects of the study were assessed for the occurrence of seizure and if there were any temporal correlation with synthetic cannabinoid use by full history taking and prolonged EEG to assess for the presence of EEG changes and its correlation with synthetic cannabinoid use and induced seizures. The main findings in this study were that the mean age of onset of synthetic cannabinoid use was 21.4 years. There is a statistically significant correlation between using synthetic cannabinoids and induction of seizures that were most commonly in the form of generalized seizure disorders. There were no significant correlation between specific addiction characteristics like duration of intake and dosage of synthetic cannabinoid used and seizure induction but about 80% of cases reported seizure induction within 15 minutes of intake. Besides, there were significant EEG changes, most commonly in the form of left frontal focus that were significantly correlated with synthetic cannabinoid use. Complicated seizures (e.g. trauma and accidents) were more associated with EEG changes than non-complicated seizures.