2020 NEI Max | Virtual
November 5, 2020 |
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Behind the Cannabis: Drug Interactions With Psychiatric Medications
Presented by Deborah A. York, MSN, PMHNP-BC, APRN, CCRA and Andrew J. Cutler, MD
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In this timely and fascinating presentation, Dr. Andrew Cutler and psychiatric nurse practitioner, Deb York discuss interactions with cannabis and psychiatric medications. Marijuana is the most used psychotropic drug in the US, after alcohol, and with the recent recreational legalization laws increases in use have been observed in adolescents and people over age 26. The pharmacokinetics of cannabis differs depending on the consumption method, dose, and formulation. The two major cannabinoids discussed in this presentation are: cannabidiol (CBD) and THC. Both cannabinoids are processed by the CYP450 system in the liver. THC is a CYP2C9 and CYP3A4 inhibitor, and CBD is a CYP2C19, and CYP3A4 inhibitor. Since many psychiatric medications are metabolized via CYP2C9, CYP2C19, or CYP3A4, potential interactions between either THC and/or CBD a variety of medications could occur. For these reasons incorporating pharmacokinetic testing into clinical practice when cannabis use is involved is important in order to determine the proper dosage of certain psychiatric medications. Thus, it is also essential to communicate openly and compassionately with patients to assess cannabinoid use. Strategies and best practices for managing cannabis use in clinical practice are discussed. |
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