Inter-species case series: seizures associated with a novel synthetic cannabinoid

June 9, 2014, 8:57 pm

crazy.monkey★★★½☆

‘Crazy Monkey’ Poisons Man and Dog: Human and canine seizures due to PB-22, a novel synthetic cannabinoid. Gugelmann H et al. Clin Toxicol 2014 Jun 6 [Epub ahead of print]

Abstract

This amazing case report (or inter-species case series) comes from the California Poison Control System and UC-SF. A 22-year-old man brings his dog to the veterinarian because of possible seizure activity. While at the veterinary clinic, the man has a witnessed tonic-clonic generalized seizure lasting 1 minute.

A friend reported that the (human) patient had recently smoked material labelled “Crazy Monkey”. He had one additional seizure, and then became agitated requiring physical restraints and then paralysis and intubation.

A urine drug screen was positive only for a benzodiazepine, which the patient had received for treatment of seizures. Extensive screens for drugs of abuse and seizure-inducing pharmaceuticals were negative. Testing for synthetic cannabinoids revealed the presence of PB-22 (QUPIC) in blood samples from the man and his dog, as well as in the specimen of “Crazy Monkey.” Metabolites of UR-144 were also found in the man’s blood.

When the patient recovered, he admitted smoking “Crazy Monkey” daily, but denied knowledge of his dog being exposed.

In their discussion, the authors note that seizures have been associated with exposure to several synthetic cannabinoids. Although the exact mechanism by which PB-22 might cause seizures is not known, it is possible that the drug might act as a partial antagonist at the CB-1 receptor.

In February 2014, the Drug Enforcement Agency classified PB-22 and three other compounds as Schedule I drugs.

[ADDENDUM 6/11/14]: A reader asked via e-mail about the comment that PB-22 might cause seizures by acting as a partial antagonist at the CB-1 receptor. There has been virtually no scientific study of PB-22, as is true with most synthetic cannabinoids. The suggestion that it might be a partial antagonist was speculation by the authors of this paper.

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