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- Interactions can be expected between cannabis and a wide range of drugs.
- Nortriptyline is a tricyclic antidepressant. Cannabis interacts
- adversely with tricyclic andidepressants. Cannabis, on its own, produces
- tachycardia as a side-effect. Tricyclics do the same. Combined, there
- is an additive effect, with a bigger increase in heart rate. I have seen
- this with cannabis + doxepin (heart rate >150, as well as BP 99/75,
- dizziness and severe anxiety). In this case, doxepin's hypotensive
- (blood pressure-lowering) effect (another common side-effect of
- tricyclics) was also potentiated. Tricyclic antidepressants have a
- certain effect on the heart. This effect can be described as
- cardiotoxicity. In normal dosage, in individuals with no heart disorder,
- this causes no problems at all. (In overdosage, tricyclics can produce
- serious cardiac arrhythmias.) I suspect that in the interaction with
- cannabis, the cardiotoxic effect of tricyclics is somewhat potentiated.
- (I don't know if this has produced hazardous changes in ECG rhythm.) The
- effects of cannabis + nortriptyline in particular have been documented.
-
- I remember seeing a couple of references to all of this in Martindale's
- "Extra Pharmacopoeia", 29th edition, under 'Cannabis', but I haven't read
- them.
-