humulene and Hypotension--Orthostatic

Marihuana inhalation was accompanied by increased heart rate and decreased intraocular and blood pressure in 18 subjects with heterogenous glaucomas. The hypotensive effects appeared in 60 to 90 minutes as the decrease in intraocular pressure (IOP) appeared to follow the decrease in blood pressure. In addition to any local effect, the mechanism of lowered to any local effect, the mechanism of lowered IOP may also involve the decreased pressure perfusing the ciliary body vasculature as a result of the peripheral vasodilatory properties of marihuana. Postural hypotension, tachycardia, palpitations, and alterations in mental status occurred with such frequency as to mitigate against the routine used in the general glaucoma population. Our data indicate that further research should be directed to local means of delivering the ocular hypotensive cannabinoid to the glaucomatous eye.

Topics: Adult; Aged; Arrhythmias, Cardiac; Blood Pressure; Cannabinoids; Cannabis; Depression, Chemical; Female; Glaucoma; Heart Rate; Humans; Hypotension, Orthostatic; Intraocular Pressure; Male; Middle Aged

Nabilone is a modified cannabinol derivative with central nervous system activity. Administration of nabilone in single doses of 1 to 5 mg results in dose-related pharmacologic effects in man. One and 2.5 mg doses of nabilone induced relaxant and sedative effects in all subjects. No euphoria, dry mouth, tachycardia, or postural hypotension was seen after 1 mg, minimal effects were seen after 2.5 mg, and marked effects were seen after 5 mg. Effects were evident within 60 to 90 min and persisted for 8 to 12 hr. Nabilone produced no significant tachycardia. There were no changes in supine blood pressure; however, marked postural hypotension occurred after the 5-mg dose. The administration of nabilone at doses of 1 mg or 2 mg two times daily resulted in euphoria and dry mouth during the first two days of drug; thereafter tolerance developed to these effects but there was no apparent decrease in relaxation. Subjects challenged with a single 5-mg dose of nabilone showed a 66% reduction in symptoms and signs after the 7-day drug period compared to that of the same dose after 1 wk of placebo. Comparison of nabilone with other cannabinol derivatives suggests that some of the undesirable pharmacologic effects can be separated within the group.

Topics: Adult; Blood Pressure; Cannabis; Dose-Response Relationship, Drug; Dronabinol; Drug Tolerance; Euphoria; Heart Rate; Humans; Hypotension, Orthostatic; Male; Placebos; Time Factors

Marijuana is known to cause symptoms suggestive of orthostatic hypotension such as dizziness and fainting during upright posture. We examined changes in cerebral blood velocity (CBV) and peripheral circulation during upright posture after smoking marijuana in 10 right-handed male subjects with a previous history of exposure to marijuana. The participants were physically and mentally healthy and drug-free for a minimum of 3 months before the experiment. Middle cerebral artery CBV, blood pressure and pulse rate were recorded during reclining position and standing, before and after smoking a high-potency marijuana cigarette or a placebo cigarette administered during 2 separate visits to the laboratory. The participants were questioned about dizziness during the upright position. Six of 10 subjects reported moderate to severe dizziness during standing after marijuana but not placebo. Subjects who experienced severe dizziness during standing showed marked decreases in blood pressure and CBV. Those who reported moderate dizziness showed reduction in CBV but not blood pressure. Subjects who reported mild dizziness after marijuana and after placebo smoking showed minimal changes in blood pressure and CBV. Cerebral ischemia during upright position after marijuana smoking may be caused by hypotension and impaired cerebral autoregulation.

Topics: Adult; Blood Flow Velocity; Blood Pressure; Brain Ischemia; Cannabis; Cerebral Arteries; Humans; Hypotension, Orthostatic; Male; Placebos; Posture; Substance-Related Disorders

Topics: Anticonvulsants; Arabia; Blood Pressure; Cannabis; Electroencephalography; History, 19th Century; History, 20th Century; History, Ancient; Humans; Hypnotics and Sedatives; Hypotension, Orthostatic; India; Intraocular Pressure; Phytotherapy; Research; Sleep; Sleep, REM; Tachycardia; United States