Ravi N. Chandiramani, ND

To the Editor: I greatly appreciate the well-presented article by Drs. Jerry, Collins, and Streem in your April 2012 issue.¹

As a specialist in integrative addiction medicine, I have had first-hand experience with many of the medical concerns described by the authors, and I expect to learn more about optimal management strategies as we learn more as a profession.

The lone case report cited in the article suggests a relatively short time to onset of seizure of 30 minutes following intentional ingestion of synthetic cannabinoids (JWH-018).²

In the residential treatment (“rehab”) setting where I work, I am seeing a latency to seizure onset of 24 to 72 hours with patients reporting use of synthetic cannabinoids.

Given this experience to date, I have two questions for the authors regarding new-onset seizures.

Are the authors aware of this trend in patients who present to non-emergency-department treatment settings such as residential treatment facilities? And in these cases, what if any recommendations would the authors make regarding seizure prophylaxis in patients with no history of seizure?

To the Editor: I greatly appreciate the well-presented article by Drs. Jerry, Collins, and Streem in your April 2012 issue.¹

As a specialist in integrative addiction medicine, I have had first-hand experience with many of the medical concerns described by the authors, and I expect to learn more about optimal management strategies as we learn more as a profession.

The lone case report cited in the article suggests a relatively short time to onset of seizure of 30 minutes following intentional ingestion of synthetic cannabinoids (JWH-018).²

In the residential treatment (“rehab”) setting where I work, I am seeing a latency to seizure onset of 24 to 72 hours with patients reporting use of synthetic cannabinoids.

Given this experience to date, I have two questions for the authors regarding new-onset seizures.

Are the authors aware of this trend in patients who present to non-emergency-department treatment settings such as residential treatment facilities? And in these cases, what if any recommendations would the authors make regarding seizure prophylaxis in patients with no history of seizure?

To the Editor: I greatly appreciate the well-presented article by Drs. Jerry, Collins, and Streem in your April 2012 issue.¹

As a specialist in integrative addiction medicine, I have had first-hand experience with many of the medical concerns described by the authors, and I expect to learn more about optimal management strategies as we learn more as a profession.

The lone case report cited in the article suggests a relatively short time to onset of seizure of 30 minutes following intentional ingestion of synthetic cannabinoids (JWH-018).²

In the residential treatment (“rehab”) setting where I work, I am seeing a latency to seizure onset of 24 to 72 hours with patients reporting use of synthetic cannabinoids.

Given this experience to date, I have two questions for the authors regarding new-onset seizures.

Are the authors aware of this trend in patients who present to non-emergency-department treatment settings such as residential treatment facilities? And in these cases, what if any recommendations would the authors make regarding seizure prophylaxis in patients with no history of seizure?