Jerrold G. Bernstein

Effects of marihuana use on body weight and caloric intake in humans

Body weight and caloric intake were measured in a group of heavy and casual marihuana users prior to, during and following 21 days of marihuana smoking under research ward conditions. A group of control subjects were studied under identical conditions, but they did not smoke marihuana. Both heavy and casual marihuana users had a significant increase in caloric intake and gained weight during the marihuana smoking period. Heavy and casual users gained an average of 3.7 and 2.8 lbs respectively during the first 5 days of marihuana smoking. In contrast, control subjects gained only a small amount of weight (0.2 lbs) during the same time interval. Water retention did not appear to be a major factor in weight gain by the marihuana users. These findings are in agreement with both anecdotal reports and previous experimental data that marihuana use is associated with increased caloric intake and weight gain.

Effectiveness of Bretylium Tosylate against Refractory Ventricular Arrhythmias

Thirty patients with ventricular tachyarrhythmias, which had not responded to intensive therapy with up to five antiarrhythmic drugs, were treated with bretylium tosylate. All patients had recurrent ventricular tachycardia, and 12 had repeated episodes of ventricular fibrillation. In 17 patients the arrhythmias followed acute myocardial infarction. Bretylium was administered intramuscularly or intravenously, and most patients received 4-5 mg/kg every 6 hours. Eighteen patients responded satisfactorily to bretylium and suffered no further ventricular tachyarrhythmias while receiving the drug. Bretylium partially suppressed ventricular arrhythmic activity in five patients and had no beneficial effects in seven patients. Administration of bretylium soon after the development of arrhythmias and withholding of other antiarrhythmic drugs during bretylium therapy favored a good antiarrhythmic response. Hypotension followed bretylium administration in 19 patients but exceeded 20 mm Hg in only one patient. Transient initial increases in blood pressure and ventricular arrhythmic activity occurred in five and four patients, respectively. Six patients were discharged from the hospital on oral bretylium 600 mg every 6 hours, and all have remained free from major ventricular arrhythmias for up to 15 months. In these patients postural hypotension was a transient and parotid pain a persistent side effect.

BEHAVIORAL AND BIOLOGIC ASPECTS OF MARIJUANA USE

Before the current decade, only three comprehensive studies of the effects of repeat-dose marijuana administration had been conducted.zs45,52 Our current data base has been expanded considerably and has been reviewed in part in several comprehensive publicatiorsz53 Yet, despite an exponential increment in our fund of information about the effects of marijuana on human biologic function and behavior, we are still far from certain about the type and nature of any subtle, and perhaps disastrous, consequences that may be associated with long-term marijuana use. Data presented in this paper reprint an overview of a series of multidisciplinary studies conducted in our laboratory. The major questions that we addressed in this research were similar to those we have posed in previous These questions were: “Does chronic use of marijuana systematically affect motivation to engage in a variety of social and goal-directed activities? Are there constant relationships between free-choice marijuana intake and antecedent and consequent mood states? What are the relationships between free-choice marijuana intake and patterns of verbal interaction? What are the relationships between free-choice marijuana intake and performance on psychologic tasks that assess such functions as problem solving and risk taking, memory, time estimation, and cognitive function? And, finally, are physiologic and biochemical changes associated with repeated doses of marijuana?” Some answers for these questions are provided in each of the topical sections of this manuscript. This report is a summary of the current “state of science” for ongoing research in our laboratory and clinical research facility. More detailed presentations of data obtained in studies of behavorial and social reactions, group interaction, and tolerance will be published by Dr. Babor and his associates. Dr. A. Michael Rossi and his colleagues will report in subsequent publications on studies of mood, short-term memory, vigilance, and reaction time. Drs. Kuehnle and Bernstein have submitted data for publication on psychiatric aspects and cardiac and pulmonary function. Drs. Greenberg and Mello and their associates have presented a detailed description of studies of operant behavior elsewhere in this monograph. One of the most important joints we would like to emphasize is the 35, 37.

Interaction of chloral hydrate and ethanol in man: II. Hemodynamics and performance

Changes in heart rate, arterial pressure, and skin temperature and in performance tests were studied in 5 male volunteers after ingestion of placebo, ethanol, chloral hydrate, both drugs, or ethanol after 7 days of chloral hydrate pretreatment. Ethanol ingestion was always associated with an increase in heart rate at 0.5 and 1.0 hours; this tachycardia was enhanced by pretreatment with chloral hydrate. Chloral hydrate followed by ethanol also caused greater increases in skin temperatures than other treatments. In one subiect this sequence led to a marked vasodilation reaction characterized by flushing, palpitations, and headache. At the peak of the reaction the blood acetaldehyde level was only half that after ethanol alone which had caused no reaction. The ability to perform a complex motor task was poorest when chloral hydrate was taken with ethanol. Auditory vigilance was significantly impaired by ethanol; concurrent chloral hydrate treatment further decreased performance. The “knock‐out” drop effect was not seen.

Propranolol and behavior of alcohol addicts after acute alcohol ingestion.

Sixty‐four adult male chronic alcoholic addicts were studied to assess the effects of propranolol pretreatment on behavioral changes induced by acute ingestion of alcohol. The study was carried out under controlled research ward conditions with a double‐blind technique. Pretreatment with 10, 20, and 40 mg of propranolol 4 times a day for 3 consecutive days prior to alcohol administration failed to block or attenuate cognitive, perceptual, motor, and affective changes induced by acute alcohol intoxication.

Medical Implications of Marijuana Use

The effect of marijuana smoking was studied in 28 healthy young adult men who had previously smoked marijuana for approximately 5 years each. The subjects were hospitalized on a closed research ward for 31 days during which comprehensive psychological, physiological, and medical observations and tests were done. Physical examinations, neurological examinations, chest X-rays, electrocardiograms, and clinical laboratory tests were all within normal limits. Marijuana produced inconstant changes in pulse rate and blood pressure in these studies. Six subjects were found to have significant reduction in resting vital capacity during the baseline period of the study which were felt to be related to their prior marijuana smoking. In contradistinction to these findings, 12 of 15 subjects had statistically significant increases in peak expiratory flow rate immediately following marijuana smoking. Body temperature tended to be slightly reduced during marijuana use.

Antipsychotic drugs in the general hospital: Uses and cautions

Abstract A variety of clinical problems may arise when a patient being treated with antipsychotic drugs is admitted to a general hospital for a medical or surgical problem. Other difficulties arise when a patient becomes acutely psychotic while hospitalized for a nonpsychiatric illness. This report focuses on the use of antipsychotic drugs in medically ill hospitalized patients, including a description of the major drug interactions that may occur and the physical effects of antipsychotic drugs that may be of importance in medically ill patients.