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.
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