Antidepressants are very popular drugs, but is CBD use dangerous coupled with these medications? According to studies, CBD has antidepressant-like properties. Does taking CBD together with conventional antidepressants make sense? Let’s find out. Learn how CBD oil and antidepressants may interact when taken together so you can decide if it’s safe to use them in tandem.
Can You Use CBD With Antidepressants?
Antidepressants are very popular drugs, but is CBD use dangerous coupled with these medications?
CBD is a molecule that keeps revealing secrets as more scientific research is done. However, some drug alterations are possible, but what if CBD is consumed with antidepressants? We will now look at CBD and the likely effect related to the consumption of antidepressants on the human body and mind
Is consuming CBD and antidepressants dangerous?
First of all, these drugs are not dangerous as a whole, but the question of a possible interaction between antidepressants and CBD can easily surface among consumers
It is also important to know that CBD has a high risk of interacting with antidepressants. Indeed, it acts on the same areas of the brain as this drug and this can alter the quality of the treatment
CBD does not cause psychotropic effects and has no or very few unpleasant side effects for consumers, such as dizziness or nausea. However, it does cause a metabolic shift in brain and liver chemistry. This can cause a significant decrease in the time it takes for the liver to process an antidepressant, which can cause an increase in blood flow
Is it possible to mix CBD and antidepressants?
This may seem like a surprising question, but it’s one that many consumers ask. Although some people consume recreational cannabis, with a high THC content, the effects will be incidentally the same, without the psychotropic effects accentuated because of THC
It is also important to know that different types of antidepressants exist, such as first and second generation antidepressants. In these drugs, there are some drugs that can cause a serious interaction on the health of the person and others that have no specific interaction.
Some people report a double effect if you take CBD with antidepressants, which may seem coherent depending on the drug concerned, because the latter may have an action on such and such a neuron and CBD could act as a complement on other neurons. But it is necessary to talk about it with a health professional, such as your doctor, before embarking on this perilous experimentation, because the effects can sometimes become dramatic.
Antidepressants with an increased risk with CBD
Antidepressants with increased risk with CBD use alongside are generally the tricyclics and MAOIs.
Tricyclics are the oldest antidepressants on the pharmaceutical market and are part of the first generation. Because of the early appearance on the market and the lack of knowledge about the side effects caused on consumers, side effects are much more numerous and interactions are possible. These drugs work by blocking the uptake of the neurotransmitters norepinephrine and serotonin to increase their levels in the brain
MAOIs are a newer generation of antidepressants and yet have a serious interaction with CBD and with many foods. These drugs work by prolonging the presence of neurotransmitters in the brain, such as dopamine, serotonin and norepinephrine
CBD also has increased risks of interaction with drugs that are not just antidepressants. Indeed, specific anxiety-reducing drugs have interactions. For example, Xanax-type drugs, can show beneficial interactions in small amounts by improving the action on the brain and the connection between neurons, while if consumed in large amounts, it could cause worrisome side effects like the ones we will see
Slurred speech and confusion
These effects caused by the simultaneous consumption of these two molecules may not occur with each consumption. It is important to know that each person will react differently when taking these drugs and that the effects may be either weaker or more serious.
In order to avoid any drug interaction that could affect your health, talk to your doctor!
The question that we can now ask ourselves is that of a possible interaction between several drugs and CBD. That is why we will list the possible interactions between drugs and CBD
Possible drug interactions with CBD
In France and in the world, several million drugs are available over the counter or by prescription. Of course, we know the main drugs and the molecules that make them up
Thus, many interactions are possible with certain drugs and with CBD. First of all, let’s remember that CBD is a molecule that has been known for several decades throughout the world and that its effects are becoming better and better known. It is also possible to affirm certain beneficial effects that it causes, such as the beneficial effects on epileptic seizures and on Parkinson’s disease by bringing well-being towards tremors
This molecule is not psychotropic, unlike its companion, tetrahydrocannabinol, otherwise known as THC. In fact, it acts on the endocannabinoid system naturally present in our body and on the CB1 and CB2 receptors that compose it
It also causes few side effects on users, although some experience nausea or dizziness following normal consumption, but these effects are experienced by a small number of people. CBD also has an overdose threshold that it is possible to reach, but this is very rare, as this threshold is 1500 mg per day, in other words, the daily average that allows you to feel the full effects is 25 mg
If you are overdosed, involuntarily or voluntarily, you just need to rest and drink or eat something sweet
So, we know what CBD is and can now know what the possible interactions are
To do this, you need to know that according to a study from the Penn State of College of Medicine on Harvey published in Medical Cannabis and Cannabinoids, CBD and THC have interaction risks towards 57 medications
CBD and corticosteroids
Corticosteroids are anti-inflammatory and immunosuppressive drugs that mimic the effects of cortisol or cortisone, which are often prescribed for autoimmune diseases. Among these drugs we can find Prednisone, Prednisolone and Betamethasone
These drugs cause severe side effects on the users and can sometimes represent increased risks on certain health concerns already present and an increased dependence when stopping the treatment
If one consumes CBD and corticosteroids at the same time, the risk of developing side effects is very high and it can quickly become dangerous. Indeed, during the passage in the liver, CBD and the molecules present in these drugs will then slow down the transformation of the molecules, which could cause an increase in the presence of cortisone in the blood, which could, obviously, worsen the known side effects.
CBD is antihistamines
These medications are common for people with many allergies, as they are used in the fight against felt allergies, such as pollen allergies, or dust mites. They are also prescribed to combat flu-like conditions
In these drugs, we find many molecules, but the one that interests us the most is still doxylamine, which is also present in the drug called“Humex“. Indeed, when you consume CBD and this drug at the same time, it is possible to develop a range of side effects
The cause of these side effects is mainly related to CBD. Yes, this “miracle” molecule is responsible for many side effects with this drug
The latter is responsible for the disruption of the enzymes responsible for the degradation of doxylamine in the liver, which leads to poor absorption and the appearance of the effects mentioned above
This drug is also in the sights of the health services, because it contains another molecule that is responsible for several negative and psychotropic effects when consumed in large quantities or in a derivative manner
CBD and anticoagulants
Anticoagulants are specific medications for certain health problems. They allow to fluidify the blood in order to reduce the formation of blood clots, which can occur on cardiovascular problems
Its use is very controlled in the medical field, because one of the most serious side effects is the risk of hemorrhage if the blood is too diluted and an injury occurs on the body
Among these drugs, we can find Warfarin on which CBD proposes a booster effect. Indeed, the latter will tend to boost the fluidifying effects of this medication, which can represent a risk over time. The risk is mainly that of bleeding in case of injury
CBD and opiates
Opiates are increasingly popular drugs, especially in the United States, which is currently experiencing an opioid crisis
This group of drugs certainly represents the most medications we all know, like efferalgan, doliprane or dafalgan, which are often used to treat fever and mild to moderate pain
However, these drugs represent a separate group in the interactions with CBD, since a study it is clear that CBD would also improve their effects
Indeed, there are no definite contraindications on these drugs and the relaxing and anti-inflammatory effects of CBD cut across the effects of opioids. Be careful not to overdose on CBD, however, so as not to have hypotensive effects that can make you feel tired throughout the day
CBD and beta blockers
Beta-blocker drugs are some of the heaviest drugs available on the market. This is because they are prescribed for people who suffer from high blood pressure or cardiovascular disorders
The treatment is quite heavy in its entirety and causes several side effects on its own
Coldness of the extremities;
Decreased heart rate
Digestive disorders, such as nausea, vomiting and diarrhea
Decreased physical exertion
This drug is obviously not available over the counter, since it causes heavy effects and is strictly dedicated to a single category of patients
The consumption of CBD coupled with the consumption of this treatment is very dangerous for the health of consumers. Indeed, CBD itself has a hypotensive effect, which, coupled with the consumption of beta blockers can be dramatic
Avoid consuming this medicine with CBD or talk to your doctor to avoid possible complications.
All these treatments are to be taken with caution and the consumption of CBD must not be medicated. This molecule should be considered as a food supplement coupled with a healthy and balanced diet and physical activity and sports.
What is an antidepressant?
An antidepressant is an often heavy medication given to patients with various anxiety and depression disorders. This medication is one of the most prescribed drugs worldwide today, to treat these mental disorders
To know the effects of an antidepressant on the human body, one must know its role performed on it. An antidepressant is a medication designed to regulate the neurotransmitters in the brain in order to restore mental balance. In our body, many chemical substances are present and allow to regulate this balance, but sometimes, the connection between these substances is not completely done because of a fragile cerebral state. The antidepressant will then act by balancing this functionality in order to reconnect our substances, which are the basis of our emotions
Generally attributed to people suffering from severe or mild anxiety, these drugs can be found in the treatment of different pathologies that we will see below
It is important to know that there are different types of antidepressants to treat people with these psychological disorders. For example, it is possible to find antidepressants that act on one or two neurotransmitters, while other antidepressants ignore them completely
In order to benefit from a treatment involving these medications, it is important to know that they are not available over the counter. In fact, you must first see your doctor and undergo certain tests to prove the presence of this psychological disorder.
For which illnesses are they prescribed?
It is important to know that antidepressants are not only prescribed for anxiety disorders, although they can trigger some of the disorders described below
A lot of research has taken place to enable the knowledge of these antidepressants and the mechanisms carried out on the brain of people with these disorders. This makes it possible to secure the consumption of these drugs and to guarantee an effective treatment, although everyone reacts differently
Regarding the psychological disorders for which these drugs are prescribed, here is the list of some of them
CBD and Antidepressants: Can You Take Them Together?
Depression has many faces, but it’s usually characterized by mood disorders, persistent feelings of sadness, and loss of satisfaction from previously enjoyed activities.
It rarely stems from a single event but rather as the combination of many factors, both individual and environmental ones. The symptoms of depression can range from mild to severe.
Depression can be treated with psychotherapy or with the use of medicines, although the most benefits are experienced by combining these two methods.
Since conventional antidepressants can have undesired side effects, people are starting to explore alternative remedies that are derived from nature — such as CBD.
CBD is a major cannabinoid found in hemp plants. It supports the endocannabinoid system (ECS) and helps maintain homeostasis throughout the body. Recent studies also show that CBD has anxiolytic and antidepressant-like properties.
In this article, we cover the topic of CBD and antidepressants; we’ll break down the pros and cons of each substance, compare their safety profiles, and explain what happens when you take them together.
Is CBD Good for Depression?
There is no single cure for depression because it’s a disease caused by multiple factors — and these factors often affect different areas of your life. There are many contributors to depression, including poor stress management, sleep deprivation, the loss of someone close or other traumatic events, and more.
There is some scientific evidence that CBD can alleviate the symptoms of depression, although these results haven’t been yet replicated in large-scale clinical trials.
Nevertheless, at least several high-quality studies have outlined CBD’s ability to help us cope with the whole set of symptoms and mental health problems commonly experienced together with depression.
Addressing these secondary conditions can indirectly improve your management of depression — lifting up your daily life.
Benefits of CBD for Depression
Depression is often accompanied by low mood, anxiety, apathy, and the loss of interest in activities that a person had considered joyful prior to their diagnosis.
Hopefully, CBD may help regulate certain processes in your body that can reduce the severity and frequency of these symptoms.
Here’s how you can use CBD for depression.
CBD May Reduce Anxiety
There’s a growing body of evidence to support the hypothesis that CBD has anxiolytic (anti-anxiety) properties in many individuals.
CBD has been studied in many types of anxiety disorders, including PTSD, obsessive-compulsive disorder, panic disorder, social phobias, and fear of public speaking.
One mechanism that helps CBD achieve such positive effects is the activation of the GABA receptor. GABA is the primary inhibitory neurotransmitter in our bodies; in simple words, it works like a hand brake for the brain — preventing neuroexcitation. Higher levels of GABA and lower levels of glutamate are associated with a better response to stress and lower levels of anxiety.
Another way CBD can help alleviate anxiety is by interacting with serotonin receptors in the brain. Serotonin is another important neurotransmitter that controls emotions, mood, and feelings of happiness. Low levels of serotonin are linked to depression, and while CBD isn’t a direct serotonin booster, it can block its reuptake so that the body can use it more efficiently — resulting in an elevated mood.
CBD May Improve Mood and Reduce Stress
As mentioned earlier in the article, CBD interacts with the endocannabinoid system (ECS). The ECS is the major regulatory system in all mammals, helping the body achieve and maintain homeostasis.
Homeostasis is a scientific term for the balance between all vital functions performed by other systems and organs. The ECS regulates memory, mood, pain perception, emotional processing, fertility, body temperature, appetite, sleep cycles, and more.
Anandamide, one of the two major endocannabinoids (endo = produced in the body) has a major role in the regulation of mood and pain threshold. Poor anandamide signaling can lead to a worse response to stress and cause a low mood. Permanent anandamide deficiencies may even result in anxiety disorders and depression.
That’s why anandamide has been dubbed as the “bliss molecule” in sanskrit.
CBD can improve anandamide signaling and slow down its breakdown by inhibiting the Fatty Acid Amino Hydrolase (FAAH) enzyme. As a result, your body can achieve higher and more stable concentrations of anandamide — improving your mood and reactions to stressors.
CBD Contributes to Neurogenesis
Studies have shown that CBD can stimulate the formation of new neurons in the brain, improving the plasticity of the hippocampus. The hippocampus is an important region in the brain that controls our cognitive performance, emotions, and mood.
Improved neuroplasticity of the hippocampus has been associated with better cognitive performance and a lower frequency of suicidal thoughts in patients with depression.
Can You Take CBD and Antidepressants Together?
“Antidepressants” is an umbrella term that covers a wide range of different products that use different mechanisms to treat depression. However, one common feature shared by all classes of antidepressants is that they are metabolized by the liver before they can start working in your body.
The liver contains a number of different enzyme systems that facilitate chemical reactions. One of these systems is the cytochrome P450 (CYP450) enzymes that metabolize the majority of medications, including antidepressants.
CBD has demonstrated potent inhibitory actions on these enzymes, suggesting that there could be interactions between CBD and antidepressants.
What kind of interactions are they? Does taking CBD and antidepressants together mean they produce a stronger effect? Or, as a result of that inhibitory mechanism, maybe they shouldn’t be taken at the same time?
What May Happen When You Take CBD with Antidepressants
CBD is generally considered safe, but it’s one thing when you take it alone, and the other thing when you combine it with other substances, such as antidepressants.
The most common side effects of CBD include lightheadedness, dry mouth, sedation, and (rarely) diarrhea. Taking CBD with other medications that have similar side effects may increase the likelihood of unwanted symptoms or toxicity.
Doubling Up On Side Effects
To put it simply, taking CBD at the same time with substances that cause sleepiness, such as benzodiazepines, antipsychotics, antidepressants, or alcohol may lead to increased fatigue, sleepiness, and possibly accidental accidents when driving.
Increased sedation may also occur when you combine CBD with other herbal supplements, such as melatonin, St. John’s wort, and kava.
Taking CBD together with stimulants — like Adderall — may lead to decreased appetite, while interactions between CBD and the diabetes drug metformin or certain heartburn medications may increase the risk of diarrhea.
CBD Can Alter the Effects of Antidepressants
Since CBD interferes with the enzymes in the liver that break down many drugs, including antidepressants, their interactions may lead to insufficient concentrations of the drug in the body — resulting in a subtherapeutic effect.
Depending on the type of interaction, CBD may also increase the drug concentration in your bloodstream, inducing toxicity and increased risk of side effects.
Researchers from Penn State College of Medicine analyzed existing data on five cannabis-based medications. Overall, the team found 139 medications that may be affected by cannabinoids. They further narrowed down that list to 57 medications, for which altered concentrations can be hazardous.
Among these medications, the researchers identified blood thinners, heart rhythm medications, thyroid drugs, and several medications for seizures.
However, antidepressants weren’t included in that list.
Does the Form of CBD Matter In CBD-Drug Interactions?
Inhaled CBD enters the blood the fastest, reaching peak levels within 30 minutes and increasing the chances of acute side effects.
CBD edibles for anxiety need more time to be processed in the digestive system and are less likely to produce high concentration levels. However, they may eventually reach high enough levels to interact with other medications.
Topical formulations are the safest from that trio because they do not absorb and reach the bloodstream; therefore, they can’t interact with other medications.
The problem with estimating the likelihood of CBD-drug interactions is the lack of regulations regarding CBD products, which may cause issues with purity, concentration, or safety.
That’s why reading third-party lab reports is critical if you want to make a well-informed decision when choosing your CBD product. These reports analyze the entire chemical profile of the tested sample, including its purity levels.
Common Antidepressants and Their Risks
Since there are different classes of antidepressants, some demonstrate a higher risk when taken with CBD oil than others.
Selective Serotonin Reuptake Inhibitors (SSRIs)
This is the most common type of antidepressant that doctors prescribe. They work similarly to CBD in the way they block the reabsorption of serotonin into the brain, leading to higher concentrations in the bloodstream and improved mood.
Common SSRI’s include:
The reason why SSRIs are the go-to treatment for depression is that they generally have fewer side effects than other antidepressants. Taking CBD with SSRIs would cause similar effects, as is the case for all antidepressants belonging to a specific drug category.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
They use a similar mechanism to SSRIs and entail the same level of risk, but some individuals may tolerate them better than others.
Common SNRIs include:
These drugs work by increasing levels of serotonin and norepinephrine in the brain. They can be very effective but also entail a higher risk than other antidepressants. For that reason, they’re only prescribed when SSRIs or SNRIs haven’t been working.
Common tricyclic antidepressants include:
Wrapping It Up: Talk to Your Doctor Before Taking CBD with Antidepressants
CBD may have more benefits in the long term than conventional antidepressants. One of the main reasons why people choose CBD instead of these treatments is that it doesn’t cause the user to build up dependencies on it.
CBD can exhibit the same degree of antidepressant effects but without getting you addicted to it.
Even though there’s no clinical evidence that would recommend the use of CBD as the go-to treatment for depression, it’s only a matter of time before such studies will start emerging on the surface.
Taking CBD and antidepressants together can lead to certain interactions that can change the way both substances are metabolized in the liver. Despite the lack of hard evidence that CBD directly interacts with antidepressants, there’s a well-grounded belief that taking them at the same time presents some concerns.
If you want to make sure you get the right CBD dosage and avoid potential interactions with antidepressants, consult your doctor before buying CBD oil.
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Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
Antidepressants and CBD Oil Interaction
In a recent review of data, the New York Times published that 25 million Americans have been on antidepressants for at least two years, a 60% increase from 2010. While antidepressants have helped millions of people, their efficacy as a long-term solution for managing depression and anxiety is debated due to users experiencing unwanted side effects and having difficulty getting off the medication.
CBD oil shares many beneficial qualities with antidepressants without producing the same potential for negative side effects. Using CBD oil for depression can improve sleep quality, reduce anxiety, and improve general mood. In fact, some people find that after a period of adjusting to the right dosage of CBD oil they are able to reduce, or even altogether remove, the use of antidepressants.
If you’ve considered transitioning from antidepressants to CBD oil, or are thinking about combining the two, here’s what you need to know.
Interactions Between CBD and Antidepressants
While CBD oil is generally well-tolerated and taken without side-effects, there are a few medications which, when used with CBD oil, can create adverse reactions. These interactions occur because CBD oil inhibits the cytochrome P-450 enzyme system.
The cytochrome P-450 system, found in the liver, breaks down medications into smaller substances that the body can more easily process. There are a range of natural foods and compounds that slow down this system, including grapefruit, St. John’s Wort, and of course, cannabidiol (CBD). When the system is inhibited, some medications, like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), remain in the system for a longer period, increasing the chance you will experience some of their unpleasant side effects.
While other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) also use this pathway, there is no definitive evidence to suggest the same adverse reactions are likely to occur.
These stipulations are not definite, partially because there is little research published on CBD and drug interactions, and partially because CBD oil possesses anti-depressive qualities of its own.
Side Effects of CBD Oil and Antidepressants
While it’s rare for adverse interactions to occur between CBD oil and antidepressants, you should still seek the advice of your physician or psychiatrist before combining the two.
Additionally, combining CBD oil with TCAs or MAOIs can put you at increased risk of experiencing the adverse side effects of the antidepressant. This is because these older groups of antidepressants have been shown to interact negatively with a range of medications and consumables, including those that inhibit the P-450 enzyme system. As such, there is a greater potential for an unfavorable interaction with CBD oil.
Knowing what potential interactions may occur will enable you to be aware of any warning signs. For reference, the table below breaks down the most common antidepressant medications and their side effects, many of which you may feel more keenly if a negative interaction occurs with CBD oil.
|Antidepressant Type||Brands Include||Common Drug Side Effects||Possible Side Effects of Combining Medication + CBD Oil|
|SSRIs||Zoloft; Prozac; Sarafem; Celexa; Lexapro; Paxil; Luvox||Nausea; insomnia; nervousness; tremors; decreased libido||The effectiveness of SSRIs should not decrease when combined with CBD oil|
|SNRIs||Pristiq; Khedezla; Cymbalta; Fetzima; Effexor XR||Nausea; drowsiness; fatigue; constipation; dry mouth||The effectiveness of SNRIs may be decreased when combined with CBD oil|
|TCAs||Anafranil; Norpramin; Tofranil; Pamelor; Surmontil||Constipation; dry mouth; fatigue. May also result in low blood pressure and irregular heart rate||Due to the high-risk of adverse side effects when combining TCAs with other medications the use of CBD oil is not advised|
|NDRIs||Wellbutrin; Forfivo; Aplenzin||Nausea; vomiting; constipation; dizziness; blurred vision||The effectiveness of NDRIs may be decreased when combined with CBD oil|
|MAOIs||Marplan; Nardil; Emsam; Parnate||Nausea; dizziness; drowsiness; insomnia; restlessness||Due to the high-risk profile of MAOIs in producing adverse reactions it is not advised to combine with CBD oil|
Avoiding the Side Effects
Given the above list of potential side effects, you may feel discouraged from using CBD oil if you take antidepressants. However, many people actually go on to replace their antidepressants with CBD oil completely. As well as its’ host of other health benefits, CBD oil has been shown to relieve anxiety, encourage relaxation, and improve mood.
To learn more about taking CBD to manage depression, head over to our guide: Depression and CBD Oil: Benefits, Effectiveness, and Dosage.
How to Safely Take CBD and Antidepressants Together
When combining CBD oil and antidepressants, or replacing current medication with CBD oil, it is always recommended to seek medical advice. Together, you and your doctor can create a plan to ensure there is minimal disruption to your system.
To minimize the risk of adverse reactions between CBD and antidepressants it is recommend that you start with a lower dose of CBD than what your product recommends and incrementally increase the dosage over time if needed. This will allow you to get used to the effects of CBD, and also allow you to decrease your antidepressant strength, if desired. Ultimately, starting slow and being conservative with dosage will allow you to more easily monitor any changes to your body and mental state.
To find information on CBD dosage, including how to find the right starting dose for your needs, read the CBD Oil Dosage Guide. You can also get more personalized help by speaking with a naturopathic doctor who specializes in using CBD oil to treat medical conditions.
Safest CBD Oils to Take with Antidepressants
Choosing the best CBD oil product can seem a daunting task. With thousands of products on the market, the range of options can leave you overwhelmed before you even start. Here are our tips for finding the safest CBD oils to take with antidepressants.
First, choose what type of CBD delivery method you’d like to use according to your needs and lifestyle. CBD oil comes in a number of forms including flower, capsules, vapes, edibles, and drops.
CBD oil vapes and drops/tinctures provide the fastest effects while capsules and edibles must pass through the digestive system, slowing down their onset. However, when matching dose-for-dose, an edible will typically yield longer lasting effects than CBD oil drops, and drops will typically yield longer lasting benefits than a vape.
After you’ve decided which type(s) of delivery format you’d like to use, you’ll need to decide on a brand to buy your CBD product from. Search for high-quality CBD companies, which will use organically grown and sustainably sourced hemp and perform third-party lab tests on their products.
Testing by independent laboratories is the only way to ensure you’re receiving the best quality CBD oil, free from any added herbicides, pesticides, or chemicals. A trustworthy company will post the resulting lab reports, called Certificates of Analysis, on their site, or make them readily available to consumers.