Antidepressants are very popular drugs, but is CBD use dangerous coupled with these medications? Learn how CBD oil and antidepressants may interact when taken together so you can decide if it’s safe to use them in tandem. Before you start treating depression and anxiety with CBD, make sure you speak to a doctor about how this may interact with your medication.
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
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.
Can you take CBD when you’re on antidepressants? What you need to know
The UK has the second largest market for CBD in the world – after the US – with a current value of around £690 million. It’s estimated that the market will be worth a whopping £1 billion by 2025.
CBD (short for cannabidiol) comes from the cannabis plant, and is one of over 110 chemical compounds called cannabinoids that are found in the plant.
These compounds interact with cannabinoid receptors in the brain and body as part of its endocannabinoid system, which helps balance things like pain, memory, mood and appetite.
Can CBD help with anxiety and depression?
Many people take CBD in the form of oil tinctures, capsules or gummies, to help alleviate symptoms of anxiety and depression.
A study on 103 patients with anxiety found that ingesting CBD capsules helped decrease anxiety symptoms in 79% of subjects, as well as improving sleep.
Another study following 90 people with depression revealed that 53% felt better overall after self-medicating with CBD oil, and 93% didn’t observe any negative side effects of taking CBD.
While research is limited, due to the high costs associated with clinical studies, results do look promising.
‘Sadly most studies on CBD are small scale, due to the high costs associated with clinical studies,’ explains Professor Mike Barnes, consultant neurologist, medical cannabis expert and advisor to hapihemp.
‘However, there is an increasing amount of “real world” evidence regarding the efficacy and safety of CBD for anxiety in particular, as well as insomnia and epilepsy, though there’s slightly less evidence regarding depression.’
What are potential interactions of CBD with antidepressants?
‘Commonly with antidepressants, it might be that CBD-based products will make other medications more or less effective,’ advises Dr Hana Patel, private GP and mental health coach.
‘This can cause unwanted side effects such as increased drowsiness, confusion and dizziness, for example.’
There are a couple of reasons for this – firstly, CBD side effects can include drowsiness, dry mouth, dizziness and diarrhoea, which can also be unwanted effects of antidepressants (who doesn’t love a bit of sertraline cotton mouth, eh?). So, you’re potentially doubling up on side effects, which may be unpleasant.
Secondly, CBD has the potential to affect the concentration of your medication.
‘Generally, antidepressants are metabolised in the liver, and CBD can affect liver enzymes,’ explains Professor Barnes.
‘With some drugs it can speed up metabolism (thus reducing the amount in the blood) or in other cases it can slow down metabolism (thus building up more in the blood).’
Research shows that CBD may inhibit the liver enzymes that metabolise most prescription meds, in the same way that grapefruit is thought to.
One study found that CBD minimally affected metabolism of common antidepressants fluoxetine, mirtazapine and sertraline, in vitro (in test tubes). However, significant interactions were observed in patients taking citalopram, with CBD causing higher concentrations of the drug in the body, though researchers couldn’t confirm whether this also increased SSRI-related side effects.
Another study in adolescents showed that even small doses of CBD could increase levels of sertraline and citalopram, raising the risk of concentration-related side effects.
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Can you get CBD from your doctor?
Currently, you can only be prescribed cannabis-based medicine – both on the NHS and privately – by a specialist doctor, and only for certain conditions like epilepsy and MS, or for chemotherapy side effects. FYI, it’s actually incredibly rare to get a medical cannabis prescription on the NHS.
The cannabis products prescribed by doctors are not the same as the ones available to purchase, which are classed as food supplements and aren’t legally allowed to make any health claims.
Thankfully, this year the Food Standards Agency (FSA) took steps to regulate the UK’s murky CBD market, becoming the first country in the world to do so. Before, you often didn’t know if the product you were splashing cash on was legit or contained what it said it did.
Now, you can check if a product in the UK is FSA-approved, by searching UK CBD List. A worrying three quarters of products submitted to them didn’t meet approval, so it’s well worth checking your products.
The Medical Cannabis Clinicians Society also recommends buying from CBD Shopy, Savage Cabbage and Mellow.
There are all sorts of products on the market – but make sure you’re getting your CBD from a reputable source (Picture: Getty Images)
Always speak to your GP before self-supplementing with CBD while on medication
A study of 90 people self-medicating with CBD while on antidepressants found that only 19% consulted their doctor before taking it. Over half never told their doctor that they were supplementing with CBD.
While interactions do appear to be minimal, they can’t be ruled out, so it’s imperative you tell your GP if you plan on taking store-bought CBD at the same time as prescription meds.
‘I often have patients ask me questions about this as they choose to self-medicate with preparations obtained from unregulated sources,’ says Dr Patel.
‘I encourage patients to tell me about other medications that they may be taking in conjunction with their prescription medications, in order to avoid potentially dangerous drug interactions.
‘Whilst it is an individual’s decision to take CBD-based medicinal products that have not been prescribed by a doctor, I would recommend getting advice from your GP first.’
Their advice might be something as simple as taking CBD at a different time of day to your meds, but it’s best to check as different antidepressants carry different risks, and no two humans are the same.
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