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cbd oil and antidepressants

What You Need To Know About CBD If You Take Antidepressants

There’s no denying that CBD, aka cannabidiol, was the reigning trend of last year, and shows no signs of stopping. From edible products and tinctures, to bath and beauty products, CBD was (and is) everywhere. Though touted as a natural, holistic, and safe way to manage a variety of health issues, you may be wondering if you can take CBD and antidepressants together. And while CBD is touted as an all-natural supplement with some evidence that it can be good for your health, it’s possible that your CBD latte can still impact the efficacy of different medications — including antidepressants.

According to statistics from the National Alliance on Mental Illness (NAMI), one in five U.S. adults live with a mental illness in any given year. Furthermore, as NBC News reported, a 2016 study revealed one in six people in the U.S. take some type of psychiatric medication, with antidepressants being the most widely prescribed. Limited research has shown that CBD may help alleviate symptoms of anxiety and sleep issues, as well as lower levels of inflammation in the body, though this research (and the dosages needed for these effects) is nowhere near conclusive. And that means you need to be careful if you’re choosing to consume it.

“Generally speaking, you can safely use CBD supplements when you’re taking antidepressants. However, there are a couple concerns,” Peter Grinspoon, M.D., an instructor in medicine at Harvard Medical School, and the author of the memoir Free Refills: A Doctor Confronts His Addiction, tells Bustle. “The first concern is that CBD isn’t regulated by the FDA. You have to be careful that the CBD you’re getting is from a reliable supplier. For example, Consumer Reports recently put out an article on how to go shopping for CBD because they’ve done tests, and found some [supplement] formulations had no CBD. Some were inaccurately labeled, and other formulations even had some THC in them.” (THC is the cannabis compound that, unlike CBD, can get you high.)

The recent passing of the bipartisan Farm Bill legalized the production of hemp on an industrial scale for the first time in the U.S. — which means it’s that the CBD industry will only continue to grow. However, this doesn’t necessarily mean there will be more oversight or required research.

So, what can potentially happen if you take CBD when on antidepressants? Unfortunately, because there’s a limited amount of studies to draw from, Grinspoon says, “CBD does have hypothetical drug interactions; the question is whether these are clinically important or not.”

The reason for this is that CBD inhibits two main enzyme systems, Grinspoon explains. Enzymes are proteins that speed up chemical reactions in the body, and play an important role in functions like digestion and respiration. They also help you metabolize antidepressants. “One system is the same one that grapefruit inhibits — the technical name is the CYP34A enzyme system. So, just like grapefruit juice, CBD can cause your body to have higher doses of benzodiazepines [anti-anxiety medications], or certain antipsychotic medications,” Grinspon explains.

What’s more, Grinspoon says that CBD also inhibits “the system that metabolizes a lot of serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and antipsychotics as well.” Meaning, taking CBD supplements while on these psychiatric medications could hypothetically interfere with how these medications are metabolized.

Despite this, Grinspoon explains that this is typically not a large cause of concern for a majority of people on antidepressants or other psychiatric medications. “Certainly, if someone is on a very delicately balanced medical regiment, CBD could knock that out of whack because of the two different enzyme systems it inhibits. In terms of actual clinical practice, I haven’t heard any stories of people having clinical decompensation because of adding CBD to their regime,” he says.

When it comes down to it, Grinspoon says that the potential interactions should be regarded as more “hypothetical than real,” and that the side effect profile of CBD is “very minimal.” Of course, it’s always good to have a conversation with your physician about potential interactions, and to disclose any prescribed or over-the-counter medications and supplements you are taking. At the end of the day, using CBD supplements while on antidepressants is an individual choice, but it’s important to go in informed.

Readers should note that the regulations and data surrounding marijuana, CBD, and other related products are still developing. As such, the information contained in this post should not be construed as medical or legal advice. Always consult with your doctor before trying any substance or supplement.

There’s no denying that CBD, aka cannabidiol, was the reigning trend of last year, and shows no signs of stopping. From edible products and tinctures, to bath and beauty products, CBD was (and is) everywhere. Though touted as a natural, holistic,…

Can CBD Help With Depression?

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Interest in the potential mental health uses of cannabidiol (CBD) has grown tremendously in recent years, including the use of CBD for depression. CBD is a chemical compound found in the Cannabis sativa plant, also known as marijuana or hemp.

Cannabis contains more than 80 compounds, known as cannabinoids. The main cannabinoid that most people are more familiar with is tetrahydrocannabinol (THC), which is the psychoactive substance that produces the “high” characteristic of marijuana.

CBD, on the other hand, is purported to have a wide range of health benefits without these psychoactive effects. Some research suggests that CBD has antidepressant-like effects, which means it may hold promise in alleviating symptoms of depression.

Benefits

Despite claims about CBD’s purported mental health benefits, it is important to understand that the research on its use is still limited. There have been studies done, but many of these have limitations and further research is needed in order to fully understand CBD’s therapeutic potential.

Research suggests that CBD has antidepressant effects, although it is important to note that many of these are animal studies.  

Other studies suggest that CBD may help alleviate symptoms of depression by interacting with serotonin receptors in the brain. Serotonin is a neurotransmitter that plays a role in a range of functions in the body including the regulation of mood. It may help contribute to feelings of happiness and well-being. It is also often implicated in the onset of depression and many types of antidepressant drugs work by increasing serotonin levels in the brain.

One study published in 2018 suggested that cannabidiol does not increase serotonin levels; rather, it appears to work by influencing how the brain responds to serotonin that is already there.  

Another study found that CBD had a “clear anti-stress effect,” which might play a role in reducing stress levels that contribute to feelings of anxiety and depression.  

How It’s Taken

Cannabidiol is available in several different forms, although only those that are ingested are likely to produce any antidepressant-like effects or other mental health benefits. It may be taken orally as an oil, spray, or capsule. CBD may also be added to edible products including beverages, candies, or chewable gummies.

CBD can also be used topically in creams, salves, lotions, and balms, although it is likely to only produce localized effects in this form. E-liquids that are inhaled via vaping are also available, though vaping comes with its own risks.

It is also important to note that CBD is available in isolate (only CBD), broad-spectrum (contains other cannabinoids but not THC), and full-spectrum (contains other cannabinoids, including THC).

Possible Side Effects

Most of the available research suggests that CBD is generally well-tolerated and produces few side effects. However, this does not mean that people may not experience any unwanted side effects, which may include:

  • Appetite changes
  • Mood changes
  • Diarrhea
  • Anxiety
  • Drowsiness
  • Nausea
  • Dizziness
  • Elevated liver enzymes  

Safety

According to the World Health Organization, the available evidence suggests that CBD is relatively safe.   However, the long-term effects are not entirely clear.

One of the biggest concerns that consumers face when purchasing CBD products is the lack of FDA regulation.

CBD products are not subject to regulation because they are marketed as supplements, which means that you don’t know if you are really getting what is described on the label. Because these products are not regulated, you have no way of knowing for sure what you are getting in terms of purity, safety, and dosage.

  • One study found that a whopping 70% of CBD products sold online were mislabeled, with many containing much more THC than the packaging claimed.   So while many CBD products are labeled as not containing THC, many do contain significant amounts. This could potentially result in a positive result on a drug test. This is a major concern, particularly if you want to avoid the psychoactive effects of THC.
  • Another study found that CBD products may also contain potentially dangerous chemicals and medications, including synthetic cannabinoids and cough medicine.   Such contamination could lead to health problems including allergic reactions or drug interactions.

CBD vs. Antidepressants

So how does CBD compare to traditional antidepressants? True comparisons of the effects are not yet possible simply because there is not enough research on CBD’s effects.

However, one animal study suggests that CBD might have some possible benefits by comparison:

  • A 2018 study published in Molecular Neurobiology concluded that CBD had promise as a fast-acting antidepressant drug. While traditional antidepressant drugs typically take some time to begin working, research on rodents found that CBD showed rapid and sustained antidepressant-like effects.  
  • CBD also appears to have relatively few side effects. Antidepressant drugs may sometimes cause things such as appetite changes and sexual side effects.

CBD holds promise, but that does not mean that you should turn to cannabidiol products over traditional treatments for depression.

A Word From Verywell

The bottom line when it comes to CBD’s potential as a treatment for depression is that more research is needed. Most of the evidence supporting CBD’s antidepressant effects comes from animal studies or small trials, and one of the largest reviews of the research found that the available evidence is not strong enough to recommend CBD as a treatment for depression.  

If you are experiencing symptoms of depression, it is important to talk to a doctor or mental health professional. Depression may worsen over time if left untreated, but there are effective treatments available including psychotherapy and medications.

If you are interested in using CBD to alleviate symptoms of depression in conjunction with other treatments, always talk to your doctor first about how to use it and about any possible medication interactions.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Cannabidiol (CBD) is a cannabis compound that has generated interest for the relief of symptoms of depression. Learn how it's used and if it works.