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cbd oil and ssri interaction

Antidepressants and CBD Oil Interaction

Written by Jason Brett — Edited by Cathy Rozyczko on April 1, 2021 — Reviewed by Sarah Neidler, PHD

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.

Learn how CBD oil and antidepressants may interact when taken together so you can decide if it’s safe to use them in tandem.

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,…