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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,…

Cautions – Antidepressants

There are several important things to consider when taking antidepressants. You should discuss these with a GP or mental health professional.

Interactions with other medicines

Antidepressants can react unpredictably with other medicines, including some over-the-counter medicines such as ibuprofen. Always read the patient information leaflet that comes with your medicine to see if there are any medicines you should avoid.

If in doubt, your pharmacist or GP should be able to advise you.

Pregnancy

As a precaution, antidepressants are not usually recommended for most pregnant women, especially during the early stages of a pregnancy.

This is because they might be dangerous for your baby.

But exceptions can be made if the risks posed by depression (or other mental health conditions) outweigh any potential risks of treatment.

If you’re pregnant and depressed, you should discuss the pros and cons of antidepressants with the doctor in charge of your care.

Breastfeeding

As a precaution, the use of antidepressants if you’re breastfeeding is not usually recommended.

However, there are circumstances when both the benefits of treatment for depression (or other mental health conditions) and the benefits of breastfeeding your baby outweigh the potential risks.

Speak to your doctor for advice.

Children and young people

The use of antidepressants is not usually recommended in children and young people under the age of 18. This is because there’s evidence that, in rare cases, they can trigger thoughts about suicide and acts of self-harm in this age group.

Concerns have also been raised that their use could affect the development of the brain in children and young people.

An exception can usually only be made if the following points are met:

  • the person being treated has failed to respond to talking therapies such as cognitive behavioural therapy, and
  • the person being treated will continue to receive talking therapies in combination with antidepressants, and
  • the treatment is supervised by a psychiatrist (a doctor who specialises in treating mental health conditions)

Alcohol

You should be wary of drinking alcohol if you’re taking antidepressants, as alcohol is itself a depressant and drinking alcohol can make your symptoms worse.

If you drink alcohol while taking types of antidepressants called tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs), you may become drowsy and dizzy.

You’re less likely to experience unpleasant or unpredictable effects if you drink alcohol while taking an SSRI or a serotonin-noradrenaline reuptake inhibitor (SNRI) antidepressant, but avoiding alcohol is often still recommended.

Illegal drugs

The use of illegal drugs is not recommended if you’re taking antidepressants, particularly if you’ve been prescribed a TCA. This is because they can cause unpredictable and unpleasant effects.

In particular, you should avoid taking:

  • cannabis – smoking cannabis while taking a TCA can make you feel very ill
  • amphetamines (speed)
  • cocaine
  • heroin
  • ketamine

As with alcohol, illegal drugs can make symptoms of depression or other mental health conditions worse.

Other antidepressants

You should never take 2 different types of antidepressants, such as an SSRI and a TCA, unless advised by a doctor. This is because taking certain combinations of antidepressants can make you feel very ill and can be life-threatening.

If a decision is taken to switch you from 1 type to another, the dosage of the first antidepressant will usually be gradually reduced before the second is started.

St John’s Wort

St John’s Wort is a popular herbal remedy promoted for the treatment of depression.

While there’s evidence of its effectiveness, many experts advise against its use, because the amount of active ingredient varies among individual brands and batches, making the effects unpredictable.

Taking St John’s Wort with other medicines, such as anticonvulsants, anticoagulants, antidepressants and the contraceptive pill, can also cause serious health problems.

You shouldn’t take St John’s Wort if you’re pregnant or breastfeeding, as it’s unclear whether it’s safe.

Driving and operating machinery

Some antidepressants can cause dizziness, drowsiness and blurred vision, particularly when you first start taking them.

If you do experience these problems, you should avoid driving or using tools and machinery.

Cautions for specific antidepressants

SSRIs

SSRIs may not be suitable if you have:

  • bipolar disorder and you’re in a manic phase (a period where you’re extremely excitable), although they can be useful for depressive phases
  • a bleeding disorder, or if you’re taking medicines that make it more likely you may bleed (such as warfarin)
  • type 1 diabetes and type 2 diabetes
  • epilepsy – SSRIs should only be taken if your epilepsy is well controlled, and the medicine should be stopped if your epilepsy gets worse
  • kidney disease

SNRIs

SNRIs may not be suitable if you have a history of heart disease or you have poorly controlled high blood pressure.

TCAs may not be suitable if you have:

  • a history of heart disease
  • recently had a heart attack
  • liver disease
  • an inherited blood disorder called porphyria
  • bipolar disorder
  • schizophrenia
  • a growth on your adrenal glands that is causing high blood pressure (pheochromocytoma)
  • an enlarged prostate gland
  • narrow angle glaucoma – increased pressure in the eye
  • epilepsy

More in Antidepressants

Page last reviewed: 16 August 2018
Next review due: 16 August 2021

There are several important things to consider when taking antidepressants. You should discuss these with a GP or mental health professional.