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cbd oil with antidepressants

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.

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.