Can You Take CBD Oil With Antidepressants

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Learn how CBD oil and antidepressants may interact when taken together so you can decide if it’s safe to use them in tandem. Many people use CBD as a wellness supplement, and many also take medications. Here’s what to know about how CBD may interact with certain medications. Before you start treating depression and anxiety with CBD, make sure you speak to a doctor about how this may interact with your medication.

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.

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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.

Is It Safe To Take CBD and Zoloft?

CBD has developed a cult following in the wellness community for its holistic benefits. While many people are interested in using CBD, it may not be a valuable option for people who are already using certain medications.

If you’re currently taking Zoloft, there are a few things you need to know about the way CBD and Zoloft may interact with each other. Although CBD’s wellness benefits are helpful to many people, they may not be safe to pursue if you’re currently using an antidepressant drug.

CBD Can Affect the Way Some Medications Work

If you’ve ever taken prescription medication, you’ve likely seen warnings about potential interactions on the label. Some medications, like birth control, can’t be taken with supplements like St. John’s Wort or saw palmetto. While these supplements are fine on their own, they don’t play well with the active constituents of birth control.

Many medications cannot be taken with alcohol. You cannot take benzodiazepine drugs with many kinds of pain relief drugs because of the way their effects stack. It’s always a balancing act, and people who need multiple medications to treat numerous concerns have to work with their doctors to find safe combinations.

Supplements and medications can interact in two different ways, and interactions should be avoided whenever possible.

By Exacerbating Their Side Effects

Many medications have side effects. The majority of people find that the side effects don’t dramatically alter their quality of life. They can work with their doctor to come to a conclusion about the way the benefits stack up against these side effects.

CBD, St. John’s Wort, kava, and melatonin all work to make their users feel more relaxed. When used with medications that cause drowsiness or sedation as a side effect, these supplements may amplify the degree of sleepiness users feel.

It may be dangerous to amplify feelings of fatigue or drowsiness, especially for medications intended for use during the daytime. Falls, automobile accidents, and injuries are more likely to occur when an individual is less alert.

By Modifying Their Absorption

The body metabolizes all medications and supplements through the liver. The liver can only produce so many enzymes necessary to metabolize drugs and supplements at one given time. When you use CBD and another medication at the same time, the two compete for these enzymes.

When this happens, the body can wind up with too much or too little of a particular drug in the bloodstream. Both outcomes can have serious consequences. If you have too little of a necessary medication in your bloodstream, your body can’t effectively use it for its intended purposes. If you have too much of a drug in your bloodstream, it may pose overwhelming or dangerous side effects.

Penn State researchers identified 57 medications that may interact with cannabinoids like CBD. Most doctors would advise against using CBD with these medications.

The only exception would be the use of cannabinoid-based medications like Epidiolex that are medically necessary for treating an underlying disorder. In those cases, doctors monitor patients closely for signs of potential negative interaction.

Can You Take CBD and Zoloft Together?

Zoloft, the brand name for sertraline, is not on the list of 57 medications that cause dangerous interactions. It does, however, cause sleepiness or changes in sleep patterns as a side effect.

Since CBD also works to promote sleep , the two may cause a strong and undesirable sedative effect when used in unison.

Using CBD with Zoloft may cause fatigue, confusion, dizziness, or difficulty with concentration. Side effects are usually more pronounced in seniors. If you’ve already used CBD in conjunction with Zoloft, avoid any activities that involve significant amounts of alertness and concentration, such as driving. Stop using CBD. Its effects will typically wear off within 12 hours.

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Most doctors would not advise patients to use CBD in conjunction with Zoloft. There may be exceptions for cannabinoid-based medications used to treat an underlying medical issue, like Epidiolex for the management of seizures. Doctors usually make assessments on a case-by-case basis in these scenarios.

What About Other Antidepressants?

Other antidepressants, like Prozac, Celexa, Paxil, and Lexapro, have similar side effects to Zoloft. These medications are all selective serotonin reuptake inhibitors, or SSRIs. It’s best to regard them all the same way. CBD is just as likely to amplify the side effects of these antidepressant medications.

Tricyclic antidepressants like Tryptizol, Anafranil, Allegron, Tofranil, and Gamanil also shouldn’t be used in conjunction with CBD. CBD can amplify the concentrations of these medications in your blood, leading to extreme versions of their side effects. Side effects of TCAs include high blood pressure, seizures, and accelerated heart rate. This isn’t a chance worth taking.

Do All Forms of CBD Cause Interactions?

CBD is most commonly taken as a sublingual tincture. Drops are placed under the tongue and pass into the bloodstream without first passing through the digestive system. This form of CBD gets to work quickly.

Alternatively, CBD can be taken in the form of a softgel capsule. These capsules are similar to any other supplement that people might use for wellness.

Some people prefer to vaporize CBD concentrate. Inhalation allows users to experience effects rapidly, but it may not be the best delivery method due to its potentially negative impact on cardiovascular health.

CBD in any form can cause interaction with certain medications. The only thing that changes from form to form is how quickly those interactions will take place. Orally ingested CBD will cause a delayed onset interaction, as it takes the body longer to process and utilize CBD in this form.

Interaction with sublingual CBD usually begins to occur within an hour as the CBD starts to take effect. Interactions related to inhaled CBD will begin nearly instantaneously. They’re most noticeable when users are already experiencing side effects from antidepressant medications like drowsiness. CBD can amplify that feeling within minutes, dramatically altering the user’s alertness.

The concern isn’t so much with the form of CBD as it is with the way CBD works. Because it reaches so many systems in the body and can inspire so many effects, there is no form of CBD users with antidepressants can take while reliably avoiding amplified side effects or compromised absorption.

Is CBD Safe on Its Own?

CBD is generally recognized as safe for most people, as long as it isn’t used in conjunction with prescription medications. Side effects from CBD use are rare and mild, and studies have demonstrated that humans can tolerate doses of up to 1,500 mg of CBD daily.

CBD does not have the potential for abuse or dependency , nor does it cause cognitive impairment. It’s fundamentally different from THC, the active constituent of cannabis that binds to receptors and produces a high.

CBD by itself is not a regulated or controlled substance. As long as the CBD product does not contain any residual traces of THC , it’s legal for use in all 50 states.

If You’re Taking Medications, You Should Always Ask Your Doctor Before Using Supplements

Many medications and supplements create the potential for interaction. If you’re currently taking any prescription medications, you shouldn’t take any supplements (including CBD) without first seeking approval from your doctor.

In some cases, you might be able to ring up your pharmacist. They’re often aware of potential interactions and will be able to give you advice.

Can People With Depression Use CBD?

Not everyone with depression uses antidepressant medications as a part of their treatment plan. If you’re using managed therapeutic or wellness approaches to cope with the symptoms and source of your depression, CBD obviously won’t cause any negative interactions with these forms of treatment.

That said, CBD is not an antidepressant. It’s a wellness supplement that often works to boost mood. It won’t treat or cure depression. People often use CBD simply because they enjoy the support it provides and the way it makes them feel.

Some mental health professionals have found merit in using CBD as part of a care plan for managing symptoms of anxiety or helping to treat those recovering from substance use disorders. CBD is not currently officially recognized for its direct benefits to the source of depression.

If you’re under the care of a mental health professional for depression treatment and you aren’t currently using any medications, speak with your mental healthcare professional about the possibility of incorporating CBD into your wellness plan and follow their advice. If you’re living with anxiety, CBD may be beneficial. It just doesn’t offer any benefits specific to depression.

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.

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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.

To chat about mental health in an open, non-judgmental space, join our Mentally Yours Facebook group.

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