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.
“Generally speaking, you can safely use CBD supplements when you’re taking antidepressants. However, there are a couple concerns,” Dr. 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.)
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.
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.
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.
There’s no denying that CBD, aka cannabidiol, has been the reigning trend of the last few years, 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.
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.
Moreover, as of now, no study has provided evidence that CBD can be used specifically to replace sertraline.
To back this up, a study published in the British Journal of Pharmacology found that CBD induced fast and sustained antidepressant-like effects in animal models comparable to those of imipramine. Imipramine is a tricyclic antidepressant (TCA) used mainly for the treatment of depression.
However, while clinical reasonings opposed the conclusions of theoretical reasoning, we can only make general educated guesses until studies are completed that provide a more substantial data set and a solid conclusion.
Dependent on brain serotonin
Third and finally, another study states that because sertraline is metabolized with the help of several enzymes, it would be complex for a single agent like CBD to cause a severe or clinically important interaction.
The study found that CBD exhibits anxiolytic (anti-anxiety), antiepileptic, and antipsychotic properties, which can reduce depression linked to stress. This benefit of CBD for depression tends to be linked to its positive impact on serotonin receptors in the brain.
So, to conclude on this point, replacing sertraline with CBD is not recommended, and as always, we would recommend that you consult with your doctor if you plan to do so.
CBD is also used for treating conditions such as anxiety, insomnia, and a variety of chronic pain. But it can cause side effects such as headaches.
The conclusions that can be drawn? You should, of course, talk to your doctor before taking any new medications (prescription or non-prescription). If you combine Zoloft with either CBD or weed, however, you should be fine. Just be careful, because you could end up more zoned out than you expect.
There’s only one study providing more specific information about that possible interaction, and it was done nearly ten years ago in Japan. The research found that CBD may block the optimal performance of the liver enzymes which help the body absorb antidepressants. In simple terms, taking CBD may cause Zoloft and other SSRIs to build up in the body in greater amounts than normal, increasing the effects – and side effects – of the antidepressant.
They say that maybe because those who use pot are afraid to report any problems they may experience. However, doctors prescribe newer generations of psych meds (like Zoloft) because they’re much less likely to cause drug interactions, so the researchers believe it’s very possible that harmful interactions with CBD or THC are “relatively rare or do not happen.”
Cannabinoids and Zoloft: What We Know
What the researchers found was surprising: there are very few reports of adverse interactions.
The rest of the “knowledge” that exists about combining CBD and SSRIs like Zoloft isn’t really knowledge. It’s mostly anecdotal evidence and common sense.
Drug interaction databases note that both CBD and Zoloft can cause some of the same side effects, like drowsiness, dizziness, and loss of concentration. So using them together can potentially increase the severity of those side effects. They only classify the interaction as “moderate,” though, meaning you should simply be careful when mixing the two drugs, and watch carefully for negative effects until you know how you’re affected.
Nearly 35 million Americans are considered “regular users” of marijuana, with another 20 million said to indulge occasionally. As you undoubtedly know, pot contains a number of cannabinoids – not just THC, but also CBD.