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CBD And Antidepressant Interactions

Now more than ever people are being prescribed and are taking antidepressants. The rise in antidepressant prescriptions can easily be contributed to the high level of stress that people stay under in today’s hectic world. Trying to keep up with finances, work, and home life is more demanding than ever, and coping with it all can cause anxiety in almost anyone. When things aren’t going as planned, it can also cause depression.

What Are Antidepressants?

Antidepressants are medications prescribed by doctors for treating depressive disorders. These medications can also be prescribed to treat some anxiety disorders, pain management, and help to manage some addictions.

Antidepressants can not be purchased over the counter without a prescription. Antidepressants can also come with many side-effects and they vary from drug to drug. Some of the common side-effects associated with antidepressants are weight gain, headaches, dizziness, dry mouth, emotional blunting, and even sexual dysfunction. Of course, not everyone will experience all of the adverse effects, but they can be quite common.

How Do Antidepressants Work?

Many researchers think that the benefits of antidepressants come from how they affect specific brain circuits and chemicals called neurotransmitters. These neurotransmitters pass signals from one nerve cell to others in the brain. These chemicals are norepinephrine, dopamine, and serotonin. Different antidepressants appear to affect how neurotransmitters behave in various ways. Below are some of the main types of antidepressants.

The most common antidepressants that are prescribed are called uptake inhibitors. Reuptake is the process in which neurotransmitters are reabsorbed naturally back into nerve cells in the brain after they have been released to send messages between the nerve cells. The job of the reuptake inhibitor is to prevent this from happening. Instead of being reabsorbed, the neurotransmitter stays temporarily in a gap between nerves called synapse.

The benefit of this is keeping levels of the neurotransmitters higher and improving communication among the nerve cells. In turn, this can strengthen circuits in the brain and helps to regulate mood.

There are 3 kinds of neurotransmitters:

SSRIs – Selective Serotonin Reuptake Inhibitors

These are the most commonly prescribed antidepressants by doctors. They include Celexa, Luvox, Lexapro, Paxil, Zoloft, and Prozac. Symbyax is a combination of the SSRI Prozac and Zyprexa, a drug approved for schizophrenia and bipolar disorder. Abilify, Seroduel, and Rexulti are used as add-on therapy for depression.

Doctors will often use a combination of drugs for depression that is treatment-resistant. The newest antidepressants are Viibryd and Trintellix and they affect the serotonin transporter similar to an SSRI, but they also affect other serotonin receptors to relieve major depression symptoms.

SNRIs – Serotonin and Norepinephrine Reuptake Inhibitors

Cymbalta, Effexor, Khedezla, Fetzima, and Pristiq are new antidepressants. Their job is to block the reuptake of both norepinephrine and serotonin.

NDRIs – Norepinephrine and Dopamine Reuptake Inhibitors

This is another class of reuptake inhibitors that affects dopamine and norepinephrine. The only drug in this class as of now is Wellbutrin.

Another class of antidepressants are MAOIs

MAOIs – Monoamine Oxidase Inhibitors

This class of antidepressants was first discovered in the 1950s. They inhibit the action of the enzyme called monoamine oxidase and its role to break down monoamines. When this effect is blocked, it makes more neurotransmitters available for use in mood regulation.

MAOIs are not used as commonly as other antidepressants because of the potential for severe reactions with foods high in tyramine. Taken incorrectly they can cause a rise in blood pressure and other side effects. However, they are useful in treating agoraphobia, bulimia, PTSD, social phobia, bipolar depression, and borderline personality disorder. These drugs include Emsam, Marplan, Nardil, and Parnate. They are usually prescribed when other antidepressants have failed.

What Is CBD Oil?

Cannabidiol, commonly known as CBD, is a product made from cannabis and has been diluted in some type of oil. CBD oil will not cause psychoactive side effects like smoking or vaping marijuana will do. CBD has been isolated from other cannabinoids in the plant, specifically, THC which does cause psychoactive effects.

Although there are more studies and research that need to be conducted concerning the benefits of CBD products, it is thought by many to be a potential treatment for many conditions including depression, anxiety, epilepsy, and pain disorders.

Mixing CBD Oil And Antidepressants

As new laws continue to increase, CBD is gaining steadily in popularity. New potential uses for the product are being discovered. On the other hand, antidepressants have been prescribed by doctors for decades and are considered the first option of treatment for many mental health conditions. While Cbd and antidepressants differ a great deal, some indications for treating depression and anxiety overlap.

Since there is some evidence that suggests CBD oil could help those that suffer from anxiety and depression, many people that are currently taking antidepressants are wondering whether mixing CBD with their prescription medication could be beneficial and safe.

SSRIs are the first-line medications used for the treatment of depression. They are well researched and offer many people relief with fewer side effects than other treatment options. People have reported that the use of CBD oil in combination with their SSRIs resulted in improved symptoms of depression without additional side effects.

That being said, this combination may not be for everyone. CBD has the potential to interact with SSRIs, and other antidepressants, resulting in increased amounts of antidepressants in the body and a higher risk of side effects.

What Is The CYP450 Pathway?

Located primarily in the liver, the CYP450 pathway is a metabolic pathway and it’s made up of many types of enzymes. The job of these enzymes is to alter or break down substances like medications and prepare them to be eliminated from the body. A unique name is given to each enzyme. Two examples of enzymes that are responsible for metabolizing medications in the body are CYP3A4 and CYP2D6. The two specific enzymes are many times responsible for the numerous reports of drug interactions in regards to the CYP450 pathway.

It has been found that CBD oil inhibits the CYP3A4 and CYP2D6 enzymes. This gives CBD the potential to interact with numerous medications by reducing their metabolism and increase the amount of medication that circulates in the body. Various antidepressants are metabolized by the CYP2D6 enzyme, so getting them cleared from the body may be reduced by using CBD oil. Like so many things dealing with CBD products, it is unclear how significant this interaction could be. It is not yet understood if this is because of the dose amount of CBD that is ingetsed or if it’s related to the route of ingestion of the CBD.

Is It Safe To Use CBD With Antidepressants?

Even though CBD is a natural product that shows promise in treating many medical issues such as anxiety and depression, it’s possible CBD could have an impact on some medications, antidepressants among them.

According to Peter Grinspoon, M.D., an instructor at Harvard Medical School stated, “Generally speaking, you can safely use CBD supplements when you’re taking antidepressants.

However, there are a couple of concerns. 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. CBD does have hypothetical drug interactions; the question is whether these are clinically important or not.”

Grinspoon also stated that “CBD also inhibits the system that metabolizes a lot of serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and antipsychotics as well.” So what you must take away from Grinspoon’s comments is that if you take CBD while also taking antidepressants, hypothetically they could interfere with how the medications are metabolized.

Only your doctor could advise you about using CBD along with your antidepressants. It is always so important to discuss any change in your medications with your doctor so you can avoid any unnecessary or potentially harmful interactions.

Can CBD Replace Antidepressants?

While many people do believe that they are treating mild to moderate depression and anxiety with CBD, if you are already taking prescription antidepressants, this would also be a discussion to have with your doctor. His advice could depend on the amounts of and what types of antidepressants you are taking.

Many people do like the way they feel or in some cases, don’t feel when they are taking antidepressants. So potentially, CBD could be an alternative for some. However, the importance of discussing getting off an antidepressant must be talked over with your doctor.

It is never advisable to stop taking antidepressants all at once. If you would like to try CBD in place of your current antidepressant, only your doctor can tell you how to make the transition safely or if you should do it at all.

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