Antidepressants and CBD Oil Interaction

Written by Jason Brett — Edited by Cathy Rozyczko on September 24, 2021 — Reviewed by Sarah Neidler, PHD

Page Overview

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.

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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.

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.

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