Hemp oil has been around for ages, and it has been used as a treatment option for conditions ranging from chronic pain to epilepsy. It has anti-inflammatory properties that may help people with high blood pressure, and it has recently been used more and more as a substitute for prescription medications to treat stress, anxiety, and other conditions related to mental health.
In order to seize the anti-inflammatory and antioxidant health benefits of CBD, people have started to incorporate various CBD products in their diet, like CBD capsules, tinctures, oils, and others. But can the consumption of hemp oil have some drug interactions when it’s used together with antidepressants? Read on to find out.
What You Need to Know About Antidepressants and the Common Antidepressant Medications
Depression has been dramatically increasing over the past years, with statistics showing that 7.8% of Americans have had a major depressive episode in 2019 ( that’s 19.4 million people). It has increased even more as a result of the pandemic that resulted in 88,000 new cases diagnosed with anxiety and depression in the US in 2020. Symptoms of depression include feeling sad for a long period of time, fatigued, and irritable, which can also be paired with changes in sleep patterns, weight loss, loss of appetite, and other symptoms.
Depressed people have lower levels of serotonin, the vital neurotransmitter associated with memory, mood, and appetite. For that reason, a lot of depressed patients are doing therapy and are prescribed antidepressants.
Antidepressants affect how important neurotransmitters like dopamine, serotonin, and norepinephrine behave. Meaning, they balance out the neurotransmitters in order to improve the mood of patients. While this is a treatment option for a lot of patients, it may come with potential side effects like drowsiness, sleep disturbance, anxiety, sexual dysfunction, changes in appetite, and others.
Tricyclic antidepressants (TCAs) are one of the first antidepressants that were invented in the 1950s. They aren’t used as much today because they have a long list of potential side effects. Monoamine oxidase inhibitors (MAOIs) are the first antidepressants on the market that are only prescribed today if all other antidepressants fail to work. They aren’t used as much because they can interact with food and wine in a manner that may be deadly to patients. On the other hand, reuptake inhibitors are one of the most commonly prescribed antidepressants today. (Hillhouse et al, 2016)
Reuptake Inhibitors: SSRIs, SNRIs, and NDRIs
Before reuptake inhibitors appeared on the market, TCAs and MAOIs were the prescription drug of choice to treat depression. Reuptake inhibitors work by blocking the reabsorption (reuptake) of neurotransmitters back to the nerve cells. By blocking the reuptake, the levels of the neurotransmitter stay temporarily higher, which could strengthen the brain circuits that regulate mood.
The three types of reuptake inhibitors that target different neurotransmitters include:
- Selective serotonin reuptake inhibitors (SSRIs) – the most commonly prescribed FDA-approved antidepressants. They include Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), and Sertraline (Zoloft). SSRIs increase serotonin levels after only a couple of hours, although it may take a few weeks before patients notice the effects of the antidepressants.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) – the newer types of antidepressants. They block the reuptake of both serotonin and norepinephrine, and can take between 3-6 weeks to start working. SNRIs include Duloxetine (Cymbalta), Venlafaxine (Effexor), Desvenlafaxine ER (Khedezla), Levomilnacipran (Fetzima), and Desvenlafaxine (Pristiq).
- Norepinephrine and dopamine reuptake inhibitors (NDRIs) – affect the reuptake of norepinephrine and dopamine, and include drugs like Dexmethylphenidate (Focalin), Bupropion (Wellbutrin), and others.
CBD and the Endocannabinoid System
Our endocannabinoid system is responsible for our emotions, memory, immune system, pain, and our inflammatory responses. This system contains endocannabinoid receptors, CB1 and CB2, which are activated by the cannabinoids found in marijuana like tetrahydrocannabinol (THC) and cannabidiol (CBD).
While the cannabis plant contains both THC and CBD, the industrially grown hemp plant contains only trace amounts of THC. So, the industrial hemp plant has THC levels limited to 0.3%, meaning that the plant is CBD-dominant. It’s used to make a whole variety of CBD products including hemp oil, which is commonly used as a therapy procedure instead of antidepressants. (Kogan et al, 2007)
The 411 on CBD Oil and Depression
CBD has been researched in order to determine its effect on depression in multiple studies, although the majority of clinical studies that research the effect of CBD on depression are animal studies. For that matter, more human clinical trials are needed to reach a definitive conclusion as to the dose of CBD that can generally be prescribed to treat this condition. For this reason, healthcare providers that use CBD as a treatment option, tailor the dose according to the patient’s needs.
A clinical study, done by the Department of Psychiatry at the McGill University in Montreal Canada, indicates that CBD stimulates serotonin receptors, can help regulate serotonin levels and help with anxiety, which is basically what SSRIs do. Moreover, CBD can potentially be used as a treatment option for epilepsy, substance abuse and dependence, schizophrenia, social phobia, post-traumatic stress, depression, bipolar disorder, sleep disorders, and Parkinson’s disease, according to this 2018 article, that summarises several studies done on the subject.
Potential Drug Interactions Between CBD Oil and Antidepressants
When taken on its own, CBD oil doesn’t generally produce side effects. However, there are some potential interactions and possible adverse effects when it comes to using CBD oil together with other medications.
CBD oil inhibits the cytochrome P-450 (CYP450) enzyme. This enzyme, located in the liver, is responsible for the breakdown of medication in the body. When its function is disturbed, drug metabolism can be slowed down. Some foods (grapefruit) and medications tend to disturb the normal function of this enzyme, and CBD is one of them.
When the system is inhibited, antidepressants like MAOIs, TCAs, and antipsychotic medication tend to remain in the system for a longer period of time which may produce adverse reactions, so using them in combination with CBD isn’t recommended.
On the other hand, other antidepressants, like reuptake inhibitors, also affect this system, and their use may be inhibited when pairing them with CBD. SSRIs, like Lexapro, are metabolized by the cytochrome P450 (CYP) and the isoenzymes CYP2C19, CYP2D6, and CYP3A4, which are also some of the enzymes that CBD inhibits.
Final Thoughts on Taking Hemp Oil With Antidepressants
If you’re a person suffering from depression, and your current antidepressant medication isn’t doing the job for you, you’re probably looking into combining them with CBD, which is why you’re here, doing your research. Even though research suggests that CBD products are useful for treating depression, it may not be a good idea to mix them with your antidepressants, or other over-the-counter medication without consulting your healthcare provider.
An alternative therapy may be an option for you, but in order to change up your therapy and have success, it’s better to get your doctor’s approval first. This way, you can go ahead and purchase a whole plant CBD formulation that’s third-party tested and start treating your depression problem with this amazing ingredient.
Hillhouse, T. M., & Porter, J. H. (2015). A brief history of the development of antidepressant drugs: from monoamines to glutamate. Experimental and clinical psychopharmacology, 23(1), 1–21. https://doi.org/10.1037/a0038550
Kogan, N. M., & Mechoulam, R. (2007). Cannabinoids in health and disease. Dialogues in clinical neuroscience, 9(4), 413–430. https://doi.org/10.31887/DCNS.2007.9.4/nkogan