The cannabis plant has been around us in many shapes and forms throughout the years. People have been using this plant as a medicine as well as to take the edge off. Generally, people are after the psychoactive and pain-relieving effects that the main cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD) provide.
Cannabis use increases year after year and some people are mixing it with other prescription medication and drugs which can result in side effects. Previously we have covered mixing Zoloft with CBD oil, and in this article, we’re focussing on what are the drug interactions between hemp and Sertraline.
What Is Hemp?
Hemp, which is also called industrial hemp, is a variety of the Cannabis Sativa plant. It’s one of the fastest-growing plants and because of that, it’s grown for industrial use. The most common use of hemp is to make textiles, paper, rope, biodegradable plastic, biofuel, food, and other commercial items.
Hemp is also used as a source of the cannabinoid CBD. But apart from the higher amounts of CBD, industrial hemp also contains levels of THC. While industrial hemp and cannabis (marijuana) both derive from the species Cannabis Sativa, hemp has significantly lower levels of THC compared to cannabis.
CBD Products and Their Use
The endocannabinoid system in our body has the role of regulating our physiological and cognitive processes. Apart from those roles, it can also be stimulated when it comes into contact with CBD. CBD stimulates the endocannabinoid system and binds with the CB1 and CB2 cannabinoid receptors. As a result, it reduces pain as well as inflammation in the body. That’s why people use CBD products like CBD oils and tinctures for pain relief and relaxation which have been a method for treating chronic pain. (Boyaji et al, 2020, Argueta et al, 2020)
Apart from being used as a pain reliever, the main cannabinoid found in hemp, CBD, is used for easing the symptoms of conditions related to depression because of its antipsychotic properties. CBD has also been used as a treatment for ADHD and case study patients from the study done in 2017 by the King׳s College London “experience a reduction of symptoms and no cognitive impairments following cannabinoid use”. Moreover, a recent study done by the Centro Neurolesi “Bonino-Pulejo” in Italy concluded that CBD may be a treatment option for epilepsy for patients who are resistant to all conventional anti-epileptic drugs.
SSRIs and Their Use
SSRIs or Selective Serotonin Reuptake Inhibitors are a class of prescription drugs that are used as antidepressants. They are generally used to improve mental health and treat depressive disorders, anxiety disorders, and other disorders that affect serotonin levels in the body which were previously treated with tricyclic antidepressants. When the levels of the neurotransmitter Serotonin decrease, antidepressant medication is prescribed to increase its levels.
FDA-approved SSRIs include:
- Citalopram (Celexa);
- Escitalopram (Lexapro);
- Fluoxetine (Prozac);
- Paroxetine (Paxil, Pexeva);
- Sertraline (Zoloft).
What Is Sertraline?
Sertraline is a selective serotonin reuptake inhibitor sold under the name Zoloft as a common prescription drug for depression. Apart from that, Sertraline is used for conditions like:
- Obsessive-compulsive disorder;
- Social anxiety disorder;
- Panic disorder;
- Premenstrual dysphoric disorder (PMDD);
- Post-traumatic stress disorder (PTSD).
While Sertraline is used medicinally, it can also cause unwanted side effects and withdrawal symptoms. For that reason, healthcare providers usually start with a low dose.
Side Effects of CBD and Sertraline
Side Effects of SSRIs
Generally, SSRIs have fewer side effects compared to other types of antidepressants. While taking them, patients can experience some of these mild side effects:
- Dry mouth;
- Excessive sweating;
- Blurred vision and dizziness;
- Loss of appetite and weight loss;
- Indigestion;
- Diarrhea or constipation;
- Feeling agitated, anxious;
- Headaches;
- Insomnia;
- Low sex drive;
- Erectile dysfunction.
Side Effects of CBD
Although CBD doesn’t produce withdrawal symptoms, it can cause some minor side effects like:
- Dry mouth;
- Diarrhea;
- Drowsiness;
- Reduced appetite;
- Fatigue;
- Can interact with blood thinners.
Drug Interactions Between Hemp and Sertraline
While the combination of CBD with other drugs hasn’t been researched thoroughly, Sertraline has. Mixing it with grapefruit juice or high doses of alcohol can result in decreased blood pressure and enhanced sedation. (Harvard Health Publishing, 2005, and Graham et al, 2007)
Using Sertraline in combination with the CBD found in hemp may come with a few side effects. Both drugs can cause some of the same side effects like headaches, drowsiness, dizziness, and difficulty concentrating, so mixing them might increase these potential side effects. Older people may experience impaired judgment, thinking, and motor coordination.
A study done in 2011 by the Hokuriku University in Japan, found out that “using CBD may block the optimal performance of the liver enzymes which help the body absorb antidepressants”. As a result, mixing Sertraline and CBD might cause SSRI build-up in the liver. So in a way taking CBD with Sertraline may decrease the efficacy of Sertraline.
Final Thoughts on Taking Hemp and Sertraline
Interactions between Hemp (and its main cannabinoid CBD) and Sertraline (a selective serotonin reuptake inhibitor) are rare. Primarily, CBD interacts with Sertraline by potentially increasing the common side effects of both drugs like dizziness, drowsiness, headaches, and difficulty concentrating. Potential interactions also include blocking the liver’s enzymes and storing more antidepressants in the body than needed.
Even though both drugs may not cause some serious interactions, if you are planning to use them, it would be best to consult your healthcare provider in order to get an appropriate dose with little to no side effects.
Additional sources
Boyaji S, Merkow J, Elman RNM, Kaye AD, Yong RJ, Urman RD. The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence. Curr Pain Headache Rep. 2020 Jan 24;24(2):4. doi: 10.1007/s11916-020-0835-4. PMID: 31980957.
Argueta, D. A., Ventura, C. M., Kiven, S., Sagi, V., & Gupta, K. (2020). A Balanced Approach for Cannabidiol Use in Chronic Pain. Frontiers in pharmacology, 11, 561. https://doi.org/10.3389/fphar.2020.00561
“Grapefruit and Medication: a Cautionary Note.” Harvard Men’s Health Watch, vol. 10, no. 4, 2005, pp. 7-8.
Graham, K., & Massak, A. (2007). Alcohol consumption and the use of antidepressants. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 176(5), 633–637. https://doi.org/10.1503/cmaj.060446