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Do Anti-depressants Adversely Interact with Marijuana?

Close to 15% of the US population is on anti-depressants and even though cannabis has been very well researched as a potent cure for depression, there are still people who need additional help to combat the blues.  

Patients suffering from depression are often prescribed medical cannabis for its irrefutable benefits, including management of anxiety, depression and other mental health issues. However, many people who are on anti-depressants often fail to disclose to their physician that they are also using cannabis medicinally.  

As a medicinal cannabis user, if you are on prescription medication for depression, then it pays to understand the relationship between cannabis and commonly used anti-depressants such as Lexapro or Celexa.  

How Cannabis Interacts with Anti-Depressants 

To understand the relationship the two share and how anti-depressants can affect the efficacy of medical marijuana, we need to quickly shed light on what the two are at their core: 

Marijuana, a substance extracted from cannabis flowers and legal in many states today, has been used for medicinal and recreational purposes for quite some time now. The main psychoactive compound in it, THC, is what provides feelings of relaxation and euphoria.  

Even though the herb is relatively harmless, and in fact, carries a plethora of health benefits, it can affect people differently, particularly when we take into account factors like dietary choices and family health history. For instance, depending on what a user is already ingesting (including certain kinds of food, drink and prescription medication), he/she may experience anxiety or paranoia after ingesting cannabis.  

Anti-depressants are a form of psychiatric prescription medicine which balances out specific chemicals in the brain to enhance and maintain positive mood, as well as influence positive thought patterns and behaviour. Depending on the patient’s mental health, unique types of anti-depressants may be prescribed including Tricyclics, MAOIs and SSRIs. Don’t worry about the abbreviations just yet as we’ll be briefly discussing these toward the end of the article.  

However, one of the most commonly used anti-depressants today is from the SSRI category – serotonin and noradrenaline reuptake inhibitors. SSRIs’ primary role is to block serotonin absorption in the brain, helping it function in a way so as to promote more a stable mental condition. Even though all these classes of drugs are widely categorised as anti-depressants, they are quite distinct from one another due to how they work. The well-known Lexapro is also an SSRI.  

As is the case with medical marijuana, patients respond different to different kinds of antidepressants. For patients who are consuming both, is there any possibility of adverse reactions that may dull the efficacy of either one or both?  

According to the product literature for escitalopram (Lexapro), using it alongside a ‘Schedule 1’ drug like cannabis may introduce side effects like confusion, drowsiness, dizziness and the inability to concentrate. Elderly patients may experience difficulty in thinking and judgement as well as motor coordination. However, the effects have not been extensively researched, and again, no two people are affected the same way.  

What Research Says about Cannabis Interaction with Anti-depressants 

Thus far, there hasn’t been extensive research on the possible drug interactions between cannabis and escitalopram. However, the studies that have been done over the last few years have revealed that any adverse reaction from combining the two are few and far between.  

Moreover, some researchers concluded that it is very rare to experience adverse effects when consuming cannabis on top of prescription medication for depression and anxiety. Still, this certainly does not mean that highly psychoactive (high THC) marijuana strains should be consumed in large doses along with anti-depression medicine.  

No matter, we would recommend that you have a frank and open discussion with your physician to discuss the possible adverse effects of using anti-depressants along with medical cannabis.  

As far as current research goes, there has been no documented effect or interaction between cannabis and anti-depressants, including Lexapro. But, it’s important to know that THC itself is the most potent and psychoactive cannabinoid in cannabis – it can bring about feelings of paranoia and anxiety, particularly when consumed in high doses. Certain cannabinoids in cannabis actually work as anti-anxiety treatments like the non-psychoactive CBD 

Therefore, patients who are on prescription medicine for depression and anxiety need to be careful when buying marijuana strains – chances are that those with a high concentration of THC will probably make anxiety (and consequently depression) symptoms worse, while those abundant in CBD can vastly improve symptoms.  

However, don’t be surprised if you’re doctor asks you to refrain from cannabis once he/she has prescribed an anti-depressant like Lexapro. As with any mental condition which requires medication, your doctor would ideally want to interpret results without the presence of any foreign substances in order to establish the efficacy of the treatment.  

Some doctors may even display outright scepticism when learning of a patient’s cannabis use and rightly so – even though cannabis is now legal in many US states, there is evidence revealing the fact those who self-medicate with cannabis are less likely to follow the doctor’s orders for treating depression through medication.  

In any case, we would, again, strongly recommend you discuss your cannabis use wholeheartedly with your doctor so that he/she may prescribe the most appropriate anti-depressant.  

How Safe is Lexapro When Combined with Medical Cannabis? 

Despite the fact that CBD strains are effective at combating anxiety and depression, they should generally not be mixed with Lexapro or other SSRI anti-depressants – the end goal should be to comfortably single out SSRIs from your system if you want to use cannabis to cure anxiety or depression.  

So, what we need to do here is carefully taper from one solution to the next. Once SSRIs have been completely depleted from your system, you can then experiment a little and find the right CBD product according to your depression or anxiety symptoms. Again, we would recommend you consult your physician before making the transition from SSRIs to medical cannabis.  

If it helps build the case for using cannabis with anti-depressants, or rather transitioning from the latter, one patient has reported that he was able to get off ‘dangerous SSRIs’ and successfully transitioned to CBD-only marijuana. In the last 3 years, it has been a life-changing experience for him – with no unsavoury side effects like cold sweats or the typical emotional roller coaster, often experienced as a result of going ‘cold turnkey’ on anti-depressants.  

We believe that in order to find a longer-term and safer cure for depression and anxiety, you should speak to your physician at the first possible opportunity, to assess what CBD dosages are required as you safely taper off from Lexapro.  

However, if you still feel that you stand to benefit in some way by combining a CBD strain with Lexapro, then we would suggest starting with 20mg of CBD to monitor how your system reacts. In any case, keep your physician in the loop! 

Understanding How Cannabis Affects Mental Health 

For majority of patients, cannabis can offer quick and sustained relief from anxiety and depression, making one feel less stressed, more relaxed and generally happier. However, this isn’t etched in stone simply because marijuana can induce certain adverse effects on mental health, particularly in patients who have a family history of depression or other mental illnesses. 

In some cases, medical cannabis can also either reduce the potency of prescription anti-depression medication or even render it useless.  

Doctors typically prescribe antidepressants to treat a range of mental health issues – continuing to use cannabis with these prescription drugs may introduce unpleasant reactions or even worsen a patient’s symptoms, in some cases. As stated earlier, it could also make it cumbersome or unnecessarily difficult for your doctor to properly diagnose your mental health condition.  

We’ve prepared a small list of different kinds of anti-depressant drugs (not a comprehensive list by any means) to help you determine which ones should not be combined with cannabis, in order to eliminate the likelihood of adverse side effects. 

Generally speaking, newer classes of antidepressants carry a low risk for contraindications. Patients suffering from anxiety and depression are typically prescribed anti-depression drugs that fall under 3 broad categories: 

SSRIs 

  • Prozac 
  • Aropax 
  • Luvox 
  • Lexapro  

Tricyclics 

  • Tryptanol
  • Protiaden 
  • Allegron 
  • Anafranil 

MAOIs – Monoamine Oxidase Inhibitors 

  • Nardil 
  • Aurorix 

Although research on the effects of anti-depression drugs and marijuana use hasn’t been extensive, certain contraindications have been reported, which may vary from person to person: 

  • Nausea 
  • Anxiety 
  • Headaches 
  • Gastrointestinal disturbance 
  • Panic  
  • Dizziness and/or drowsiness 
  • Muscle twitching 
  • Increased heart rate 
  • Brain fog 

Final Thoughts 

Using certain kinds of anti-depressants while consuming specific marijuana strains can not only exacerbate symptoms but also pose a danger to your overall mental health. Therefore, always: 

  • Give your doctor an honest and up front picture regarding your marijuana use 
  • Give your prescription medication some time to work as it can take up to several weeks 
  • Gauge the effects of the two and seek professional help to determine which one you should be consuming to alleviate depression and anxiety 

And with that, we wish you good mental health and many enjoyable cannabis sessions!  

References 

https://www.quora.com/Is-it-safe-to-take-Escitalopram-Lexapro-with-medical-Cannabis 

https://www.reddit.com/r/CBD/comments/6vrq6d/cbd_oil_and_lexapro_or_other_ssris/ 

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