We take a look at how safe it is to take CBD oil alongside the antidepressant Lexapro. Here's everything you need to know. According to studies, CBD has antidepressant-like properties. Does taking CBD together with conventional antidepressants make sense? Let’s find out.
Does CBD Oil Interact with Lexapro?
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Is it safe to use CBD with Lexapro? We take a look at the facts…
CBD oil is becoming popular for relieving the symptoms of various medical conditions. Among the most common reasons that people use CBD oil is to alleviate anxiety and depression.
This poses a potential problem as CBD oil may interact with many medications – including antidepressants.
In this article, we explore whether CBD oil interacts with the antidepressant Lexapro.
What Is Lexapro?
Lexapro is the brand name for a drug called escitalopram. It is a selective serotonin reuptake inhibitor (SSRI). SSRIs are a class of antidepressant. They’re used to treat major depressive disorder and generalized anxiety disorder.
SSRI antidepressants work by boosting the amount of serotonin in the brain. Serotonin is a neurotransmitter associated with feelings of happiness and well-being. Furthermore, low serotonin levels are associated with conditions like depression.
Initially, Lexapro was introduced in 2002. It became widely available by 2012. Although escitalopram may cause fewer side effects than similar medications, they can still occur in some cases.
The most common Lexapro side effects include:
- Reduced libido
- Ejaculation disorders
- Inability to orgasm
In addition to these, there is a small chance that Lexapro can worsen the symptoms of depression. As a result, this can lead to suicidal thoughts and behavior. In some patients, Lexapro may also cause several other serious side effects, including:
- Serotonin syndrome
- Hyponatremia (low sodium levels)
- Abnormal bleeding
- Cognitive and motor impairment
Lexapro should be used with caution for people with other medical conditions, including seizures and angle-closure glaucoma. Pregnant or breastfeeding women should only use Lexapro if the benefits outweigh the risks.
Since many antidepressants carry a long list of potential side effects, more and more people are turning to natural alternatives. One such option that has gained much attention in recent years is CBD.
How Can CBD Help Depression and Anxiety?
CBD (cannabidiol) is one of the many active compounds found in cannabis. These compounds are called cannabinoids. Unlike its cousin THC (delta-9-tetrahydrocannabinol), CBD does not cause an intoxicating ‘high.’
However, that is not to say that CBD has no psychoactive effects whatsoever. In fact, it has become well known for its supposed anti-anxiety and antidepressant properties.
According to a 2018 piece published in the journal Cannabis and Cannabinoid Research, anxiety and depression are the third and fourth most common issues for which people use CBD. As an aside, the first and second most common issues are chronic pain and arthritis/joint pain.
Nowadays, more people are turning to CBD to relieve the symptoms of anxiety and depression. However, scientists are still trying to ascertain exactly how the cannabinoid works for these conditions.
How Does the Body Process CBD?
There are several theories, but it seems likely that CBD influences the brain by acting on the endocannabinoid system (ECS). The ECS is a complex system of cell receptors (known as endocannabinoid receptors) and chemicals called endocannabinoids.
The body naturally produces these endocannabinoids. When they bind with cannabinoid receptors, they trigger a series of physiological reactions. These reactions help to maintain a state of homeostasis (balance) within the body.
One of the best-known endocannabinoids is called anandamide. It gets its name from the Sanskrit word for ‘bliss,’ which should give you some idea of its function. Among other things, anandamide regulates the serotonin system in the brain. It is released under stressful conditions and helps to restore a sense of calm.
Research has shown that CBD can slow down the rate at which anandamide is broken down by the body. This means that more of this endocannabinoid becomes available and its effects are greatly enhanced.
Therefore, in many ways, CBD works similarly to an SSRI antidepressant. It increases the levels of ‘feel-good’ chemicals in the brain, like serotonin, to reduce depression and anxiety.
Does CBD Interact with Lexapro?
If someone is considering using CBD to relieve any medical condition, it is important to know that it can interact with numerous medications.
Drug interactions happen because many different substances break down in the liver during a process called drug metabolism. The majority of prescribed medications metabolize in a particular pathway known as the CYP450 pathway.
This CYP450 pathway is comprised of several different enzymes that act on various substances. Therefore, when one takes two drugs that are metabolized by the same enzymes together, an interaction can occur.
In this situation, the two drugs compete with one another for the enzymes, so one or the other breaks down more slowly than usual. This increases the amount of that drug in the body, which can raise the risk of adverse effects.
Lexapro metabolism involves three different enzymes, which means it is less likely to cause interactions than some other medications. Even if it has competition for one of its pathways, there are still two more from which to choose.
The following enzymes metabolize Lexapro:
The CYP450 pathway also metabolizes CBD in the liver. The specific enzymes responsible for breaking down CBD are:
As it turns out, CBD inhibits the enzymes CYP3A4 and CYP2C6. As you can see, Lexapro and CBD share many of the same enzymatic pathways and, therefore, have a strong chance of interacting.
Is It Safe to Take Lexapro and CBD Together?
Taking CBD alongside Lexapro may increase the amount of antidepressants in the body. One might assume this is a positive thing, but it significantly increases the risk of harmful side effects if taken together.
The Depression Alliance recommends that anyone wanting to try CBD for depression should stop taking their medication first and then make the switch. However, it is essential that one does this gradually, carefully, and under the supervision of a doctor.
Stopping an antidepressant medication suddenly can cause the original symptoms to return. One may also experience withdrawal symptoms, including:
- Mood changes
- Sleep disturbances
- Flu-like symptoms
- Digestive issues
It is important to have an honest discussion with one’s doctor before making any changes so that they can help reduce dosages safely and effectively.
Using CBD for Depression and Anxiety
There are many different methods of taking CBD for anxiety and depression. For instance, one of the most popular ways is CBD oil. To do so, one can drop CBD under the tongue. Most manufacturers recommend holding the oil under the tongue for at least 30 seconds so that it can be absorbed effectively into the bloodstream.
Similarly to antidepressants, CBD oil can take a while to start working. However, one should not exceed the maximum dose recommended by their doctor.
If using CBD oil is inconvenient or doesn’t taste great, one could also try CBD capsules, edibles, or vaping.
Each of these consumption methods has its own advantages and disadvantages. To find out more, read our related article on the best forms of CBD products.
Does CBD Oil Interact with Lexapro? Final Thoughts
In conclusion, both Lexapro and CBD oil are popular remedies for depression and anxiety. However, taking the two together may cause a drug interaction as they are both metabolized by the same enzymes in the liver.
If you are taking Lexapro and would like to give CBD a try, talk to your physician first. They will guide you in managing your drug regimen safely and finding an effective dose.
If you have made the switch from antidepressants to CBD oil, we would love to hear from you. Share your experiences in the comments and help our community learn about the benefits and risks of CBD for depression and anxiety.
CBD and Antidepressants: Can You Take Them Together?
Depression has many faces, but it’s usually characterized by mood disorders, persistent feelings of sadness, and loss of satisfaction from previously enjoyed activities.
It rarely stems from a single event but rather as the combination of many factors, both individual and environmental ones. The symptoms of depression can range from mild to severe.
Depression can be treated with psychotherapy or with the use of medicines, although the most benefits are experienced by combining these two methods.
Since conventional antidepressants can have undesired side effects, people are starting to explore alternative remedies that are derived from nature — such as CBD.
CBD is a major cannabinoid found in hemp plants. It supports the endocannabinoid system (ECS) and helps maintain homeostasis throughout the body. Recent studies also show that CBD has anxiolytic and antidepressant-like properties.
In this article, we cover the topic of CBD and antidepressants; we’ll break down the pros and cons of each substance, compare their safety profiles, and explain what happens when you take them together.
Is CBD Good for Depression?
There is no single cure for depression because it’s a disease caused by multiple factors — and these factors often affect different areas of your life. There are many contributors to depression, including poor stress management, sleep deprivation, the loss of someone close or other traumatic events, and more.
There is some scientific evidence that CBD can alleviate the symptoms of depression, although these results haven’t been yet replicated in large-scale clinical trials.
Nevertheless, at least several high-quality studies have outlined CBD’s ability to help us cope with the whole set of symptoms and mental health problems commonly experienced together with depression.
Addressing these secondary conditions can indirectly improve your management of depression — lifting up your daily life.
Benefits of CBD for Depression
Depression is often accompanied by low mood, anxiety, apathy, and the loss of interest in activities that a person had considered joyful prior to their diagnosis.
Hopefully, CBD may help regulate certain processes in your body that can reduce the severity and frequency of these symptoms.
Here’s how you can use CBD for depression.
CBD May Reduce Anxiety
There’s a growing body of evidence to support the hypothesis that CBD has anxiolytic (anti-anxiety) properties in many individuals.
CBD has been studied in many types of anxiety disorders, including PTSD, obsessive-compulsive disorder, panic disorder, social phobias, and fear of public speaking.
One mechanism that helps CBD achieve such positive effects is the activation of the GABA receptor. GABA is the primary inhibitory neurotransmitter in our bodies; in simple words, it works like a hand brake for the brain — preventing neuroexcitation. Higher levels of GABA and lower levels of glutamate are associated with a better response to stress and lower levels of anxiety.
Another way CBD can help alleviate anxiety is by interacting with serotonin receptors in the brain. Serotonin is another important neurotransmitter that controls emotions, mood, and feelings of happiness. Low levels of serotonin are linked to depression, and while CBD isn’t a direct serotonin booster, it can block its reuptake so that the body can use it more efficiently — resulting in an elevated mood.
CBD May Improve Mood and Reduce Stress
As mentioned earlier in the article, CBD interacts with the endocannabinoid system (ECS). The ECS is the major regulatory system in all mammals, helping the body achieve and maintain homeostasis.
Homeostasis is a scientific term for the balance between all vital functions performed by other systems and organs. The ECS regulates memory, mood, pain perception, emotional processing, fertility, body temperature, appetite, sleep cycles, and more.
Anandamide, one of the two major endocannabinoids (endo = produced in the body) has a major role in the regulation of mood and pain threshold. Poor anandamide signaling can lead to a worse response to stress and cause a low mood. Permanent anandamide deficiencies may even result in anxiety disorders and depression.
That’s why anandamide has been dubbed as the “bliss molecule” in sanskrit.
CBD can improve anandamide signaling and slow down its breakdown by inhibiting the Fatty Acid Amino Hydrolase (FAAH) enzyme. As a result, your body can achieve higher and more stable concentrations of anandamide — improving your mood and reactions to stressors.
CBD Contributes to Neurogenesis
Studies have shown that CBD can stimulate the formation of new neurons in the brain, improving the plasticity of the hippocampus. The hippocampus is an important region in the brain that controls our cognitive performance, emotions, and mood.
Improved neuroplasticity of the hippocampus has been associated with better cognitive performance and a lower frequency of suicidal thoughts in patients with depression.
Can You Take CBD and Antidepressants Together?
“Antidepressants” is an umbrella term that covers a wide range of different products that use different mechanisms to treat depression. However, one common feature shared by all classes of antidepressants is that they are metabolized by the liver before they can start working in your body.
The liver contains a number of different enzyme systems that facilitate chemical reactions. One of these systems is the cytochrome P450 (CYP450) enzymes that metabolize the majority of medications, including antidepressants.
CBD has demonstrated potent inhibitory actions on these enzymes, suggesting that there could be interactions between CBD and antidepressants.
What kind of interactions are they? Does taking CBD and antidepressants together mean they produce a stronger effect? Or, as a result of that inhibitory mechanism, maybe they shouldn’t be taken at the same time?
What May Happen When You Take CBD with Antidepressants
CBD is generally considered safe, but it’s one thing when you take it alone, and the other thing when you combine it with other substances, such as antidepressants.
The most common side effects of CBD include lightheadedness, dry mouth, sedation, and (rarely) diarrhea. Taking CBD with other medications that have similar side effects may increase the likelihood of unwanted symptoms or toxicity.
Doubling Up On Side Effects
To put it simply, taking CBD at the same time with substances that cause sleepiness, such as benzodiazepines, antipsychotics, antidepressants, or alcohol may lead to increased fatigue, sleepiness, and possibly accidental accidents when driving.
Increased sedation may also occur when you combine CBD with other herbal supplements, such as melatonin, St. John’s wort, and kava.
Taking CBD together with stimulants — like Adderall — may lead to decreased appetite, while interactions between CBD and the diabetes drug metformin or certain heartburn medications may increase the risk of diarrhea.
CBD Can Alter the Effects of Antidepressants
Since CBD interferes with the enzymes in the liver that break down many drugs, including antidepressants, their interactions may lead to insufficient concentrations of the drug in the body — resulting in a subtherapeutic effect.
Depending on the type of interaction, CBD may also increase the drug concentration in your bloodstream, inducing toxicity and increased risk of side effects.
Researchers from Penn State College of Medicine analyzed existing data on five cannabis-based medications. Overall, the team found 139 medications that may be affected by cannabinoids. They further narrowed down that list to 57 medications, for which altered concentrations can be hazardous.
Among these medications, the researchers identified blood thinners, heart rhythm medications, thyroid drugs, and several medications for seizures.
However, antidepressants weren’t included in that list.
Does the Form of CBD Matter In CBD-Drug Interactions?
Inhaled CBD enters the blood the fastest, reaching peak levels within 30 minutes and increasing the chances of acute side effects.
CBD edibles for anxiety need more time to be processed in the digestive system and are less likely to produce high concentration levels. However, they may eventually reach high enough levels to interact with other medications.
Topical formulations are the safest from that trio because they do not absorb and reach the bloodstream; therefore, they can’t interact with other medications.
The problem with estimating the likelihood of CBD-drug interactions is the lack of regulations regarding CBD products, which may cause issues with purity, concentration, or safety.
That’s why reading third-party lab reports is critical if you want to make a well-informed decision when choosing your CBD product. These reports analyze the entire chemical profile of the tested sample, including its purity levels.
Common Antidepressants and Their Risks
Since there are different classes of antidepressants, some demonstrate a higher risk when taken with CBD oil than others.
Selective Serotonin Reuptake Inhibitors (SSRIs)
This is the most common type of antidepressant that doctors prescribe. They work similarly to CBD in the way they block the reabsorption of serotonin into the brain, leading to higher concentrations in the bloodstream and improved mood.
Common SSRI’s include:
The reason why SSRIs are the go-to treatment for depression is that they generally have fewer side effects than other antidepressants. Taking CBD with SSRIs would cause similar effects, as is the case for all antidepressants belonging to a specific drug category.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
They use a similar mechanism to SSRIs and entail the same level of risk, but some individuals may tolerate them better than others.
Common SNRIs include:
These drugs work by increasing levels of serotonin and norepinephrine in the brain. They can be very effective but also entail a higher risk than other antidepressants. For that reason, they’re only prescribed when SSRIs or SNRIs haven’t been working.
Common tricyclic antidepressants include:
Wrapping It Up: Talk to Your Doctor Before Taking CBD with Antidepressants
CBD may have more benefits in the long term than conventional antidepressants. One of the main reasons why people choose CBD instead of these treatments is that it doesn’t cause the user to build up dependencies on it.
CBD can exhibit the same degree of antidepressant effects but without getting you addicted to it.
Even though there’s no clinical evidence that would recommend the use of CBD as the go-to treatment for depression, it’s only a matter of time before such studies will start emerging on the surface.
Taking CBD and antidepressants together can lead to certain interactions that can change the way both substances are metabolized in the liver. Despite the lack of hard evidence that CBD directly interacts with antidepressants, there’s a well-grounded belief that taking them at the same time presents some concerns.
If you want to make sure you get the right CBD dosage and avoid potential interactions with antidepressants, consult your doctor before buying CBD oil.
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Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.