Hemp cannabinoids CBD and THC may interfere with the metabolism of some drugs, and in the case of antidepressants, they may also affect their effects at the level of the nervous system. According to available data, cannabis may affect the effectiveness of antidepressants, and the dose of both may be important for the occurrence and extent of this effect.
CBD and THC may affect the metabolism of antidepressants
After administration, the drug releases the active substances it contains, which are absorbed and distributed throughout the body. Drug metabolism (biotransformation) is a biochemical process of transforming drugs in the body, involving enzyme systems present in the liver, gastrointestinal tract, skin and other tissues. The end result are compounds that can be easily excreted from the body.
After administration of the drug, the process of its transformation begins, during which chemical processes take place leading to the decomposition of the drug. The resulting metabolites may be active - "healing" - or inactive. The latter are immediately excreted from the body.
The process of drug metabolism is influenced by many factors (genetic factors, gender, age, diseases, method of administration), a particularly important one in the context of antidepressants and marijuana is the interaction with other substances.
Vaughn, S.E. et al (2021), Journal of Personalized Medicine.
2021 review of research CBD and THC ) may interfere with one enzyme in the liver that is responsible for breaking down many drugs, including some antidepressants.
Reducing levels of this enzyme may lead to increased levels of the drug in the bloodstream and increase the risk of side effects. However, it is important to remember that the interactions between cannabis and antidepressants depend on the type of antidepressant.
recorded during studies resulting from the abnormal metabolism of some antidepressants caused by interaction with marijuana include:
- nausea,
- diarrhea,
- constipation,
- anxiety, fear,
- fatigue,
- dizziness,
- appetite disorders and weight changes,
- somnolence,
- excessive sweating,
- headaches,
The interaction of CBD and THC with antidepressants at the level of the nervous system
Both antidepressants and cannabis affect the “behavior” of the nervous system and neurotransmitters in the brain.
The most commonly used group of antidepressants are SSRIs, i.e. selective serotonin reuptake inhibitors. They can be used, among others: in people with anxiety disorders, depression, PTSD, social phobia .
Serotonin is a neurotransmitter that plays a huge role in the nervous system. It influences, among others: on well-being - too little serotonin contributes to depression and anxiety disorders . SSRI drugs work by inhibiting the reuptake of serotonin from the synaptic cleft of nerve cells, i.e. by leaving it for a longer time in a place where it can stimulate nerve cells to send impulses. The anti-anxiety and antidepressant properties result from the fact that the concentration of serotonin in the brain increases under the influence of drugs.
Consuming cannabis can also potentially worsen some mental health symptoms, such as anxiety, nausea and vomiting. High doses of cannabis can cause more serious symptoms such as delusions, hallucinations or psychosis.
Does cannabis have an antidepressant effect?
Research into the medicinal use of cannabis is still in its early stages, but there are some signs that cannabis may have a beneficial effect on symptoms of depression. For example, a 2020 review highlighted some evidence from animal studies and possible mechanisms by which CBD may reduce symptoms of anxiety and depression.
When to contact your doctor
Anyone taking antidepressants should consult a doctor before trying any cannabis products. Cannabis compounds can interact with antidepressants in various ways, which may increase the risk of side effects and reduce the effectiveness of antidepressants.
People should also discuss the side effects of cannabis products . These side effects may contribute to symptoms of depression such as anxiety or nausea.
Research shows that marijuana use may also affect the way SSRIs work - the cannabinoids CBD and THC also affect serotonergic centers in the brain. There is no data yet that would clearly explain the mechanism of this interaction, but the patient cases discussed in the article show that simultaneous use of antidepressants and marijuana may lead to a relapse of the disease or an exacerbation of its symptoms.
Due to the fact that this phenomenon was observed in people using cannabis on their own, it is difficult to determine what doses, method of administration or varieties of cannabis caused the exacerbation of the disease for which the patients were treated with antidepressants.
Scientists point out the need to conduct controlled research in this area, especially considering the enormous popularity of products containing hemp cannabinoids and the ever-growing number of people treated with antidepressants.
