CQ Medical

Antidepressants and CBD Oil Interaction

Written by Jason Brett — Edited by Cathy Rozyczko on September 24, 2021 — Reviewed by Sarah Neidler, PHD

In a recent review of data, the New York Times that 25 million Americans have been on antidepressants for at least two years, a 60% increase from 2010. While antidepressants have helped millions of people, their efficacy as a long-term solution for managing depression and anxiety is debated due to users experiencing unwanted side effects and having difficulty getting off the medication.

CBD oil shares many beneficial qualities with antidepressants without producing the same potential for negative side effects. The CBD improves sleep quality, reduces anxiety, and improves general mood. In fact, some people find that after a period of adjusting to the right dosage of CBD oil they are able to reduce, or even altogether remove, the use of antidepressants.

If you’ve considered transitioning from antidepressants to CBD oil, or are thinking about combining the two, here’s what you need to know.

Interactions Between CBD and Antidepressants

While CBD oil is generally well-tolerated and taken without side effects, there are a few medications that, when used with CBD oil, can create adverse reactions. These interactions occur because CBD oil inhibits the cytochrome P-450 enzyme system.
The cytochrome P-450 system, found in the liver, breaks down medications into smaller substances that the body can more easily process. There is a range of natural foods and compounds that slow down this system, including grapefruit, St. John’s Wort, and of course, cannabidiol (CBD). When the system is inhibited, some medications, like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), remain in the system for a longer period, increasing the chance you will experience some of their unpleasant side effects.
While other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) also use this pathway, there is no definitive evidence to suggest the same adverse reactions are likely to occur.
These stipulations are not definite, partially because there is little research published on CBD and drug interactions, and partially because CBD oil possesses anti-depressive qualities of its own.

Side Effects of CBD Oil and Antidepressants

While it’s rare for adverse interactions to occur between CBD oil and antidepressants, you should still seek the advice of your physician or psychiatrist before combining the two.
Additionally, combining CBD oil with TCAs or MAOIs can put you at increased risk of experiencing the adverse side effects of the antidepressant. This is because these older groups of antidepressants have been shown to interact negatively with a range of medications and consumables, including those that inhibit the P-450 enzyme system. As such, there is a greater potential for an unfavorable interaction with CBD oil.

How to Safely Take CBD and Antidepressants Together

When combining CBD oil and antidepressants, or replacing current medication with CBD oil, it is always recommended to seek medical advice. Together, you and your doctor can create a plan to ensure there is minimal disruption to your system.
To minimize the risk of adverse reactions between CBD and antidepressants it is recommended that you start with a lower dose of CBD than what your product recommends and incrementally increase the dosage overtime if needed. This will allow you to get used to the effects of CBD, and also allow you to decrease your antidepressant strength if desired. Ultimately, starting slow and being conservative with dosage will allow you to more easily monitor any changes to your body and mental state.

Avoiding the Side Effects

Given the above list of potential side effects, you may feel discouraged from using CBD oil if you take antidepressants. However, many people actually go on to replace their antidepressants with CBD oil completely. As well as its’ host of other health benefits, CBD oil has been shown to relieve anxiety, encourage relaxation, and improve mood.

Knowing what potential interactions may occur will enable you to be aware of any warning signs. For reference, the table below breaks down the most common antidepressant medications and their side effects, many of which you may feel more keenly if a negative interaction occurs with CBD oil.

Antidepressant TypeBrands IncludeCommon Drug Side EffectsPossible Side Effects of Combining Medication + CBD Oil
SSRIsZoloft; Prozac; Sarafem; Celexa; Lexapro; Paxil; LuvoxNausea; insomnia; nervousness; tremors; decreased libidoThe effectiveness of SSRIs should not decrease when combined with CBD oil
SNRIsPristiq; Khedezla; Cymbalta; Fetzima; Effexor XRNausea; drowsiness; fatigue; constipation; dry mouthThe effectiveness of SNRIs may be decreased when combined with CBD oil
TCAsAnafranil; Norpramin; Tofranil; Pamelor; SurmontilConstipation; dry mouth; fatigue. It May also result in low blood pressure and irregular heart rateDue to the high risk of adverse side effects when combining TCAs with other medications the use of CBD oil is not advised
NDRIsWellbutrin; Forfivo; AplenzinNausea; vomiting; constipation; dizziness; blurred visionThe effectiveness of NDRIs may be decreased when combined with CBD oil
MAOIsMarplan; Nardil; Emsam; ParnateNausea; dizziness; drowsiness; insomnia; restlessnessDue to the high-risk profile of MAOIs in producing adverse reactions, it is not advised to combine with CBD oil