Depression is a very serious condition which should not be taken for granted.
Due to social and health factors, depressed people have an imbalance of serotonin (happy hormone) levels, which leads to a debilitating state of body and mind.
On another note, it’s widely familiar that medical cannabis makes people feel more relaxed, happy and sometimes even aids in managing stress.
Considering this fact, it’s no wonder why people suffering from depression tend to consume more marijuana than others.
To be precise, individuals with depression and/or anxiety tend to use cannabis two to eight times more than those who don’t suffer from this condition. (1)
There are several conventional ways of treating depression and, sometimes, the best results are achieved by combining two or more therapies. Doctors usually prescribe antidepressants along with cognitive therapy and psychological consulting.
So here comes the main question:
If cannabis is so widely consumed among depression patients, do marijuana and antidepressants go along together well or not? How do they actually interact?
How do antidepressants work?
Antidepressants are a group of medications used for treating all types of depression, from mild to severe, but also for different mental disorders such as anxiety, ADHD, eating disorders, OCD and a few others. They can even be prescribed in combination with other medications.
There are several groups of antidepressants.
- Tricyclics antidepressants (TCAs) are still prescribed for treating depression but have mostly been replaced in clinical use by other types of antidepressants. Most common TCAs are Amitriptyline (Tryptanol), Nortriptyline (Allegron), Clomipramine (Anafranil), Imipramine (Tofranil), Dothiepin (Prothiaden).
- Selective Serotonin Reuptake Inhibitors (SSRIs), most commonly used for treating deep depression and anxiety. These serotonergic antidepressants influence the increase of serotonin hormone secretion. There are a number of SSRIs, but the best known are Sertraline (Zoloft), Fluoxetine (Prozac), Paroxetine (Aropax), Citalopram (Cipramil), Fluvoxamine (Luvox).
- Monoamine Oxidase Inhibitors (MAOIs) usually used and very effective in treating atypical depression. The best known MAOIs are Phenelzine (Nardil), Tranylcypromine and Moclobemide (Aurorix).
- Reversible Inhibitors of Monoamine Oxidase A (RIMAs), a subclass of MAOIs. They are not very widespread in Canada and the US.
- Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs), most effective in treating the major depressive disorder (MDD), but also other types of anxiety and depression. Most common SNRIs are Duloxetine, Venlafaxine, and Desvenlafaxine.
- Noradrenaline reuptake inhibitors (NRIs) are giving best results in treating the major depressive disorder (MDD), ADHD, anxiety and panic disorder. The best known is Reboxetine.
- Tetracyclic antidepressants (TeCAs) do not inhibit the reuptake of serotonin but do inhibit the reuptake of norepinephrine. Most common are Mianserin (Tolvon), Mirtazapine (Remeron) and Setiptiline (Tecipul).
- Melatonergic antidepressants
- Newer antidepressants
As you can see, antidepressant therapy usually deals with regulating serotonin levels. Unfortunately, medication associated with serotonin regulation tends to cause restlessness, mania, emotional liability and sleeping problems.
SSRIs are recommended by the doctors as the first choice for treating depression, along with cognitive therapy if necessary. However, the most popular antidepressants in the US and Canada such as Zoloft, Prozac and Lexapro tend to be overshadowed by a lot of controversies.
“Meanwhile, 30 years after Prozac was released, rates of depression are higher than ever.” – Olivia Goldhill, Quartz
A few meta-analyses and comprehensive review studies have found that these medications do not have (or have a very little) impact on mild and moderate short-term depression.
The big problem here is that antidepressants have a lot of adverse effects. Changes in weight, sleep, emotions, are just a few reasons why patients tend to quit their therapies.
Is this the reason why people that suffer from depression tend to use cannabis more? What happens if we combine antidepressants and cannabis?
Research and users’ experiences on mixing weed with antidepressants
When it comes to mixing marijuana and antidepressants, we can conclude more from the testimonies of patients and doctors that we can from the existing academic research and clinical trials. Sadly, academic and clinical databases have just a few reports on the topic.
Researchers from the Division of Child and Adolescent Psychiatry at the University of Connecticut Health Center made a review of published reports on cannabis and antidepressants interaction. As they pointed out, there have been only a few cases reported on adverse effects as a result of mixing cannabis and antidepressant drugs. (2)
This can mean a few things:
Either there are no adverse effects, they happen rarely or they do happen but are not reported due to social stigma. Additionally, there have been some reports on increased heart rate as a result of combining older types of antidepressants with weed.
As of recently, there have been several reports dealing with how CBD (the second most prominent cannabinoid in marijuana) interacts with pharmaceuticals. These findings claim that CBD deactivates P450 liver enzymes, which metabolize the majority of the drugs we use today. (3)
Luckily for us, this interaction is noticeable only if we take higher doses of CBD, and are negligible in lower doses of 2-10 mg/day.
I’d also like to stress that some reports claim that older antidepressants tend to produce more adverse effects when combined with cannabis, but newer generations of these medications tend to have a lower risk of negatively interacting with cannabis.
Medical experts, speaking from their experience with patients using antidepressants in combination with cannabis, say that the biggest problem is the inability to know which adverse effects to expect from the combination.
Doctors usually advise their patients to stay away from marijuana for a while until their prescription medications start to improve their mood.
From the doctors’ experiences, patients struggling with depression and anxiety who often combine antidepressants with other drugs and alcohol tend to have problems following their instructions and medical protocols.
But, what about patients themselves?
To find out what patients who like to smoke cannabis while taking antidepressants have to say about their experience, I did a little research online and found some interesting threads on Reddit.
A lot of patients say they usually don’t experience any adverse effects when combining SSRIs with marijuana.
For example, this thread was among the more interesting ones…
Here’s another user who had no issues:
As I previously mentioned in my article on marijuana and anxiety, both main cannabinoids found in cannabis (THC and CBD) can have very positive effects on anxiety and depression.
The downside is that cannabinoids produce biphasic effects. Too much THC can cause paranoia and panic attacks, as well as increased anxiety. So, if you have previously experienced paranoia or a panic attack as a result of smoking weed or eating an edible, you should probably stay away from cannabis during your antidepressant therapy.
Since CBD reduces the psychoactive effects of THC, stick to CBD-rich strains or CBD oils. You can find a lot of CBD products on the market, but I advise you to get yours from a reputable dispensary and in the form of a whole plant extract.
More related posts
Marijuana and Depression: Can Weed Help You Make a Positive Change? — breaking down the studies on marijuana and depression and exploring the 10 best strains for managing symptoms of depression.
17 Truly High CBD Strains And Their Effects (The Complete List) — high CBD strains bring forth a heap of medical benefits and are awesome for treating depression. You should say “hi”.
- Jonathan B. Bricker, Joan Russo, Murray B. Stein, Cathy Sherbourne, Michelle Craske, Trevor J. Schraufnagel, Peter Roy‐Byrne. “Does occasional cannabis use impact anxiety and depression treatment outcomes?: results from a randomized effectiveness trial”, August 2007, 24(6): 392-398
- Dr. Yifrah Kaminer, Pablo Goldberg, Daniel F. Connor, Psychotropic Medications and Substances of Abuse Interactions in Youth, Substance Abuse, July 2011, 31(1):53-57
- Lester M. Bornheim, E. Thomas Everhart, Jianmin Li, M. Almira Correia, Characterization of cannabidiol-mediated cytochrome P450 inactivation, Biochemical Pharmacology, March 1993, 45(6): 1323-1331