CBD and SSRI medications like Zoloft each can treat stress and depression and have similar side effects – is it safe to take both of them at the same time? In our latest question and answer, the pharmacist discusses whether or not Zoloft (sertraline) interacts with CBD (cannabidiol).
CBD Oil and Zoloft: Dangerous To Use CBD When On SSRI?
More than one-hundred million Americans are on antidepressant medications, and tens of millions of them take Zoloft on a daily basis. In fact, Zoloft is the most commonly-prescribed psych med in the United States, even more popular than other drugs in the “SSRI” class like Lexapro, Paxil, Celexa and Prozac. (Zoloft is the brand name for the medication sertraline.)
Nearly 35 million Americans are considered “regular users” of marijuana, with another 20 million said to indulge occasionally. As you undoubtedly know, pot contains a number of cannabinoids – not just THC, but also CBD.
And a growing number of Americans say they use CBD-based products; the latest estimate from the Gallup polling organization puts that figure at 14% of all adults.
Needless to say, there’s a decent amount of crossover between those taking Zoloft and those consuming CBD. That’s even easier to believe when you consider that:
- People take antidepressants, including SSRIs like Zoloft, to fight stress and depression.
- Existing evidence on CBD products shows that they’re often useful to fight stress and depression.
- And, of course, one of the major effects of using cannabis is that it relieves – say it with us – stress and depression.
Is using some or all of them at the same time a problem?
It’s possible; there’s very little research on the subject. But if it is a problem, it’s probably not a major issue for most people.
Cannabinoids and Zoloft: What We Know
There has only been one rigorous medical review examining the effects of combining Zoloft (or similar SSRIs) and CBD use. It was done at the University of Connecticut and considered all the evidence involving concurrent use of antidepressants (“psychotropic” drugs) and psychoactive drugs like cannabis.
What the researchers found was surprising: there are very few reports of adverse interactions.
They say that maybe because those who use pot are afraid to report any problems they may experience. However, doctors prescribe newer generations of psych meds (like Zoloft) because they’re much less likely to cause drug interactions, so the researchers believe it’s very possible that harmful interactions with CBD or THC are “relatively rare or do not happen.”
CBD and Zoloft: What Medical Experts Think
The rest of the “knowledge” that exists about combining CBD and SSRIs like Zoloft isn’t really knowledge. It’s mostly anecdotal evidence and common sense.
Drug interaction databases note that both CBD and Zoloft can cause some of the same side effects, like drowsiness, dizziness, and loss of concentration. So using them together can potentially increase the severity of those side effects. They only classify the interaction as “moderate,” though, meaning you should simply be careful when mixing the two drugs, and watch carefully for negative effects until you know how you’re affected.
There’s only one study providing more specific information about that possible interaction, and it was done nearly ten years ago in Japan. The research found that CBD may block the optimal performance of the liver enzymes which help the body absorb antidepressants. In simple terms, taking CBD may cause Zoloft and other SSRIs to build up in the body in greater amounts than normal, increasing the effects – and side effects – of the antidepressant.
The conclusions that can be drawn? You should, of course, talk to your doctor before taking any new medications (prescription or non-prescription). If you combine Zoloft with either CBD or weed, however, you should be fine. Just be careful, because you could end up more zoned out than you expect.
Aspiring political journalist & small-town stoner currently living in Los Angeles. My day job consists of studying the mental health effects of cannabis in my role as a mental health case manager at Kaiser Permanente. By night, I roll fat joints and do my best to debrief Weed News readers on the latest cannabis happenings.
Does CBD Interact With Zoloft (Sertraline)?
In our latest question and answer, the pharmacist discusses whether or not Zoloft (sertraline) interacts with CBD (cannabidiol).
I currently take 50mg of Sertraline, I have tried increasing Sertraline but I don’t like the side effects. The 50mg of Sertraline has improved my overall mood but I still feel anxious. Would it be safe to also use CBD oil alongside Sertraline?
At a glance
- Drug interaction studies with CBD are lacking, but preliminary evidence suggests a variety of potential interactions based on what we know of CBD metabolism.
- The chance of CBD having a clinically significant interaction with Zoloft (sertraline) is low based on available data.
Cannabidiol, also known as CBD, is a major component of cannabis (i.e. marijuana).
While THC (delta-9-tetrahydrocannabinol) is likely more well-known due to its psychoactive and euphoric effects, CBD makes up almost 40% of cannabis extracts and has a wide range of potential benefits when used medicinally, although more studies are certainly needed to better understand the compound.
While the exact dosing of CBD explored in studies ranges wildly (from 1 mg to over 600 mg), there is preliminary positive evidence for a variety of indications, including:
- Multiple Sclerosis
- Parkinson’s Disease
Further adding to the potential benefit of CBD, is the fact that it is considered CBD is considered “non-euphoric”, even at high doses.
CBD has recently exploded in popularity, with multiple products and brands available at a number of natural health food and supplement stores. It is even being mixed with traditional consumer products, like water!
With this, it is important to consider potential drug interactions with prescription medication.
Due to the relatively recent nature of CBD use for medicinal purposes, there is a distinct lack of studies when it comes to potential drug interactions between CBD and prescription medication, like Zoloft (sertraline).
Zoloft – CBD (Cannabidiol) Interaction
Zoloft (sertraline), an SSRI (Selective Serotonin Re-uptake Inhibitor), is metabolized extensively by a variety of CYP enzymes, including:
As discussed above, research indicates that CBD can inhibit many of the metabolizing enzymes listed above.
Therefore, the use of CBD and Zoloft together could theoretically increase the risk of adverse effects, due to increasing Zoloft concentrations in the body.
However, additional data on CBD drug interactions indicate the risk of an interaction between CBD and Zoloft specifically is low.
There are many studies that postulate that while CBD does inhibit metabolizing enzymes, it is not significant and the blood concentrations needed to affect these metabolizing enzymes in humans far exceeds what is possible with usual dosing.
In addition, since Zoloft is metabolized in the body by a number of enzymes, it is thought that it would be difficult for a single agent to cause a clinically significant interaction. In the words of one study:
“The observation that multiple enzymes appear to be involved in sertraline [Zoloft] metabolism suggests that there should be no single agent that could substantially alter the pharmacokinetics of sertraline, nor should there be any single drug-metabolizing enzyme genetic polymorphism (e.g., CYP2D6, CYP2C19, CYP2C9, UGT1A1) that could profoundly impact the pharmacokinetics of sertraline.”
Nevertheless, until studies are completed that specifically look at how CBD interacts with Zoloft (sertraline), we can only make educated guesses. It would be prudent to let your doctor know you are interested in trying CBD, so you can be appropriately monitored, just in case.