Can I Use Weed When I’m on Antidepressants?

Weed might affect the way you react to your medication. Read on to learn why, some associated risks, and other important information about cannabis and depression.

Weed use — whether smoking, vaping, eating edibles, or using CBD extracts — is pretty common.

Having depression and taking antidepressants is also pretty common.

But can weed and antidepressants mix?

Here’s a look at what can happen if you use weed when you’re on antidepressants, including the ways it may affect antidepressants in your body, and the risks — and potential benefits — of using weed or taking CBD when you have depression.

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Will marijuana affect my antidepressants?

If you take antidepressants to help treat your depression, you may be wondering if you can also use weed.

The short answer is, it’s probably better to avoid weed while on antidepressants. Here’s why.

First, let’s start inside the body.

Whether it’s food, drink, medication, or drugs, your body breaks down, or metabolizes, everything that you consume.

This process converts the substances you’ve consumed so that your body can eliminate them.

One of the main players responsible for metabolism is a family of enzymes in the liver called cytochrome P450 (CYP450).

Now, back to antidepressants and weed.

Research indicates that CYP450 enzymes metabolize cannabinoids, the chemical substances in weed including THC (tetrahydrocannabinol) and CBD (cannabidiol). CYP450 enzymes metabolize antidepressants too.

The problem is, cannabinoids also inhibit CYP450 enzymes, making it harder for them to do their job of metabolizing your antidepressants.

This affects both how your antidepressants work and their effect on your body. Here’s why.

What does metabolism have to do with antidepressants?

When you began taking your antidepressants, you and your doctor likely found the correct dosage through trial and error — based first on general dosage recommendations for your body type, then adapted according to the specific ways you reacted.

Your metabolism determines in part the dosage balance you found together.

If your body metabolizes more slowly, it means medication concentrations in your blood remain higher for longer, so your medication dosage will be lower.

A faster metabolism means medication leaves your body more quickly, so your dosage will be higher.

By tuning your dosage to the speed at which your body metabolizes your antidepressant, it ensures that you always have the correct levels of antidepressants in your body and keeps your medication functioning the way it’s supposed to.

How does weed impact antidepressant metabolism?

When other chemicals, including weed, affect your metabolism, it also affects the way your body reacts to your antidepressant dosage.

And if your dosage isn’t adapted to the effects of that new chemical, the levels of medication in your body are no longer correct.

Take the antidepressants escitalopram (Lexapro), citalopram (Celexa), and sertraline (Zoloft), for example.

These three antidepressants are at particular risk of being affected when cannabinoids interfere with metabolism.

If your body usually metabolizes antidepressants like these at a typical rate, your dosage is higher. But when you use weed, it inhibits your metabolism, slowing down your typical rate.

Antidepressant dosage recommendations from the Clinical Pharmacogenetics Implementation Consortium (CPIC), an international group that releases evidence-based and peer-reviewed medication guidelines, can help put metabolism speed into perspective.

The CPIC recommends reducing escitalopram, citalopram, and sertraline dosages by 50% for people with a slower metabolism.

This means calibrating your antidepressants to your body can result in some pretty big differences in medication amounts.

But setting your dosage to your metabolism speed doesn’t account for weed.

When weed inhibits your metabolism, your body isn’t breaking down your antidepressant as quickly as your dosage calls for. This leaves too much medication in your body.

When antidepressant levels in your body are too high, you’re more likely to experience antidepressant side effects, like

• cough
• diarrhea
• dizziness
• fatigue

You’re also at a higher risk of experiencing serotonin syndrome, a reaction caused by having too much serotonin in your body. Symptoms include:

• agitation
• anxiety
• vomiting

In more extreme cases, using weed while on antidepressants increases the risk of:

• hyponatremia, when sodium levels are too low
• hemorrhage, or internal bleeding
• longer QT intervals, which affect heart rhythm and increase the risk of cardiac arrest

With other antidepressants, like duloxetine (Cymbalta, Irenka) and amitriptyline, weed can also have the opposite effect on your metabolism.

Weed may make your body metabolize these antidepressants more quickly than your dosage calls for, leaving medication levels too low.

When the concentration of antidepressants in your body is too low, the medication isn’t as effective as it should be, and your depression symptoms may resurface.

Which antidepressants may be affected by weed?

Antidepressants that weed use may affect include:

• escitalopram (Lexapro)
• citalopram (Celexa)
• sertraline (Zoloft)
• duloxetine (Cymbalta, Irenka)
• amitriptyline
• venlafaxine (Effexor XR)
• fluoxetine (Prozac)
• mirtzapine[CS2] (Remeron)

This list isn’t exhaustive. It’s important to keep in mind that weed may also affect other antidepressants.

Can I use weed while taking antidepressants?

Suffice it to say, it’s probably best to avoid mixing weed and antidepressants.

And since the cannabinoids that mess with antidepressants are present in weed whether you smoke it, vape it, take edibles, or even take CBD alone, it may be a good idea to avoid weed — no matter its form.

What are the risks associated with weed and depression?

There isn’t only a risk that weed can negatively affect your antidepressants. Using weed when you have depression may also come with emotional and psychological risks.

This 2017 study looked at how people in a psychiatric institution with depression reacted to weed use. It found that weed worsened symptoms of depression and anxiety in participants, led to poor mental health, and impeded recovery.

Smoking weed or taking edibles can also bring on uncomfortable symptoms no matter your mental health.

Negative reactions to weed include experiencing anxiety, paranoia, or even delusions or hallucinations in more extreme cases. When someone says they had a “bad high,” these types of reactions are often part of the reason.

For people with existing mental health conditions like depression or anxiety, it may well be counteractive to take a drug that can cause the very symptoms that your treatment regimen is helping you address.

Whether or not these symptoms stick around once your high wears off, experiencing them while under the influence may be an even more uncomfortable experience for you than for people who don’t have depression.

Can weed help depression?

As medical weed and recreational weed are legal in more and more places, some people are turning to weed to self-medicate for mental health conditions.

This 2019 review looked at medical weed use in over 30 different countries. It notes that 34% of medical weed users reported depression or mood as their reason for using weed, and 50% reported anxiety.

But can weed actually help depression and anxiety? Research into the question is ongoing and the answer isn’t yet clear.

A different 2019 review examined studies on treating mental health conditions with medical cannabinoids, including THC, CBD, and synthetic forms.

The review notes very few randomized controlled studies (one of the most reliable types of research) examined medical weed or pharmaceutical CBD – most looked at pharmaceutical THC. In other words, there’s room for research.

The review determined that, based on current research, cannabinoids don’t appear to improve mental health conditions, including depression and anxiety.

It also concluded that there isn’t currently enough clinical evidence to give guidance on cannabinoids as a treatment for mental health conditions, meaning more research is necessary.

There is also research that suggests a bidirectional relationship between depression and cannabis — that cannabis use increases the risk of depression and depression increases the risk of cannabis use.

So while some people may use weed to self-medicate, clinical data doesn’t currently suggest that weed can help depression, anxiety, or other mental health conditions.

Is CBD good for depression?

The two main cannabinoids in weed are THC (tetrahydrocannabinol) and CBD (cannabidiol). The difference between the two is that THC gets you high, whereas CBD doesn’t.

However, even if it can’t get you high, CBD can still mess with antidepressants by blocking your body from metabolizing your medication as it should – just like THC and other cannabinoids.

Taking CBD with antidepressants increases your risk of uncomfortable side effects from your medication, like diarrhea and dizziness, and your risk of certain medical reactions, like serotonin syndrome.

Still, research is ongoing into CBD as a form of treatment, outside of antidepressants, for depression, anxiety, and other mental health conditions.

According to this 2018 study, some research appears to suggest that CBD may be able to act on certain neurological pathways and neurotransmitters to reduce anxiety.

The study also notes that in preclinical studies (studies that are not yet in human clinical trials), CBD has shown potential for treating mental health conditions, including depression and anxiety.

Like with medical weed, current research indicates that it’s still too early to confidently say whether CBD can help with depression and anxiety.

What is clear, however, is that CBD and antidepressants don’t mix well.

The takeaway

Smoking weed, taking edibles, vaping, using CBD — whatever the form, weed doesn’t mix well with antidepressants.

This is because the cannabinoids in weed can block your body from metabolizing your medication as it should.

When medication levels are thrown off, your antidepressant can be less effective, and you’re more likely to experience uncomfortable side effects and adverse reactions.

While research into medical weed and CBD use outside of antidepressants is still ongoing, current data doesn’t indicate that these forms of weed can help treat depression or other mental health conditions.

However, if you’re still curious about weed (recreational or medical) or CBD, consider talking with your doctor first about how weed could interact with your medications and affect your body.

FAQ

Can I use weed when I’m on antidepressants?

It may be best to avoid weed if you’re taking antidepressants. Weed can interfere with your medication, causing uncomfortable side effects and making your antidepressant less effective.

Can you eat edibles on antidepressants?

Like with smoking weed, it’s likely better to avoid taking edibles while on antidepressants, as edibles also interfere with your medication.

Plus, compared to smoking, edibles are more potent and take longer to kick in, making it harder to know how much weed you’ve ingested, or even causing you to take more than you meant to.

This increases the risk of uncomfortable side effects.

Can I take CBD with antidepressants?

It’s probably better to avoid all weed products while on antidepressants.

Even though CBD doesn’t get you high, it still contains cannabinoids (the chemical substances found in weed). And anything with cannabinoids can affect your medication.

Can I vape on antidepressants?

Using a weed vape can negatively affect your antidepressants and increase the risk of uncomfortable side effects. Try to avoid weed vapes while taking antidepressants.

As for nicotine vapes, they likely aren’t helping your mental health, either. Quitting nicotine can boost mental health and improve mood.