CBD and Zoloft (Sertraline)

Cannabidiol, more recognized as CBD, is a commonly accepted cure for many common ailments. It is one of the many chemical compounds known as cannabinoids found in the cannabis plant, which is also occasionally called hemp or marijuana, depending on the degree of tetrahydrocannabinol (THC) it contains. THC is another cannabinoid that is linked to a “high”, being the psychoactive constituent of marijuana. Unlike THC, however, CBD keeps one alert and energetic. CBD counters the effects of THC by decreasing the level of stress or anxiety. Because of this action, CBD is frequently extracted to use distinctly for medical use that is non-psychoactive.

CBD oil is the undiluted liquid decoction of Cannabis sativa, a plant commonly known as marijuana. Consumers can purchase CBD oil separately and use it orally. The CBD oil is a popular CBD product that one may purchase online or over the counter.

CBD continues to gain in acceptance and approval in recent years as more research uncovers many of potential health benefits, which may also include considering it as possible treatment depression.

How CBD Works as Antidepressant

The results of research from 2014 may provide enlightenment why CBD could be useful in treating depression. They show that, in many studies, CBD exhibits a positive interaction with serotonin receptors in the brain. Serotonin affects a variety of functions in the human body, together with a person’s emotional condition and feelings of contentment. A significant remedy for people with depression is often maintaining a balanced level of serotonin.

Authors of the 2014 review say that results from different studies show that CBD seems to perform as an antidepressant and antianxiety compound in animal representations of depression. The authors of a review from 2018, meanwhile, said that numerous studies had shown the anti-stress and antidepressant activity of CBD in animal representations. CBD displays a robust anti-stress effect after short- or long-term use, and in particular assessments, CBD performed as an antidepressant. Also, the compound functioned without directly triggering the endocannabinoid receptors of the brain. This function is an indication that there is less danger of CBD becoming habit-forming or addictive.

CBD and Zoloft

There is evidence suggesting that CBD oil may provide relief to those who suffer from anxiety or depression. However, people wonder if supplementing Zoloft or any antidepressant therapy with CBD oil is a safe and effective option. Although more investigation is still needed, many people already include CBD in their treatment program.                                         

Using Zoloft (sertraline) together with CBD, however, may intensify side effects such as confusion, dizziness, drowsiness, and difficulty concentrating. Under these conditions, it is wise to refrain from engaging in activities that would require mental alertness, such as driving a vehicle or operating heavy machinery. Also, avoid or limit alcohol intake while taking this combination of medications. Some older people also experienced cognitive decline that results in poor judgment and weak motor coordination.

It is also possible that using CBD oil and SSRI (like Zoloft) at the same time may cause the blood pressure to drop. Low blood pressure could become dangerous if one is involved in active sports or doing strenuous activities. CBD should help lessen the need for SSRIs, however. To reduce the risks of blood pressure drop, one may take the CBD oil in small doses at regular intervals throughout the day, and decrease the SSRI dose by taking a pill every other day. 

Interactions Between CBD and Other Medications

More than half of the medications on the market are metabolized through liver enzymes, cytochrome P450 or CYP450. These are the same enzymes that break down and process CBD in our body.  Previous research suggests that CBD is a CYP450 enzyme inhibitor. Taking CBD while on another medication, CBD could block these critical enzymes. The increased concentration of medication in the system might complicate a medical condition. How our bodies process medication and how it would affect us are greatly influenced by body size, age, and genetics. However, to reduce the workload on the liver, take medicines at longer time intervals. Taking medications and CBD at different times of the day would reduce the risk of having a severe drug interaction. 

Cannabis can make people feel less anxious and more relaxed. People who are experiencing anxiety or depression are most probably curious about CBD, and they would most likely want to use CBD in conjunction with their medications. However, there are possible interactions that could arise by combining CBD with other antidepressants, and patients need to be well-informed.

Amino acids are substances that generate proteins in the body. 5-HTP (L-5-hydroxytryptophan) is an amino acid that may raise levels of serotonin in the brain. Research suggests that 5-HTP may relieve depression as effectively as some antidepressants. 5-HTP gives a calming effect, allowing the brain to become less active but not sedated. There are CBD products that contain 5-HTP, such as Irwin Naturals CBD +5-HTP. This product is a comprehensive formula that combines the calming effect of CBD with the anti-anxiety characteristic of 5-HTP to support mood and relaxation. 

It is a challenge for doctors to prescribe the right dose of antidepressant medication that could be effective with the right dose of CBD. Most CBD products, especially the ones made from the CBD oil extracted at home, may not accurately indicate the dosage or the concentration of CBD that the product contains. Problems with knowing the exact dosage may impede the CBD’s potential to work with other antidepressants effectively. Also, combining CBD and antidepressants could increase the risk of hypomania in persons with bipolar disorder. Nevertheless, many doctors approve of SSRIs because adverse interactions rarely occur.   

It is generally safe to use CBD supplements when taking other antidepressants. Confidence in one’s CBD supplier is essential to ensure getting good quality CBD products that are organic, sustainably farmed without pesticides, and ethically-sourced.         

Meanwhile, some asthma medicines, stimulants, and steroids like prednisone can trigger anxiety or make it worse. Prednisone, a corticosteroid, can also help combat chronic inflammation. Similarly, CBD has the potential to help alleviate inflammation, as the researchers in a review in 2009 concluded. However, mixing CBD and prednisone has not specifically been studied, so it is unsafe to combine the two substances. Because CBD inhibits the actions of CYP3A4 in the liver, a higher-than-expected dose of medication could enter the bloodstream. Do not mix CBD and prednisone without the approval or knowledge of a doctor. 

The Grapefruit Test

It is interesting to note, however, that like CBD, grapefruit has furanocoumarins that attach to and efficiently counteracts enzymes in the gut ( called CYP450 enzymes), which helps to dissolve and reject drugs from the body. When these enzymes are not able to perform its functions, a significant amount goes into the liver and passes unrefined into the bloodstream. This process gives rise to the dangers of having alarming increased levels of the drug in one’s system. A low dose of prescription medication may become high, and a high dose of a specific medicine becomes an overdose.

CBD can also raise the level of blood thinners coumadin, as well as other medicines in the blood by the same method that grapefruit juice does. It is a safety issue with CBD that it is mainly advertised and sold as a supplement, not a remedy.

Replacing Antidepressants with CBD Oil

Some people consider it more ideal to stop using antidepressants altogether instead of taking CBD with these medications. Preparation is key to achieving a smooth transition from antidepressants to CBD alone. Slowly decrease the dose of the antidepressants before removing them entirely from one’s current regimen. If taking multiple antidepressants, it is better to transition by decreasing the dose one medication at a time. Patience in this slow process would ultimately lead to a reduction of withdrawal symptoms associated with antidepressants, as well as making the transition to CBD oil successful.

Abruptly stopping any antidepressant may put the patient at risk of experiencing withdrawal symptoms. In some cases, the symptoms of anxiety or depression may even worsen. Risk is significant when the patient has been taking antidepressants for an extended period, or if the patient has been taking high doses of the medication. Some people who take an antidepressant for six or more weeks may experience withdrawal symptoms if they suddenly stop taking medicine.

Withdrawal symptoms of SSRIs or antidepressants like Zoloft may include difficulty sleeping, flu-like symptoms, sudden change of mood, drowsiness or vertigo, vomiting, upset stomach, muscle spasms, and loss of coordination. Some people describe experiencing electric shock sensations in their brain for weeks after stopping antidepressants. Symptoms most often occur within three days of stopping the antidepressant and may pass within two weeks.

Understanding Treatment Options

Different types of antidepressants would most effectively address issues with the nervous system. Antidepressants often can help when one is dealing with treatment-resistant depression. CBD is an excellent treatment option as it binds with both CB1 and CB2 receptors in the immune and gastrointestinal system (CB2) and the brain/throughout the body (CB1). CBD may help treat a variety of psychological conditions, including mental health and post-traumatic stress disorder (PTSD).

However, knowing the right dosage of CBD oil to use may require some trial and error. The dosage of CBD would also need to be adjusted over time as the doses of antidepressants are reduced. The patient should carefully examine his or her body’s reactions to these changes. The patient should find a doctor that would be able to help in determining the dose of CBD that would be most effective in his or her situation. The right dosage, which largely relies on many factors, from weight and age to the severity of the symptoms. 

CBD products are not regulated by the U. S. Food and Drug Administration (FDA), so the quality and the potency of the CBD that these products contain may be questionable. The lack of standardization also makes CBD products challenging to dose for different indications.

CBD has been marketed as a useful tool to treat a variety of health problems. However, the lack of federal regulation on CBD products and substantial research that would provide evidence to CBD’s efficacy elicits many questions about how it may impact a user’s life, specifically if they’re taking medications for serious health concerns. Always consult a doctor or a trusted medical professional before making any changes to one’s usual antidepressant therapy.

More Information on Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors (SSRIs) are used in the treatment of depression. They are also used in panic disorder, obsessive compulsive disorder and bulimia nervosa. Selective Serotonin Reuptake Inhibitors (SSRIs) are potent inhibitors of serotonin re-uptake by central nervous system neurons and may interact with other drugs or circumstances which cause serotonin release. The enhancement of serotonergic effects may produce a life-threatening serotonin syndrome.

Selective Serotonin Reuptake Inhibitors (SSRIs) can inhibit in vitro and in vivo the hepatic isoenzyme 2D6 of the cytochrome P450 system (CYP2D6), which is involved in the oxidative metabolism of numerous drugs. Caution should be used when combining an SSRI with CYP2D6 substrates (desipramine, nortriptyline, haloperidol, thioridazine, flecainide, codeine, propranolol, metoprolol), as the SSRI can cause a significant increase in serum concentrations of these drugs.

Selective Serotonin Reuptake Inhibitors (SSRIs) specifically inhibit central nervous system neuronal reuptake of serotonin, thus increasing the concentration of serotonin at the synapse and enhancing of serotonergic neuronal transmission. A deficiency of serotonin is thought to play a major role in depression, therefore increasing the availability of serotonin would be expected to improve the clinical signs of depression.

Main Risks

When taken alone, Selective Serotonin Reuptake Inhibitors (SSRIs) appear safer in overdose than most other classes of antidepressants. They are potent inhibitors of serotonin reuptake by central nervous system neurons and may interact with other drugs or circumstances which cause serotonin release. The enhancement of serotonergic effects may produce a life-threatening serotonin syndrome. Drugs which can increase the serotonin level when taken in combination with SSRIs include tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), carbamazepine, lithium or serotonergic substances.

Symptoms

Drowsiness, tremor in upper extremities, lightheadedness, nausea, vomiting are the most common symptoms. Other symptoms include tachycardia (occasionally bradycardia), hypo/hypertension, dilated pupils, agitation, dry mouth and sweating. Coma and convulsions may occur in large overdoses. They are much less cardiotoxic than the conventional antidepressants, though citalopram has caused nodal rhythm, QT and QRS prolongation. The combination of Selective Serotonin Reuptake Inhibitors (SSRIs) with agents that increase serotonin availability in the central nervous system can cause the serotonin syndrome which is characterized by the presence of at least 3 of the following symptoms: mental status changes (confusion, hypomania), agitation, myoclonus, hyperreflexia, sweating, shivering, tremor, diarrhea, motor incoordination, muscle rigidity and fever. Severe complications may occur, including severe hyperthermia, rhabdomyolysis, disseminated intravascular coagulation (DIC), convulsions, respiratory arrest and death.

Management

The primary management of SSRI overdose consists of the institution of careful observation of vital signs and neurological status and supportive care until signs and symptoms resolve. In more severe intoxications or where there is a co-ingestion, more aggressive measures such as establishment of an airway, ventilation, administration of intravenous fluids, control of seizures, and control of hyperthermia may be necessary.

Susan Lindeman

Susan is a young mother and writer, passionate about cooking and blogging. She makes CBD-infused foods, like cookies and candies, to help her cope with anxiety and perform her daily tasks better.
Susan Lindeman

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