Considering taking CBD and sertraline? Or looking to replace sertraline with CBD? Here's the guide on what you need to do, potential outcomes, and studies. In our latest question and answer, the pharmacist discusses whether or not Zoloft (sertraline) interacts with CBD (cannabidiol). Many people use CBD as a wellness supplement, and many also take medications. Here’s what to know about how CBD may interact with certain medications.
CBD and Sertraline, Read This Before Taking Both – Interactions and Side Effects
Considering taking both CBD and sertraline? If so, then you will need to understand the interactions and potential implications this might cause.
In this article, we’ll be guiding you through what happens if you take both CBD and sertraline, starting with a quick sum-up answer.
CBD and Sertraline? CBD and sertraline taken together are believed to interact adversely, increasing the side effects of sertraline. This includes increased dizziness, drowsiness, confusion, and difficulty concentrating. But the clinical significance of this is vague. CBD also reflects some sertraline properties.
The outcome for CBD and sertraline is not that promising, so do not stop taking your medication at this point. Proceed with caution and consult your doctor before taking these elements together.
What are CBD and sertraline?
Before beginning with this topic, it’s important to get a breakdown of what these two components are.
What is CBD
CBD is short for cannabidiol and is a known chemical compound of the cannabis sativa plant. This compound is naturally occurring and is added to products such as oils and other edibles.
Unlike some other components of the cannabis sativa plant – CBD is not psychoactive. Meaning it will exhibit its benefits without the feeling of becoming high.
CBD is a supplement used mainly to provide the user with a feeling of calmness and relaxation, including promoting positive sleep patterns.
CBD is also used for treating conditions such as anxiety, insomnia, and a variety of chronic pain. But it can cause side effects such as headaches.
What is sertraline
Sertraline is an antidepressant sold under the brand name Zoloft.
Sertraline is known as a “selective serotonin reuptake inhibitor” or (SSRI) and works by restoring the balance of serotonin in the brain.
It is used for treating a variety of conditions starting from, but not limited to:
- Obsessive-compulsive disorder
- Panic attacks
- Stress disorder
- Social anxiety disorder (social phobia)
- Severe forms of premenstrual syndrome (premenstrual dysphoric disorder)
Aside from its benefits, drugs like sertraline do have their side effects. Still, sertraline helps improve your overall mood, supports quality of sleep, and boosts appetite and energy levels to restore your interest in daily living. It also reduces fear, anxiety, and other unwanted thoughts.
Moreover, it can reduce your urge to perform repeated tasks that disturb your daily routine.
When comparing CBD with sertraline, they both exhibit general characteristics in terms of treating anxiety and promoting a sense of calmness and relaxation.
However, the use of both in combination has a different perspective as to its safety and effectiveness.
Can you take CBD with sertraline?
Firstly, it’s important to mention that CBD has gained much popularity recently. This popularity is what helped CBD reveal its medicinal nature. Consumers then began mixing CBD with prescription medications in the hope of maximizing effectiveness.
Because of this recent trend of using CBD for medicinal purposes, there is a distinct lack of studies to validate drug interactions for many drugs, including CBD and sertraline.
The studies we know of that we can fall back on help us answer whether you can take CBD with sertraline.
It’s believed that using CBD with sertraline is likely to worsen the side effects of sertraline.
Specifically, using sertraline with CBD can increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. To add to this, the elderly may experience impairment in thinking, judgment, and motor coordination when sertraline is taken alongside CBD.
In general, it’s believed that CBD does have some theoretical drug interactions. However, many believe that the interactions are only mild or rare and would not bring about any severe reactions. However, there is not enough clinical evidence to say for sure.
A solid answer to whether you can take CBD with sertraline is still largely unknown because of unstudied potential interactions.
So with that in mind, it’s best to understand more about how CBD could interact with sertraline. Let’s tackle that next.
How can CBD interact with sertraline?
Sertraline is an SSRI (Selective Serotonin Re-uptake Inhibitor) that requires extensive metabolization by various CYP enzymes, including ones like CYP2B6, CYP2C19, CYP2C9, CYP3A4, and CYP2D6.
The metabolization of any medications is essential to get rid of the pharmaceutical compounds from the body.
The slower the drug metabolization process is, the more the drug stays in the system, causing potential toxicity and other dangerous outcomes.
In contrast to this process, research indicates that CBD inhibits many of the metabolizing enzymes listed above. This increases the risk of adverse effects as a result of increasing sertraline concentration in the body.
Meaning, the longer sertraline stays in the body because CBD inhibits its metabolizing enzymes, the greater the concentration of sertraline remains in the system, which can be toxic and cause adverse effects.
Can CBD and sertraline interaction severe?
Although theoretical reasoning says that CBD and sertraline interactions can pose adverse effects, some data and studies say otherwise.
Firstly, additional data on CBD interaction states that the risk of CBD interacting with sertraline is specifically is low.
Secondly, many studies project that even if CBD inhibits certain specific enzymes necessary for metabolizing sertraline, it is not significant. The blood concentration required to affect and inhibit these enzymes significantly exceeds regular CBD dosages.
Third and finally, another study states that because sertraline is metabolized with the help of several enzymes, it would be complex for a single agent like CBD to cause a severe or clinically important interaction.
However, while clinical reasonings opposed the conclusions of theoretical reasoning, we can only make general educated guesses until studies are completed that provide a more substantial data set and a solid conclusion.
So, be advised, it is crucial that you consult your doctor if you want to combine CBD with sertraline and follow any guidance they provide.
Can CBD replace sertraline?
With such interaction-based confusions, it’s common to wonder whether CBD can replace sertraline, given the fact that they have similar properties.
Starting with a study undertaken in 2018, published in the Frontiers in Immunology, CBD was demonstrated as a potential remedy for depression, similar to how sertraline is taken for depression.
The study found that CBD exhibits anxiolytic (anti-anxiety), antiepileptic, and antipsychotic properties, which can reduce depression linked to stress. This benefit of CBD for depression tends to be linked to its positive impact on serotonin receptors in the brain.
In another study published in Frontiers in Neuroscience, also in 2018, it was stated that CBD might help treat a variety of psychological conditions. Such conditions include mental health and post-traumatic stress disorder (PTSD) – the same conditions for which sertraline is commonly prescribed.
CBD also appears to work faster than most antidepressant medications, including sertraline, which in most cases takes weeks to start performing.
To back this up, a study published in the British Journal of Pharmacology found that CBD induced fast and sustained antidepressant-like effects in animal models comparable to those of imipramine. Imipramine is a tricyclic antidepressant (TCA) used mainly for the treatment of depression.
Dependent on brain serotonin
However, deviating from these positive statements, a further study published in Progress in Neuro-Psychopharmacology & Biological Psychiatry Journal shows that these antidepressant-like effects induced by CBD are dependent on brain serotonin levels.
Moreover, as of now, no study has provided evidence that CBD can be used specifically to replace sertraline.
So, to conclude on this point, replacing sertraline with CBD is not recommended, and as always, we would recommend that you consult with your doctor if you plan to do so.
We hope this has helped you to understand the interactions, risks, and benefits around CBD and sertraline.
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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.
Is It Safe To Take CBD and Zoloft?
CBD has developed a cult following in the wellness community for its holistic benefits. While many people are interested in using CBD, it may not be a valuable option for people who are already using certain medications.
If you’re currently taking Zoloft, there are a few things you need to know about the way CBD and Zoloft may interact with each other. Although CBD’s wellness benefits are helpful to many people, they may not be safe to pursue if you’re currently using an antidepressant drug.
CBD Can Affect the Way Some Medications Work
If you’ve ever taken prescription medication, you’ve likely seen warnings about potential interactions on the label. Some medications, like birth control, can’t be taken with supplements like St. John’s Wort or saw palmetto. While these supplements are fine on their own, they don’t play well with the active constituents of birth control.
Many medications cannot be taken with alcohol. You cannot take benzodiazepine drugs with many kinds of pain relief drugs because of the way their effects stack. It’s always a balancing act, and people who need multiple medications to treat numerous concerns have to work with their doctors to find safe combinations.
Supplements and medications can interact in two different ways, and interactions should be avoided whenever possible.
By Exacerbating Their Side Effects
Many medications have side effects. The majority of people find that the side effects don’t dramatically alter their quality of life. They can work with their doctor to come to a conclusion about the way the benefits stack up against these side effects.
CBD, St. John’s Wort, kava, and melatonin all work to make their users feel more relaxed. When used with medications that cause drowsiness or sedation as a side effect, these supplements may amplify the degree of sleepiness users feel.
It may be dangerous to amplify feelings of fatigue or drowsiness, especially for medications intended for use during the daytime. Falls, automobile accidents, and injuries are more likely to occur when an individual is less alert.
By Modifying Their Absorption
The body metabolizes all medications and supplements through the liver. The liver can only produce so many enzymes necessary to metabolize drugs and supplements at one given time. When you use CBD and another medication at the same time, the two compete for these enzymes.
When this happens, the body can wind up with too much or too little of a particular drug in the bloodstream. Both outcomes can have serious consequences. If you have too little of a necessary medication in your bloodstream, your body can’t effectively use it for its intended purposes. If you have too much of a drug in your bloodstream, it may pose overwhelming or dangerous side effects.
Penn State researchers identified 57 medications that may interact with cannabinoids like CBD. Most doctors would advise against using CBD with these medications.
The only exception would be the use of cannabinoid-based medications like Epidiolex that are medically necessary for treating an underlying disorder. In those cases, doctors monitor patients closely for signs of potential negative interaction.
Can You Take CBD and Zoloft Together?
Zoloft, the brand name for sertraline, is not on the list of 57 medications that cause dangerous interactions. It does, however, cause sleepiness or changes in sleep patterns as a side effect.
Since CBD also works to promote sleep , the two may cause a strong and undesirable sedative effect when used in unison.
Using CBD with Zoloft may cause fatigue, confusion, dizziness, or difficulty with concentration. Side effects are usually more pronounced in seniors. If you’ve already used CBD in conjunction with Zoloft, avoid any activities that involve significant amounts of alertness and concentration, such as driving. Stop using CBD. Its effects will typically wear off within 12 hours.
Most doctors would not advise patients to use CBD in conjunction with Zoloft. There may be exceptions for cannabinoid-based medications used to treat an underlying medical issue, like Epidiolex for the management of seizures. Doctors usually make assessments on a case-by-case basis in these scenarios.
What About Other Antidepressants?
Other antidepressants, like Prozac, Celexa, Paxil, and Lexapro, have similar side effects to Zoloft. These medications are all selective serotonin reuptake inhibitors, or SSRIs. It’s best to regard them all the same way. CBD is just as likely to amplify the side effects of these antidepressant medications.
Tricyclic antidepressants like Tryptizol, Anafranil, Allegron, Tofranil, and Gamanil also shouldn’t be used in conjunction with CBD. CBD can amplify the concentrations of these medications in your blood, leading to extreme versions of their side effects. Side effects of TCAs include high blood pressure, seizures, and accelerated heart rate. This isn’t a chance worth taking.
Do All Forms of CBD Cause Interactions?
CBD is most commonly taken as a sublingual tincture. Drops are placed under the tongue and pass into the bloodstream without first passing through the digestive system. This form of CBD gets to work quickly.
Alternatively, CBD can be taken in the form of a softgel capsule. These capsules are similar to any other supplement that people might use for wellness.
Some people prefer to vaporize CBD concentrate. Inhalation allows users to experience effects rapidly, but it may not be the best delivery method due to its potentially negative impact on cardiovascular health.
CBD in any form can cause interaction with certain medications. The only thing that changes from form to form is how quickly those interactions will take place. Orally ingested CBD will cause a delayed onset interaction, as it takes the body longer to process and utilize CBD in this form.
Interaction with sublingual CBD usually begins to occur within an hour as the CBD starts to take effect. Interactions related to inhaled CBD will begin nearly instantaneously. They’re most noticeable when users are already experiencing side effects from antidepressant medications like drowsiness. CBD can amplify that feeling within minutes, dramatically altering the user’s alertness.
The concern isn’t so much with the form of CBD as it is with the way CBD works. Because it reaches so many systems in the body and can inspire so many effects, there is no form of CBD users with antidepressants can take while reliably avoiding amplified side effects or compromised absorption.
Is CBD Safe on Its Own?
CBD is generally recognized as safe for most people, as long as it isn’t used in conjunction with prescription medications. Side effects from CBD use are rare and mild, and studies have demonstrated that humans can tolerate doses of up to 1,500 mg of CBD daily.
CBD does not have the potential for abuse or dependency , nor does it cause cognitive impairment. It’s fundamentally different from THC, the active constituent of cannabis that binds to receptors and produces a high.
CBD by itself is not a regulated or controlled substance. As long as the CBD product does not contain any residual traces of THC , it’s legal for use in all 50 states.
If You’re Taking Medications, You Should Always Ask Your Doctor Before Using Supplements
Many medications and supplements create the potential for interaction. If you’re currently taking any prescription medications, you shouldn’t take any supplements (including CBD) without first seeking approval from your doctor.
In some cases, you might be able to ring up your pharmacist. They’re often aware of potential interactions and will be able to give you advice.
Can People With Depression Use CBD?
Not everyone with depression uses antidepressant medications as a part of their treatment plan. If you’re using managed therapeutic or wellness approaches to cope with the symptoms and source of your depression, CBD obviously won’t cause any negative interactions with these forms of treatment.
That said, CBD is not an antidepressant. It’s a wellness supplement that often works to boost mood. It won’t treat or cure depression. People often use CBD simply because they enjoy the support it provides and the way it makes them feel.
Some mental health professionals have found merit in using CBD as part of a care plan for managing symptoms of anxiety or helping to treat those recovering from substance use disorders. CBD is not currently officially recognized for its direct benefits to the source of depression.
If you’re under the care of a mental health professional for depression treatment and you aren’t currently using any medications, speak with your mental healthcare professional about the possibility of incorporating CBD into your wellness plan and follow their advice. If you’re living with anxiety, CBD may be beneficial. It just doesn’t offer any benefits specific to depression.