Drug and Alcohol - Dual Diagnosis
Mixing Weed and Antidepressants: Is It Safe?
Weed and antidepressants can be dangerous together. Mixing weed with an SSRI like Prozac can be very risky. Read our blog to learn more.
Whether you call it weed, cannabis, or marijuana, one thing’s for sure: it’s one drug that gets a lot of good press.
It’s easy to find articles that tout its benefits. It’s increasingly legal nationwide, often touted for its pain management and sleep-inducing properties. When compared to the incredible damage other drugs like opioids, meth, and even alcohol can create, weed often winds up looking pretty good.
However, that’s not to say weed is entirely safe. It seems to have a fair amount of negative side effects, especially if used regularly (including an increased risk of heart attack). Even when used medicinally, weed can cause serious problems.
For one thing, there’s not much understood about weed and how it interacts with other substances. This is particularly true for antidepressants. If you’re currently taking a prescription drug antidepressant and were curious about weed, or if you simply want to know the connections between weed and antidepressants, keep reading this blog.
What Are Antidepressants?
Antidepressants are a class of drugs used to treat depression and other mental health disorders. They can only be prescribed by a doctor, although some over-the-counter herbal supplements are advertised as antidepressants.
These drugs work by altering the balance of certain chemicals in the brain, such as serotonin, associated with mood control.
How Do Antidepressants Affect the Brain?
Antidepressants are believed to improve mood by changing the way certain chemicals, such as serotonin and norepinephrine, interact with brain cells. The drugs work by blocking the reuptake of these neurotransmitters and allowing them to remain in the synaptic space longer; this increases their levels in the brain.
Serotonin is a chemical associated with positive moods. When its levels are too low, it may cause feelings of sadness and depression. Norepinephrine helps to regulate attention, alertness, and energy.
It is believed that antidepressants may also increase the production of new brain cells, which can help improve cognitive function.
What Are the Types of Antidepressants?
There are several different types of antidepressants, including:
Selective Serotonin Reuptake Inhibitors (SSRIs): These are the most commonly prescribed antidepressants. Examples include Prozac, Zoloft, and Paxil.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These drugs help increase levels of both serotonin and norepinephrine in the brain. Examples include Cymbalta and Effexor.
Tricyclic Antidepressants (TCAs): These drugs are rarely prescribed due to the risk of dangerous side effects. Examples include Elavil and Tofranil.
Monoamine Oxidase Inhibitors (MAOIs): These drugs are reserved for severe cases of depression and help increase serotonin, norepinephrine, and dopamine in the brain. Examples include Marplan and Nardil.
Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs): These drugs are an alternative to SSRIs and SNRIs and have fewer side effects. Examples include Remeron and Desyrel.
Are Antidepressants Addictive?
Antidepressants are not considered to be addictive. However, it is important to note that the body can become reliant on them if they are taken for too long or at too high of a dose. This means that if an individual suddenly stops taking their antidepressant, they may experience withdrawal symptoms such as nausea, dizziness, headache, and irritability.
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What Is Weed?
Weed is the slang term used for marijuana, which is a drug derived from the cannabis plant. It contains cannabinoids that act upon various receptors in the brain and body known as CB1 and CB2 receptors. These interactions produce effects including relaxation, increased appetite, altered perception of time, heightened sensory experiences, and decreased anxiety.
Is There a Difference Between Cannabis and Marijuana?
Generally speaking, no. Most people use the terms interchangeably. Cannabis is the scientific name for the plant, a member of the Cannabaceae family. Three strains of this plant are psychoactive, meaning they can change a person's perspective when used.
Marijuana, on the other hand, is a slang term for cannabis with uncertain origins. In general, "marijuana" tends to refer to preparations made from cannabis: joints, edibles, etc.
Is Weed Addictive?
Yes, and cannabis use disorder is a recognized substance use disorder. Some people may not be able to stop using weed even if it's causing them problems in their day-to-day life. The stereotypical "wake and bake" behavior associated with stoners is often played for humor in media, but it's actually a textbook demonstration of cannabis addiction.
What Is CBD?
CBD, or cannabidiol, is one of the active compounds found in weed. CBD does not cause any psychoactive effects like THC does and has been studied for its potential medical benefits. However, it still interacts with antidepressants and other drugs. CBD is often legal in areas where weed is not, and it's used in many supplements and other products, including skin creams.
How Does Weed Affect the Brain?
Weed has many effects on the brain, altering the user's state of mind and affecting their mood. It can produce feelings of euphoria, relaxation, and impaired cognitive ability. It can also increase heart rate and decrease blood pressure.
When ingested, cannabis attaches to receptors on nerve cells. Known as "cannabinoid receptors," these areas respond to a neurotransmitter called endocannabinoids. Our bodies naturally produce endocannabinoids; researchers think they play a role in thinking, mood, memory, emotion, and others.
Cannabinoids are chemically similar to endocannabinoids, and bond to the same receptors. This disrupts the body's normal function, and leads to the effects weed has when it's ingested. According to the National Institute on Drug Abuse (NIDA), one of the ways weed affects our nervous system is in the hippocampus and orbitofrontal cortex areas of the brain. These areas of the brain are involved in creating new memories and focus. This is why weed makes thinking and performing complicated tasks difficult.
NIDA also reports that weed affects the cerebellum and basal ganglia of the brain, which govern balance, reflexes, and coordination. This means driving or operating heavy machinery while using weed is a terrible idea.
Although more studies need to be done, weed often interacts with other substances in unpredictable ways. Let's use alcohol as an example. Alcohol is a depressant, and like weed, it affects how neurotransmitters function. In alcohol's case, it increases the activity in the body's GABA system. When there's a larger presence of GABA in our system, the central nervous system slows down.
When mixed with weed, alcohol actually increases the body's absorption of THC (delta-9-tetrahydrocannabinol), the active ingredient in weed. For some, this means they get much higher than they may have intended to, which some call "greening out." There may be additional risks, too; a study from 2017 found people who used weed and alcohol tended to consume more of both, which in turn can lead to addiction.
Mixing weed with other substances can be far more dangerous, however.
What Are the Dangers of Mixing Weed and Antidepressants?
Mixing weed and antidepressants can be very dangerous. Both drugs affect the same brain chemicals and interact with each other in unpredictable ways, making it difficult to anticipate how they will react in the body. In some cases, mixing these two substances can cause side effects such as hypertension, increased heart rate, dizziness, and confusion.
Additionally, it is possible for marijuana to interfere with the effectiveness of the antidepressant medication, reducing its therapeutic value.
Surprisingly, weed interacts negatively with each kind of antidepressant.
Weed & SSRIs: Dangerous Drug Interactions
As we mentioned earlier, SSRIs are the most commonly prescribed form of antidepressant.
They include:
Prozac (Fluoxetine)
Zoloft (Sertraline)
Cipramil (Citalopram)
SSRIs are prescribed because they tend to have low side effects. As for its interaction with weed, a study published by the National Library of Medicine found some patients who took SSRIs had panic attacks while using weed.
Additionally, CBD seems to stop the body from metabolizing both CBD, THC, and SSRIs. When taken together, SSRIs and CBD cause what researchers call “metabolic competition,” meaning neither gets broken down by our bodies. With SSRIs, this can be incredibly dangerous.
Serotonin syndrome is a complication of SSRIs and is caused by having high levels of serotonin in the body. Symptoms of serotonin syndrome include irregular heartbeat, a high fever, and even seizures.
Weed & SNRIs: Negative Drug Interactions
SNRIs are relatively new medications and are claimed to have fewer side effects.
More common SNRIs include:
Cymbalta (Duloxetine)
Effexor (Venlafaxine)
Pristiq (Desvenlafaxine)
This class of prescription antidepressant is still new, and its interactions with weed aren’t yet understood. However, weed might amplify the effects of both SNRIs and THC, so it’s best to play it safe.
Weed & TCAs: Negative Drug Interactions
Although TCAs are still used to treat depression, they tend to only be prescribed if SSRIs and SNRIs are ineffective.
They include:
Elavil (amitriptyline)
Sinequan (Doxepin)
Surmontil (trimipramine)
Weed and TCAs seem to have very harmful interactions. When mixed, weed and TCAs can cause tachycardia (increased heart rate), high blood pressure, and a higher risk of anxiety, panic attacks, and heart attack in extreme cases.
Weed & MAOIs: Negative Drug Interactions
According to the Mayo Clinic, MAOIs were the first antidepressant drugs that were developed. While these drugs are effective at treating depression and other disorders, they can be difficult to manage. Among other issues, they can cause high blood pressure when taken with other medications or certain foods.
Common MAOIs include:
Marplan (Isocarboxazid)
Pamate (Tranylcypromine)
Emsam (Selegiline)
As for MAOIs and weed, there isn’t a lot of information on interactions between weed and MAOIs. A study available in the National Library of Medicine found weed made MAOIs less effective in some people.
Weed & NaSSAs: Negative Drug Interactions
NaSSAs are an emerging class of antidepressants. They are thought to avoid many of the side effects of SSRIs and other antidepressants.
Common NaSSAs include:
Avanza, Norset, Remeron (Mirtazapine)
Noval (Mianserin)
Interactions between weed and NaSSAs aren’t widely understood yet. It's best to avoid mixing the two.
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Weed and Antidepressants: What’s the Final Word?
Weed and CBD products are often claimed to have beneficial effects for people, especially for pain management and sleep disorders. However, weed is still an addictive drug, and while nowhere near as bad as meth or opioids like heroin and fentanyl, is still capable of trapping someone in the repetitive, harmful behaviors of addiction.
Polydrug use, often called “crossfading,” is always unsafe. There are still a lot of unknowns around even a popularly used drug like weed, and any interactions weed has with other addictive substances or medications aren’t completely understood yet. Combining weed with other drugs – even alcohol – can be very risky and should always be avoided.
Depression, the mood disorder antidepressants that are most often prescribed to treat, is a major driver of addiction. According to the National Institute of Mental Health (NIMH), 21 million adults in the US reported having at least one major depressive episode during the year. NIMH also reports nearly half of the people with a substance use disorder also have a co-occurring mental health disorder. This combination, known as a dual diagnosis, can be complex to treat.
Recovery is always possible, however. Whether you’re struggling with a potential cannabis use disorder, a mood disorder, or a combination of both, treatment is always available.
Struggling With Weed & Antidepressants? The Edge Treatment Center Offers Evidence-Based Treatment for Dual Diagnosis, Cannabis Use Disorder, and More!
If you’re struggling with depression and are relying on substances like weed for relief, you’re playing a risky game. The Edge Treatment Center can help you break your reliance on drugs and live a happier life without substance abuse.
We’ll start by finding you a drug detox center to help you safely detox from whatever addictive drugs you’re trying to break addiction from. Once you enter our long-term outpatient drug rehab, we’ll help you continue to progress toward recovery. The Edge will make sure you have every resource you need for a happy, substance-free life.
Weed and antidepressants are a dangerous combo. The Edge Treatment Center can help you deal with both. For more information, reach out to us today.
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If you or a loved one is struggling with addiction, there is hope. Our team can guide you on your journey to recovery. Call us today.
Written by
Content Writer
Reviewed by
Chief Clinical Officer
Drug and Alcohol
Dual Diagnosis
February 25, 2023