Many people take prescription medication to treat depression. Some also use marijuana to improve their mood and ease their symptoms. Is it dangerous to have marijuana and antidepressants in your system at the same time?
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How Does Marijuana Affect Your System?
To understand why it can be risky to use marijuana while taking antidepressants, it can help to first review a few fundamental facts about each substance separately. We’ll start with marijuana.
Cannabis – which is also often referred to as marijuana, weed, herb, and an array of other names – contains more than 100 naturally occurring compounds called cannabinoids. The two most prevalent cannabinoids are:
- Delta-9 tetrahydrocannabinol (THC)
- Cannabidiol (CBD)
THC is by far the more abundant of these two compounds. Though amounts can vary from one strain to the next, a typical cannabis plant may include 15%-30% THC and 2%-4% CBD.
Effects
THC is also responsible for most of marijuana’s psychoactive effects, which can include both positive and negative experiences such as:
- Relaxation
- Improved mood
- Increased appetite
- Diminished pain
- Distorted perceptions
- Short-term memory loss
- Impaired coordination
- Anxiety
- Panic and paranoia
- Nausea
CBD doesn’t cause any intoxicating effects. However, as described in a September 2021 report in the journal Current Addiction Reports, some studies suggest that it may reduce symptoms of epilepsy, anxiety, pain/inflammation, schizophrenia, and posttraumatic stress disorder (PTSD).
Mechanism of action
Both THC and CBD produce their effects by binding with specific receptors in the endocannabinoid system, which is a complex network of chemicals and cells in the human body.
The speed of this binding and the intensity of the resultant effects vary depending on several factors, including the THC and CBD percentage of the marijuana and how it was ingested (such as by smoking, eating an edible, or drinking an infused beverage).
According to a November 2020 article in The Permanente Journal, the plasma half-life of THC can range from one to three days in occasional users, while the plasma half-life of CBD is usually 18-32 hours. This means that traces of these compounds may be detectable in a person’s system for weeks after the last time they used the drug.
How Do Antidepressants Work?
The category of antidepressants includes several types of medications. Three of the most frequently prescribed types are:
- Selective serotonin reuptake inhibitors (SSRIs) such as escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil).
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq)
- Norepinephrine-dopamine reuptake inhibitors (NDRIs) such as bupropion (Wellbutrin), dexmethylphenidate (Focalin)
As their names imply, these medications work by preventing the reuptake (or reabsorption) of certain brain chemicals, including serotonin, norepinephrine, and dopamine, which boosts their presence and can amplify their impact.
Other antidepressants, which are usually only prescribed after a person’s symptoms haven’t responded to the ones listed above, are:
- Tricyclics (TCAs), which boost serotonin and norepinephrine in a different manner than SNRIs do
- Monoamine oxidase inhibitors (MAOIs), which cause enzyme changes that can alter levels of serotonin, dopamine, and norepinephrine
What Happens if You Mix Marijuana and Antidepressants?
There’s no single answer to the question of what happens if you mix marijuana and antidepressants. One significant reason for this is that, as noted in the previous section, antidepressants don’t all function in the same way.
Other factors that can affect how a person may be impacted by having marijuana and antidepressants in their system at the same time include:
- The amount and frequency of their marijuana use
- Their antidepressant dosage level
- If they are also using other prescription medications or recreational drugs
- Their age, metabolism, and overall physical and mental health
Depending on these and other relevant factors, someone who combines marijuana and antidepressants may experience various effects, including:
- As described in a June 2021 article in the Journal of Personalized Medicine, THC and CBD may hinder the body’s ability to break down and eliminate certain SSRIs. This can cause a person’s serotonin levels to become dangerously high, possibly leading to a potentially fatal condition called serotonin syndrome. Elevated SSRI presence in a person’s system can also intensify the side effects that have been linked with these types of antidepressants.
- Several reports have also noted that marijuana may disrupt how the body processes and eliminates duloxetine (Cymbalta), which is an SNRI. As with SSRIs, this can ratchet up the severity of the antidepressant’s side effects. It may also put a person at increased risk of serotonin syndrome, but the danger of this outcome doesn’t appear to be as high as it is for people who combine cannabis and SSRIs.
- A November 1999 case report in the journal Canadian Family Physician reported that a 17-year-old experienced “transient cognitive changes” and a life-threatening increase in heart rate after using marijuana while taking amitriptyline, which is a tricyclic antidepressant.
- A January 1997 case study in The Journal of the American Academy of Child & Adolescent Psychiatry found similar results among four teens ages 15-18 who used marijuana while taking tricyclic antidepressants to treat attention-deficit/hyperactivity disorder (ADHD).
To understand the risks posed by using marijuana if you’re taking an antidepressant, ask the doctor who prescribed the medication to you. A qualified professional who understands your specific circumstances will be able to help you understand the degree of danger you may be placing yourself in if you choose to use cannabis while taking medication for depression.
Find Help for Addiction and Depression in Atlanta
The best way to eliminate your risk of negative outcomes related to marijuana and antidepressants is to stop using cannabis. If you’re unable or unwilling to do you, you may benefit from professional help for addiction. Treatment may also be an ideal option if medication alone hasn’t been enough to ease your depression symptoms.
Valor Behavioral Health offers personalized outpatient care for adults and adolescents whose lives have been disrupted by addictions and mental health concerns. Treatment options at our rehab in Atlanta, GA, include a partial hospitalization program (PHP), intensive outpatient program (IOP), adolescent program, and virtual (online) IOP.
To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.
