If you're looking to get off antidepressants and try CBD as an alternative, we've got the information to help you start making the right choice for you. CBD can interact with escitalopram, an antidepressant, by slowing down its metabolism and increasing the risk of side effects. Find out how they interact. Senior citizens, teenagers with and pets with anxiety are the fastest growing demographics of cannabidiol consumption.
Making the Switch: CBD Oil and Antidepressants
Information provided in this article is for educational purposes only and should not be considered as a substitute as medical advice from a qualified physician. Always consult with your doctor before making any changes to prescribed medications.
Understanding CBD Oil and Antidepressants
CBD oil is gaining popularity as laws continue to increase its access and new uses for these products are discovered. Antidepressants, on the other hand, have been around for decades and have established themselves as first-line treatment options for many mental health conditions. While their statuses differ drastically, some of their indications for the management of anxiety and depression overlap.
What is CBD Oil?
CBD oil is a product made from cannabidiol that has been diluted in some type of oil. Cannabidiol is a cannabinoid derived from cannabis plants like marijuana or hemp. CBD oil does not produce the psychoactive side effects seen with the use of marijuana because the CBD has been isolated from the many other cannabinoids in the plant. THC specifically, which is the cannabinoid responsible for the “high” feeling many people describe when using the plant product, is not present in CBD oil products. CBD oil has emerged as a potential treatment option for a variety of conditions, including anxiety, epilepsy, depression, and pain disorders.
What Are Antidepressants?
Antidepressants are medications used to treat mental health conditions such as depression and anxiety. There are many different classes of antidepressants approved by the FDA. These include SSRIs, SNRIs, tricyclic antidepressants, and other miscellaneous antidepressants. These medications are thought to improve symptoms of depression by increasing certain chemicals in the brain, namely serotonin, norepinephrine, and dopamine, to improve mood although their exact mechanism in depression is not clear. These medications have been developed and improved over many decades to optimize their effectiveness and reduce their side effects. However, some people still struggle to manage their anxiety and symptoms of depression using antidepressants alone.
Mixing CBD Oil and Antidepressants
With evidence suggesting CBD oil may benefit those who suffer from anxiety or depression, many people wonder if supplementing their antidepressant therapy with CBD oil is a safe and effective option.
CBD Oil and SSRIs
SSRIs are the first-line medications used for the treatment of depression. They are well researched and offer many people relief with fewer side effects than other treatment options. People have reported that the use of CBD oil in combination with their SSRIs resulted in improved symptoms of depression without additional side effects. That being said, this combination may not be for everyone. CBD has the potential to interact with SSRIs, and other antidepressants, resulting in increased amounts of antidepressant in the body and a higher risk of side effects.
The CYP450 Pathway
The CYP450 pathway is a metabolic pathway, located primarily in the liver, that is made up of many types of enzymes. These enzymes help break down or alter substances we have ingested, such as medications, to prepare them to be eliminated from the body. Each enzyme has a unique name. CYP3A4 and CYP2D6 are two examples of enzymes that are frequently responsible for the metabolism of medications in the body. These two enzymes are often responsible for the many reported drug interactions related to the CYP450 pathway.
CBD oil has been found to inhibit the CYP3A4 and CYP2D6 enzymes. This means it has the potential to interact with many medications by reducing their metabolism and increasing the amount of medication circulating in the body. Many antidepressants are metabolized by the CYP2D6 enzyme, so their clearance from the body could be reduced by the use of CBD oil. It is still unclear is how significant this interaction is; it is not completely understood if this interaction is related to the dose of CBD oil ingested or related to the route of ingestion of the product.
What The Research Says
The research for the use of CBD products in the treatment of depression and anxiety is expanding. A small study evaluated the use of CBD in patients with anxiety before a public speaking test. This study found that those who used CBD before their speech experienced less anxiety and discomfort than those who were given a placebo. This suggests CBD oil can benefit people who need help reducing anxiety levels before a particular event.
Much of the current research into the use of CBD in depression has been in animals. However, studies have evaluated the mechanism of CBD in the treatment of depression. CBD is known to act on the endocannabinoid system to reduce pain symptoms. Researchers have also begun to study the effect of antidepressants on this system to reduce symptoms of depression. This research has also discovered the impact of other receptors and areas of the brain that are affected by both antidepressants and CBD. This developing research suggests that CBD’s activity in the brain could improve depression, but more investigation into this indication is needed.
Can CBD Replace Antidepressants?
Instead of adding CBD to an antidepressant regimen, it may be more ideal for you to be able to stop using your antidepressants altogether. If you would like to try CBD oil in place of antidepressants, there are some important things you should consider.
How to Prepare the Switch
Preparation is important before deciding to stop taking antidepressants in favor of CBD oil. First, evaluate your current antidepressant regimen. If you are taking antidepressants, these are best stopped by titrating down the dose before quitting them all-together. If you have multiple antidepressants, talk to your physician about how to slowly decrease and remove these medications; it will be a better transition if you decrease one medication at a time. This process may be slow, but it will reduce withdrawal symptoms and improve your chance for a successful transition to CBD oil.
Dangers of Going Cold Turkey with SSRIs
Stopping any antidepressant “cold turkey” can put you at risk for withdrawal symptoms and worsening symptoms of depression or anxiety. This risk is increased if you have been taking antidepressants for a long time or are taking high doses. This is because your body is used to the effects of the medication; when you rip it away suddenly, your body is left scrambling to recover. Withdrawal symptoms of SSRIs can include sleep disturbances, flu-like symptoms, stomach upset, drowsiness, and mood disturbances. Some people also describe shock-like feelings in their brain for weeks after stopping SSRIs. These risks reinforce the importance of preparation when stopping SSRIs and working closely with your provider to do this safely.
Finding the Right Dosage
Using CBD oil may require some trial and error. You may find better luck with some products over others. Similarly, you may find that the original dose you use needs to be adjusted in order to see an effect. The dose may also need to be adjusted over time as the doses of antidepressant are reduced and your body adjusts to these changes. Finding a provider knowledgeable in the use of CBD products can help you find the right dose and product more efficiently.
Risks of Replacing Antidepressants with CBD Oil
While CBD is a more natural product, it carries certain risks that are not seen with antidepressants. One of the biggest risks with using these products is their current lack of regulation. Because CBD oil is sold online and in stores, there is little to no regulation controlling the quality of the products being marketed and sold. This lack of regulation and standardization makes these products harder to dose for different indications.
Research is improving for CBD oil and other cannabinoid products, but there is less quality evidence for the use of CBD oil in anxiety and depression at this time. This leaves uncertainty about its efficacy and most appropriate uses. With this lack of strong evidence available, it can be hard to find knowledgeable providers who understand CBD and the best way to take advantage of these products.
Finally, stopping antidepressants can be a challenging task. Reducing or stopping antidepressants cause withdrawal symptoms, such as those listed above, which may discourage some people from effectively making this transition. Stopping these medications too early or too quickly can also cause you to experience worsening anxiety or depression symptoms. To be safe, this process must be carefully executed and closely monitored by a physician or other qualified psychiatric care provider.
CBD May Be the Relief You’re Looking For
If you have been struggling with anxiety or depression symptoms despite antidepressant therapy options, CBD oil may be a good option for you. With the help of a knowledgeable provider, you may be able to improve your depression symptoms and potentially reduce or stop the use of your antidepressant medications. If you decide to use CBD oil to improve your depression and anxiety symptoms, develop a well-informed plan to introduce this supplement. You may find that this provides the relief you’ve been searching for.
Does CBD Interact With Escitalopram (Lexapro)?
Escitalopram (Lexapro) is an antidepressant of the serotonin reuptake inhibitor (SSRI) class.
It’s used to treat depression, anxiety, and obsessive-compulsive disorder.
CBD may slow down the metabolism of escitalopram and lead to its excess accumulation in the body , making it more potent but more liable to cause unwanted side effects.
Can CBD and escitalopram be taken together safely?
Table of Contents
Does CBD Interact With Escitalopram (Lexapro)?
CBD (cannabidiol) may interact with escitalopram (Lexapro). There are two ways by which CBD and escitalopram can act:
1. Slowed Elimination (Metabolic Inhibitor)
CBD can slow the metabolism of escitalopram and consequently increase its concentration in circulation.
Metabolic inhibition occurs when two drugs get metabolized by the same enzymes. Hence, they compete against each other for the said enzymes, slowing down the metabolism of one or both drugs.
Escitalopram is metabolized by CYP2C19, CYP2D6, and CYP3A4 enzymes. These same enzymes metabolize CBD as well.
CBD also has the additional feature of inhibiting these enzymes. Therefore, taking escitalopram and CBD together could slow down the metabolism of the former, leading to an unhealthy accumulation of this compound in the body .
It could lead to more side effects of escitalopram such as headache, nausea, drowsiness, etc.
There is a possibility that an excess of taking these two drugs together could give rise to serotonin syndrome, a condition where the body has too much amount of serotonin.
2. Increased Effect (Agonistic Interaction)
CBD can interact with escitalopram agonistically as well.
Agonistic interaction happens when two drugs have a similar effect on the body. They work on the same receptors causing the effects in the same direction.
Both escitalopram and CBD act on the central nervous system (CNS). While escitalopram acts by increasing the levels of serotonin, CBD acts by neuromodulation. Although their mechanism of action is different, they both have similar anxiolytic and antidepressant actions when consumed.
If taken together, the actions of these substances could have a synergistic effect. However, this may also cause an exaggeration in the intended effects leading to symptoms such as drowsiness and lethargy.
Other Names For Escitalopram
Escitalopram is sold under many different names. All share the same risk and potential interactions.
Other names for escitalopram (Lexapro) include:
Similar Medications: CBD & Escitalopram (Lexapro)
Escitalopram (Lexapro) is classified as a selective serotonin reuptake inhibitor (SSRIs). CBD and SSRIs all share similar risks for interaction and side effects.
Here’s a list of similar medications that share a similar level of risk when combined with CBD:
- Citalopram (Cipramil and Celexa)
- Dapoxetine (Priligy)
- Fluoxetine (Prozac, Rapiflux, Sarafem, Selfemra, and Oxactin)
- Fluvoxamine (Faverin)
- Paroxetine (Seroxat)
- Sertraline (Lustral)
- Vortioxetine (Brintellix)
Is It Safe to Take CBD & Escitalopram (Lexapro) Together?
While the risk of interaction with CBD and escitalopram is low, it’s not impossible. The potential side effects from this interaction can be severe, which make it a bad idea to combine these drugs unless you’ve consulted with your prescribing doctor first.
The interaction between CBD and escitalopram is considered moderate.
Is CBD a Viable Alternative to Escitalopram (Lexapro)?
CBD could be a viable alternative to escitalopram (Lexapro), but not if you’re currently using escitalopram.
CBD can help with depression and anxiety and might even help with OCD, but it might not be enough for some people.
If you’re currently using an antidepressant, you have to talk to your doctor about using CBD. Never adjust your dose or add CBD on your own.
CBD may act as an antidepressant as per some studies on animal models . It may possess fast-onset and sustained antidepressant effects through molecular changes in the brain cells and interactions with various neurotransmitters.
Via similar pathways, CBD may also decrease symptoms of anxiety and anxiety disorders .
What Is Escitalopram (Lexapro)?
Escitalopram (Lexapro) is an antidepressant of the selective serotonin reuptake inhibitor (SSRIs) family.
It is an FDA-approved prescription drug that’s used as a treatment for major depressive disorder (MDD), generalized anxiety disorder (GAD), and other psychiatric disorders such as obsessive-compulsive disorder (OCD).
|Trade Names||Lexapro, Cipralex, Jolivel, Cilentra, Elorpax, Nexito|
|Classification||Selective Serotonin Reuptake Inhibitor (SSRIs)|
|CYP Metabolism||CYP2C19, CYP2D6, and CYP3A4.|
|Interaction With CBD||Metabolic competitor|
|Risk of Interaction||Moderate|
What Does Escitalopram (Lexapro) Do?
Escitalopram (Lexapro) works as an antidepressant and an anxiolytic by stopping the serotonin (5-HT) reuptake in the brain.
Serotonin stabilizes the mood, happiness, and feeling of well-being in the body. Studies have found that the level of serotonin in the brain is lower in people with depression. This action could lead to the effects commonly experienced in depression, such as low mood, lack of interest in previously enjoyable activities, etc.
Escitalopram increases the level of serotonin in the brain by stopping its reuptake into the presynaptic neuron. It binds to the orthosteric or the primary binding site on the serotonin transporter (SERT). SERT is the same site where the endogenous serotonin binds. By binding to the SERT, escitalopram thus prevents the reuptake of serotonin. Escitalopram has almost no affinity at other receptors such as histamine and muscarinic receptors.
Escitalopram is the S-enantiomer of racemic citalopram. It is nearly 150 times more potent than citalopram’s R-enantiomer and is responsible for most of the citalopram’s activity. Of all the SSRIs, escitalopram has the highest selectivity for the serotonin transporter. It means it has the lowest rates of adverse effects as compared to other drugs of SSRI. It is also more efficacious and has a faster onset compared to other SSRIs.
Escitalopram, like other SSRIs, can cause abnormal bleeding. Patients at risk of bleeding or those receiving other serotonergic drugs need to be highly cautious.
Side Effects of Escitalopram (Lexapro)
The following list includes the most common side effects of escitalopram:
- Ejaculation disorder
- Dry mouth
- Decreased appetite
- Weight gain
Key Takeaways: Is It Safe to Take Escitalopram (Lexapro) With CBD?
CBD carries a moderate risk of interaction with escitalopram by slowing down the metabolism of escitalopram in the body and acting synergistically with its antidepressant effects.
This may increase the potency of escitalopram by increasing its concentration in the body.
Always discuss new supplements with your doctor if you’ve been prescribed any medications, including escitalopram.
In most cases, CBD won’t interact with SSRIs. However, in rare cases, this combination could result in serious side effects.
Can CBD Replace Antidepressants?
People who are eligible for AARP memberships, teenagers, and even pets, make up the fastest growing demographics of those who are consuming cannabidiol or CBD.
Former New York resident Cory Gleichenhaus, 42, grew tired of the harsh winters, and relocated to Florida for the warmth and palm trees. Last week, he opened a CBD American Shaman store in Delray Beach. Not surprisingly, many of his customers are senior citizens, who, like him, became full-time snowbirds, à la “Seinfeld migration.”
CBD American Shaman is headquartered in Kansas City, Missouri, and has over 150 stores in the Midwest. Although CBD is not legal in all 50 states, their CBD is sourced from industrial hemp grown in Kentucky, which is legal under the farm bill.
During Gleichenhaus’ grand opening, he was pleasantly surprised to hear from a number of his new customers, that they ordered his products from the Internet, and were excited that the brand had finally come to Delray.
The foot traffic has been equally rewarding. “Usually older people are walking by in a group of three or four friends. One person in the group is aware of, or knowledgeable about, CBD and is excited to bring the others up to speed. They do the selling for me,” Gleichenhaus says honestly.
American Shaman does not believe in hard sell tactics. Gleichenhaus candidly admits that senior citizens have enough to deal with, both health-wise, and to avoid being taken in by pushy salespeople and scam artists.
“Our older customers are generally more cautious and skeptical,” he says. “They are worried, ‘Is this marijuana?’ No. ‘Is this legal?’ Yes. Education is a big part of our ethos. We are happy to answer any questions. We have a lot of samples on display that we encourage people to try and experience first hand.”
His typical customers are seeking relief from Fibromyalgia, Parkinson’s disease, arthritis, and general aches and pains.
“One of our first customers was a lady in her 50s who has Parkinson’s disease. When she came in, she couldn’t control her head. I gave her a stronger product called ‘Equine,’ that was originally formulated for horses. It is a 900mg water-soluble CBD. By the time she left the store, her head was shaking slightly but she was no longer having such serious tremors. We all know there is growing anecdotal evidence about the efficacy of CBD, but when you see it with your own eyes, it makes a lasting impact,” says Gleichenhaus.
Helping people naturally is what CBD is all about. “We are definitely seeing a huge shift away from pharmaceuticals,” he says.
Aside from senior citizens, Gleichenhaus recalls noticing two teenagers during his week-long trip to one of CBD American Shaman’s Missouri locations. The teenage customers, who came in separately, had both just turned 18. Each disclosed that they had been on mood and behavior modification medicines for most of their lives. However, when they reached the legal age of consent and were allowed to refuse to be on mood-stabilizers, the two teens wanted to try transitioning to CBD instead. However, it is recommended to attempt this transition under a doctor’s supervision, since it is an adjustment.
One such teenager, a 15-year-old LaCrosse player from Las Vegas, Nevada, was on Zoloft, to help reduce his anxiety, which was exacerbated by his Tourette’s Syndrome. In his case, his mother Roxanne Benton was able to wean him off Zoloft using CBD and they, “have never looked back,” she says. Not only did CBD work much better to control his Tourette’s tics, it greatly reduced his subsequent anxiety.
While physicians are not yet fully aware of what causes Tourette’s, other than the fact that it stems from a neurological issue, taking CBD is a multifaceted approach to helping the body and the mind. An added bonus, her son is achieving a deeper REM sleep, so his brain is potentially being purged of toxins.
His mother Roxanne Benton was so impressed with the positive effects CBD had on her child, that she started her own CBD company called Patriot Botanicals. The hemp used in her products is also sourced legally from a federal pilot program in Kentucky.
Gleichenhaus’ store even has a section for senior pets. “We see pets with separation anxiety, or they have trouble navigating stairs like they used to. Some pets have thunder anxiety during the rainy season,” he says.
All mammals have an endocannabinoid system. The CBD that his company provides to treat pets is human grade.
“It is the same product, just with different flavors,” he says.
While humans are trying blueberry and strawberry flavors, cats are consuming fish flavor, and there is a meat flavor for dogs.
“I have healthy friends who have tried CBD for no particular reason,” says Gleichenhaus. “One said it gave him energy and that it ‘took the edge off things’. Another one said he wanted to take a nap. The reaction is tailored to the person.”
Another significant portion of his clientele are people who want to transition off opioids.
“I had a tenant in a townhouse that I own who overdosed on opioids and died,” Gleichenhaus admitted. “When I had surgery on my knee, I never even filled the painkiller prescription.” He credits a topical CBD salve that he rubs on his knee every morning, for providing pain relief.
“A lot of patients are ditching painkillers for CBD,” he says. “There is much less risk of addiction.”
Gleichenhaus claims that his company uses nanotechnology in the manufacturing process, which shrinks the CBD molecules so it has more bio-availability. In other words, your body absorbs more of it, unlike sublingual tinctures. Still, some people prefer the tinctures because they want to taste the product and feel it working, as opposed to consuming water-soluble CBD, or capsules.
“What you are smelling are the terpenes. Some people are reluctant to try a shot of CBD because they think it will taste bad. Most of these same folks are willing to overlook that concern when doing a shot of Tequila,” he laughs.
The good thing about CBD, Gleichenhaus points out, is that there are various ways in which to consume it. Some people might want to vape it, which is helpful as a smoking cessation aid, while others might want to swallow CBD capsules, so it feels more like taking traditional medicine. “As long as you get it into your body somehow, you will start to feel better.”