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Solidarité Femmes, c'est un réseau d'associations spécialisées dans l'accueil, l'accompagnement et l'hébergement des femmes victimes de violences. Plus de… In our latest question, our cannabis pharmacist discusses whether using CBD alongside the antidepressant medication sertraline is safe. What happens when someone takes Zoloft and marijuana at the same time? Here are the side effects and reactions can occur between these two substances.

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Is it Safe to Use CBD and Zoloft (sertraline) at the same time?

In our latest question and answer, the medical cannabis pharmacist discusses if it is ok to use CBD oil while taking sertraline.

Answered by: Dr. Geoffrey Brown, PharmD

Khia Asked

I take Zoloft for my depression and would like to start supplementing CBD to reduce inflammation and help with anxiety. Is it safe to use with Zoloft?

Summary

There is limited data available on CBD’s potential to cause interactions with sertraline (Zoloft).
CBD may inhibit metabolic enzymes involved in the metabolism of sertraline but, the chances of CBD causing clinically significant interactions with sertraline are rather low.
Be sure to let your psychiatrist or doctor that manages your sertraline therapy know that you’re using CBD.

Answer

Hi Khia, and thank you for your question. While I couldn’t find any studies investigating this interaction in particular, I was able to find some information regarding the metabolism of both of drugs which can help us answer questions about the likelihood of an interaction.

In short, CBD may inhibit some of the enzymes that’re involved in the metabolism of sertraline (Zoloft). Therefore, theoretically, there is a possibility the two could interact. However, the likelihood that this interaction would be clinically significant or something you need to be concerned with is rather low.

Sertraline (Brand name Zoloft) is a selective serotonin reuptake inhibitor or SSRI and is the most commonly prescribed antidepressant medication in the United States. Sertraline is metabolized by a number of CYP enzymes present in the liver including CYP2B6 and to a lesser extent CYP2C19, CYP2C9, CYP3A4, and CYP2D6 . According to the manufacturer’s package insert for sertraline, that’s reviewed by the FDA, dose reductions may be warranted in patients treated with sertraline that are taking other drugs metabolized by these enzymes.

Cannabidiol (CBD) is the primary non-euphoric cannabinoid in cannabis/hemp and is now a common ingredient in many health and consumer products. One of the most commonly claimed indications for CBD is anxiety. Preliminary evidence suggests CBD shows promise as a potential treatment for anxiety, but the doses researched vary greatly between studies.

CBD is also metabolized by CYP enzymes in the liver, so using CBD may alter the way these enzymes function in regard to their ability to metabolize other drugs such as sertraline.

According to the package insert for the FDA approved CBD oral solution, CBD is metabolized by CYP3A4 and CYP2C19, and has the potential to inhibit CYP1A2, CYP2B6, CYP2C8, CYP2C9, and CYP2C19. Therefore, because CBD can inhibit some of the same enzymes that’re responsible for the metabolism of sertraline, there’s a possibility that CBD could reduce the metabolism of sertraline leading to increased concentrations of the drug in the body increasing the risk of adverse effects due to sertraline.

While there’s certainly a theoretical basis for this interaction, I would not be too concerned about this from a safety standpoint for two reasons. For one, the blood concentrations of CBD needed to inhibit these enzymes aren’t likely to be achieved by CBD taken at usual doses. The second reason is because multiple CYP enzymes are responsible for the metabolism of sertraline it would be difficult for CBD alone to cause a serious interaction by interfering with just one or even a couple of those enzymes. That being said, i t’s still a good idea to let your doctor of psychiatrist that manages your sertraline therapy know that you’re using CBD. That way they can monitor for any changes or adverse effects from changes in sertraline metabolism.

To summarize, there’s a possibility an interaction between CBD and sertraline could occur, but unless you’re consistently using high doses of CBD (upwards of 100 mg multiple times per day) I wouldn’t worry too much about it. I hope this helps answer your question.

Thanks again Khia. Please don’t hesitate to reach out again in the future with any cannabis questions you have.

References

Zoloft [package insert]. New York, NY: Pfizer, Inc. 2016.

Epidiolex [ package insert ]. Carlsbad, CA: Greenwich Biosciences, Inc. 2020.

Marijuana and Zoloft: Interactions, Effects, & Reactions

By The Recovery Village | Editor Melissa Carmona
Medically Reviewed By Dr. Jessica Pyhtila, PharmD A licensed behavioral health or medical professional on The Recovery Village Editorial Team has analyzed and confirmed every statistic, study and medical claim on this page. | Last Updated: May 25, 2022

Though not enough research has been conducted on marijuana and Zoloft interactions, people combining these two substances may experience intensified side effects.

When you take a prescription medication, particularly one intended for long-term use, it’s important to be aware of any possible interactions, effects, and reactions that may come with its use. One example of a long-term medication that’s commonly prescribed is Zoloft.

Zoloft is a prescription antidepressant, and people frequently wonder how it might interact with other substances or what the potential side effects may be. Here is more information about one substance in particular: marijuana, what interactions, effects, and reactions it may have with Zoloft.

Article at a Glance:

  • Marijuana and Zoloft interactions may be mild.
  • Marijuana may worsen anxiety and amplify Zoloft’s side effects.
  • At this time, there has not been much research conducted on marijuana use with Zoloft.

Combining Marijuana and Zoloft

At this time, there is no known drug interaction between marijuana and Zoloft. Little research has been done on the topic of marijuana and antidepressant interactions. However, how a person will react to combining the substances can be difficult to predict. Because the THC content of marijuana can worsen anxiety, someone taking Zoloft for anxiety or a panic disorder may have worsened symptoms if they take marijuana, especially if it has a high THC content or they take a high dose.

That said, there could be some other negative consequences to taking both substances together. They share some similar side effects, including nausea and dizziness. Taking both substances at the same time may intensify these side effects.

It can also be difficult to determine if Zoloft is working when you’re also using marijuana. It may make the Zoloft appear less effective when, in reality, it’s the marijuana and Zoloft interaction you’re experiencing. Your doctor will likely recommend that you abstain from using marijuana when you’re first prescribed Zoloft, so they will be able to determine how well it’s working to treat your symptoms.

What is Marijuana Used For?

Marijuana is legal for medical use in many states, and recreationally in a few. Some people use marijuana to treat mood disorders like depression and anxiety. One of the main components of marijuana, cannabidiol, or CBD, may be beneficial in anxiety. However, another main component of marijuana, tetrahydrocannabinol, or THC, is linked to mood problems, including psychosis, especially when used in large amounts. Cannabis use disorder is common in people with depression and may contribute to the development of depression.

What is Zoloft Prescribed For?

Zoloft is a prescription medicine that’s FDA-approved to treat mood problems like depression and anxiety. The generic name is sertraline, and it’s a selective serotonin reuptake inhibitor or an SSRI. The way Zoloft and other SSRIs work is by increasing the level of serotonin in the brain, which improves mood. This can also help with sleep problems and boost energy levels.

When someone is first prescribed Zoloft, the doctor will likely start them on the lowest possible dose that will treat symptoms but minimize side effects, and over time the dose may be adjusted as needed. Some of the common side effects of Zoloft can include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Nervousness
  • Dizziness
  • Sexual problems
  • Weight changes

Zoloft tends to be more likely than other SSRIs to cause diarrhea. In younger people, it may create severe side effects such as suicidal tendencies.

Zoloft and many other SSRIs may interact with other drugs such as monoamine oxidase inhibitors, or MAOIs. It’s important when discussing Zoloft with your doctor that you let them know of any prescription drugs, over-the-counter medicines, or herbal supplements you may be taking.

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