CBD & drug-drug interactions

How CBD Interact With Your Psychiatric Drugs:

A Quick Guide

It isn’t exactly news that drugs have been in use as part of mental-health treatments for quite some time—legally, illegally, with a prescription, or without one.

With the increasing acceptance of CBD as a remarkable natural supplement for mental wellness, it’s normal for people to want to pair it with their prescribed drugs.

Evidence indicates that CBD is safe to consume, and side effects are low and mild. But it still comes with a potential risk.

There’s a chance that CBD may interact with your medicines and cause unwanted side effects. Drug-drug interactions are a reality for many patients, and virtually every substance, natural or synthetic, will interact with other substances.

Since you’re currently using CBD for medical purposes—or are considering doing so—you need to think about the interaction between CBD and psychiatric drugs and take caution.

Let’s shed some light on this important subject.

Table of Contents

Types of Drug Interactions

While there may be many types of dangerous drug interactions, they usually fall into the following three categories.

DRUG-DRUG INTERACTIONS

Drug-drug interactions occur when a drug interferes with or modifies the effect of another drug.

They can either make the original drug less effective or increase the overall effect of both drugs. Some interactions may even cause you adverse side effects.

DRUG-FOOD INTERACTIONS

Drugs don’t only react with other drugs and may also be triggered because of your everyday diet. This is the case of grapefruits, as they can interact with cholesterol-lowering drugs—statins.

This interaction can increase the amount of some statins in your blood and lead to side effects like muscle soreness and liver abnormalities.

DRUG-CONDITION INTERACTIONS

This is probably the most troublesome category of drug interactions. It’s caused when the drug reacts with a known or unknown medical condition in the user.

An example of such an unwanted interaction could be as simple as a person with high blood pressure taking beta-blockers being unable to use decongestant nasal products without the risk of worsening asthma.

What Are Psychiatric Drugs?

They’re basically legal drugs used to balance chemicals in your brain to help you alleviate the symptoms associated with different types of mental disorders.

Drugs for mental health problems were introduced after the World War II. Nerve tonics were used to keep people from visiting the asylum, while sedatives helped control patients at asylums. But the side-effects of these drugs were unbearable for many patients.

As time passed the world witnessed dramatic drugs devel­opments. In the early 50s, the introduction of the first effective anti-psychotic—Chlorpromazine—to treat schizophrenia, and anti-depressants like Imipramine, are considered some of the great breakthroughs in psychiatry’s history.

This drugs controlled patients without making them sleepy while showing improvements in thinking and emotional behavior. And also ended the need for inhumane procedures like lobotomy and electroconvulsive therapy (ECT).

Now that we have advanced laboratories all over the world, there have been many breakthroughs in pharmaceuticals. We now have minor tranquilizers for anxiety sufferers, mood stabilizers, antidepressants, antipsychotics, and even drugs that can tone down and treat ADHD.

All of these breakthroughs led to a huge boom for pharmaceutical products and the closure of most mental institutions. On the other hand, more incidents of drug abuse and adverse drug-drug interactions started to be reported.

 

Psychotropics: The Pros

Heads up: This article is not intended to make recommendations about medication or serve as medical advice. You should use the information provided only for reference.

There’s a time and a place for medication to deal with mental health concerns such as anxiety and depression, let’s explore these situations:

MEDICATION CAN BE VERY USEFUL IF YOU'RE IN A VERY LOW PLACE

Imagine for a second that you have anxiety that’s so severe that you feel paralyzed, or your depression has escalated so much that you’re having suicide thoughts. Now with the help of modern medication, you can reduce such effects.

For people who feel derailed by everything life has to throw at them, the right psychotropics can quiet their busy minds.

MEDICATION CAN SUPPORT YOUR PSYCHOTHERAPY PROCESS

It can be very difficult to focus on self-care while experiencing symptoms of depression, anxiety, and other mental-health problems. With the help of the right medications, you can bring stability into your life, which results in a smooth ride along your process of psychotherapy.

Even the Journal of the American Medical Association pointed out that targeted medication and cognitive behavioral therapy (CBT) can bring about quite a lot of improvements in ADHD symptoms in adults. This will eventually lead to the complete elimination or reduced use of psychotropics.

Psychotropics: The Cons

DRUGS DON’T WORK FOR EVERYONE

Anyone dealing with a mental-health disorder knows how challenging it can be to find a medication that actually works.

You bounce from drug to drug, hoping to find relief, but nothing gets better, or, even worse, your symptoms are exacerbated.

I’ve been there. I tried several medicines without success, and the side effects were as bad as the anxiety symptoms.

DRUGS AREN’T ALWAYS NECESSARY

Yes, they’re effective, but it has been proven time and time again that cognitive therapy can be slightly more effective while also more affordable than these drugs.

The latest research has also brought forth findings that antidepressants might be just as effective as placebos.

DRUGS CAN BE HARMFUL

We have already recognized that medication is necessary at times. However, like every drug, psychotropic medications come with their own side effects and risks.

Yes, we’re talking about physical and psychological side effects like:

PHYSICAL SYMPTOMS

  • Changes in appetite
  • Drowsiness
  • Dizziness
  • Weight gain
  • Sleep disturbance
  • Heart attack, stroke and sudden death

PSYCHOLOGICAL SYMPTOMS

  • Mania
  • Psychosis
  • Hallucinations
  • Depersonalization

Psychotropic drugs can double the risk of suicide. Long-term use can create a lifetime of physical and mental damage.

That’s why these medications need to be taken with a qualified health professional’s guidance, and this warning is echoed by public awareness advertisements and doctors.

Furthermore, antipsychotics have also been found to cause some permanent damages that could lead to Parkinson’s disease, dyskinesia, and even death.

Moving on to the CBD zone, now let me ask you, do you know….

What the Heck Is CBD?

CBD stands for cannabidiol, a phytocannabinoid found in the cannabis plant.

The first thing you need to understand about CBD is that it’s non-intoxicating, meaning it won’t get you high. Not. One. Bit. At least, not on its own.

The term “cannabis” includes both hemp and marijuana. Marijuana is rich in THC, which is the compound that alters your mind. Hemp, on the other hand, is rich in CBD and contains only minimal traces of THC—less than 0.3%.

Most of the CBD you find on the market is hemp-derived, which makes it safe and legal.

CBD is also a non-toxic substance: the World Health Organization (WHO) confirmed that CBD is well-tolerated for most people with a good safety profile and no potential for abuse.

CBD is a full-blown phenomenon, touted as Nature’s most powerful multitasking substance—but the truth is… CBD is NOT approved as a supplement, and it’s NOT a cure-all drug.

Currently, CBD is a drug approved by international federal agencies to treat seizures, multiple sclerosis, and cancer-related pain. One of these drugs has been approved by the FDA—Epidiolex, a drug to treat childhood epilepsy.

Many other therapeutic benefits are attributed to this cannabinoid, but there’s not enough scientific evidence to fully prove them.

CBD is believed to be a potent antioxidant that fights chronic inflammation and pain. Countless success stories vouch for CBD as a natural treatment to relieve stress and anxiety.

Ongoing research holds a promise of the potential benefits of CBD, possibly treating psychological disorders like PTSD, schizophrenia, and OCD.

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Many people are using CBD to treat a wide range of ailments, and I wish its use alongside other medicines was a simple matter—but that isn’t the case.

Let’s dig a little deeper into the issue.

How Does CBD Interact with These Medications?

CBD is a botanical, meaning it’s a plant’s natural compound with drug-like activities.

Your body has ways to metabolize drugs and potential toxic compounds. The cytochrome P450 (CYP450) enzyme system in your liver is responsible for the metabolism of many medications—including CBD and your psychotropics.

According to experts, this system is host to about 50 unique kinds of enzymes that locate, process, and eliminate the toxins that were consumed or developed within your body.

WHY IS THIS IMPORTANT?

Do you know how doctors determine the right dosages of drugs and medications for you? Well, one of the most important factors they take into consideration is how much of these substances can be healthily processed by your cytochrome P450 system.

Now, if it were as simple as you taking one drug at a time, then calculating dosage information would be much simpler.

There are, however, many substances and medications that have the knack of affecting the individual processing time, making drugs metabolize slower or faster than they would have on their own.

Since we’re on the topic, it’s also possible for someone who has an unhealthy liver because of pre-existing health problems to experience the effect of drugs and medications differently—and not in a good way.

CBD & THE CYTOCHROME P-450 SYSTEM

Just as a drug may alter the CYP450 metabolizing enzymes, so can a botanical like CBD. Adding your favorite CBD for anxiety into the equation means that your cytochrome system’s natural rate of breaking down certain drugs is compromised further.

Cannabinoids are known to increase the overall processing times of your cytochrome P450 system. With the CYP450 system in your body compromised, you can expect to have higher levels of drugs in your system than intended at any given point of time.

In other words, the cytochrome p450 enzymes in the liver aren’t as efficient as it used to be after the ingestion of cannabinoids.  

This is usually the reason why people experience unwanted side effects—the most lethal of which is an overdose.

WHAT ARE THE DANGERS OF MIXING PSYCHIATRY DRUGS?

How botanicals and psychotropics interact is not a straightforward or predictable process.

  • SEROTONIN SYNDROME

    Serotonin syndrome is rare but definitely a risk to be considered when combining multiple antidepressants. Serotonin syndrome symptoms usually occur when you take a new drug or increase the dose of one you’re already taking. The symptoms associated with this syndrome:

  • Headaches
  • Muscle rigidity
  • Heavy sweating
  • Diarrhea
  • Agitation or restlessness
  • Confusion
  • Rapid heart rate and high blood pressure
  • Dilated pupils
  • Twitching muscles or loss of muscle coordination
  • Shivering
  • Goose bumps
  • DRUG-INDUCED LONG QT SYNDROME

    Combining first-generation antipsychotics increases the risk of drug-induced long QT syndrome, which is a condition that makes your heart muscle take longer than normal to recharge between beats.

  • RISK OF FALLING

    Mixing sedative drugs can increase the risk of falling, which can be pretty dangerous for elderly patients.

What Psychotropics May Interact with CBD?

ANTIDEPRESSANTS

Antidepressants are drugs that aim to correct chemical imbalances in your brain. They’re not a take-as-needed drug, because they don’t soothe your anxiety right away.

The process to relieve the symptoms can take weeks or even months. If you stop them too quickly, antidepressant withdrawal can spark symptoms such as:

  • Extreme depression
  • Fatigue
  • Insomnia
  • Irritability
  • Flu-like symptoms
  • More anxiety

CBD and psychiatric drugs like tricyclic antidepressants (TCAs) may have adverse drug-drug interactions.

Both of these drugs are known to result in abnormally high blood pressures and fast heartbeats. This often also leads to other side effects such as mood swings, restlessness, confusion, and even hallucinations.

Mixing both of these drugs has been found to be the cause of tachycardia, and you could end up with this even when there are no apparent signs of any heart condition.

BENZODIAZEPINES

Commonly known as “benzos,” this drugs impact the GABA-A neurotransmitter, slowing down the activity of nerves in your brain. By enhancing the effects of GABA-A, benzos produce sedative, anticonvulsant and anxiolytic effects.

They’re fast and effectivel but they also come with side effects, such as dependency and withdrawal. When taken regularly, you build up a tolerance and they will no longer work; you will need more and more each time, leading to addiction.

One popular drug that has been classified as a benzodiazepine is Xanax, which isn’t an over-the-counter drug. To get Xanax, you need a prescription.

If you were to mix CBD with these drugs, you would experience heightened effects of both or at least one of the drugs. This means having trouble concentrating, getting confused easily, and even severe drowsiness.

If you’re a little older, then you may even experience problems coordinating your thoughts and actions.

STIMULANTS

Also known as “uppers,” stimulants are drugs that can increase dopamine levels within the brain. They have performance-enhancing and mood-enhancing properties and are typically prescribed for disorders such as ADHD and narcolepsy.

They’re highly addictive, and therefore, some of the most abused drugs in the world.

You can find over-the-counter uppers such as caffeine and nicotine. Legal uppers like Adderall and Ritalin that require a doctor’s order and illegal stuff such as ecstasy and cocaine.

If these highly addictive drugs are mixed with cannabis, it will give the person taking them paranoia or anxiety.

It has been found that this particular drug-drug interaction can cause increased vulnerability to schizophrenia, because developing psychotic manifestations in this state is easy.

This drug-drug interaction can get worse. Some studies have even found that mixing cannabinoids with these stimulants can actually increase the effects of the latter’s addictive properties.

ANTI-PSYCHOTICS

These medications are major tranquilizers used for people who are experiencing psychotic episodes such as delusions, hallucinations, or the symptoms that are related to schizophrenia.

Cannabinoids tend to alter the metabolism enzymes of the user—which also means that it alters how drugs are broken down in your body.

So, how is that bad? Well, once the drug-drug interaction occurs, the antipsychotics aren’t broken down as efficiently as they did before. As a result, people with schizophrenia will begin to experience severe forms of depression, which can only be cured if they’re treated.

Symptoms to watch out for include:

  • Impaired driving
  • Confusion
  • Decreased cognitive function
  • Slow motor skills
  • Excessive sedation

MOOD STABILIZERS

Mood stabilizers are exactly what their name implies. One particularly common mood stabilizer is Lamotrigine, or Lamictal.

Mixing this drug with cannabis causes the user to experience difficulty in focusing, confusion, drowsiness, and dizziness.

These effects are naturally more dangerous when they’re experimented by older folks. You shouldn’t try such dangerous drug-drug interactions in any way.

Final Thoughts

CBD on its own, is a very safe compound and has never resulted in overdoses. You can enjoy its therapeutic benefits for anxiety and depression among so many more health-related reliefs, without any risk of intoxication.

However, like any other drug, CBD can interact with other substances, and it’s extremely important to be aware of these drug-drug interactions.

Psychotropic drugs, on the other hand, almost always have a side effect—if not many—and they’re also known to have adverse reactions with foods and pre-existing medical conditions.

I strongly encourage you to consult with your physician before taking CBD if you’re currently using any other medication or if you have a disorder that could be affected.