As cannabidiol (CBD) becomes more widely available, research continues to discover new benefits with its use. With knowledge of these benefits, also comes more information about how CBD works and how it affects our bodies. Just like other substances you might ingest, CBD acts on certain receptors in our body and must eventually be metabolized and eliminated. It is these interactions within your body that also create the potential for CBD to interact with other medications you might take.
The Dangers of Mixing Drugs
You’ve probably heard from either a healthcare provider or TV advertisement that medications and other substances have the potential to interact with each other when they are taken at the same time. Some interactions occur because the substances create a synergistic effect, which can lead to an exaggerated response in the body when these are combined. Other interactions occur because substances act on or are metabolized by the same receptors in the body. This causes one substance to impact the amount of another substance in the body. These drug interactions can be dangerous, especially when you are unaware or unprepared for the effect.
Psychiatric Drugs that May Interact with Cannabidiol
There are many drugs that have the potential to interact with CBD. Many of the interactions that have been discovered so far have been with medications used in mental health disorders. CBD and other cannabinoids have long been used for their anxiolytic properties. This has led to higher use of these products by people who may also take prescription medications for anxiety or other mental health conditions. Let’s take a closer look at how some of these medications may interact with CBD.
Antidepressants are used frequently for the treatment of anxiety and depression. There are many different classes of antidepressants available, including SSRIs, SNRIs, and tricyclic antidepressants. These medications have been well researched and offer many people relief for their symptoms. Over the years, these medications have been improved to reduce their side effects and improve their effectiveness for treating depression. However, some people are unable to find relief with antidepressant medications alone.
CBD interacts with the endocannabinoid system, which has been linked to affects in mood, emotions, and anxiety. Studies suggest that CBD may improve symptoms of depression through actions on this system and other areas in the brain. People who have added CBD oil to their antidepressant regimen have reported improved symptoms; this is most reported by patients using SSRI medications. That being said, the combination of CBD oil and antidepressants is not taken without risk. CBD has the potential to interact with many antidepressants through the inhibition of their metabolism.
The use of CBD oil in patients on antipsychotic medications is somewhat controversial and is heavily dependent on the cannabis product used and the indication for the antipsychotic medication. The Department of Health has reported that cannabis products are contraindicated, or should not be used, in people with acute psychosis or unstable psychiatric conditions. This warning may be more applicable for products containing THC, which is the psychoactive cannabinoid found in marijuana plants. CBD oil products do not contain this cannabinoid and do not have psychoactive properties. Products high in CBD have actually been found to potentially reduce symptoms of psychosis. That being said, CBD oil does have the potential to interact with antipsychotic medications. It has been found to reduce the clearance of some antipsychotic medications from the body. Before using CBD oil with antipsychotics, you should discuss the risks and benefits with your healthcare provider.
There are a variety of mood stabilizers used to treat bipolar disorder and supplement treatment for other mental health disorders. Lithium has been used as a mood stabilizer for decades. There are also many medications that are used as mood stabilizers that are also used in seizure disorders, such as lamotrigine or valproic acid. CBD has been studied in these patients as well, and it has been found to improve mood in bipolar disorder. Some studies have found that CBD may have effects similar to lithium for these patients. Patients who suffer from bipolar disorder may be at higher risk for mood swings if using products containing THC, which can be anxiety-inducing. CBD also has the potential to interact with these medications through the CYP-450 system in a similar way that it interacts with antidepressants and antipsychotic medications.
CBD and cannabinoids have been used to reduce anxiety for many years. They produce a calming effect and can help users relax. Benzodiazepines are also used by those who suffer from anxiety to calm their symptoms. When used in combination with benzodiazepines, CBD products have the potential to increase sedation. These side effects should be monitored closely to ensure the safe use of these drugs together. If cannabis products are used that contain THC, there is also a risk that this product could cause worse anxiety.
The use of CBD with caffeine, the most commonly used stimulant, has been found to be a good combination. These drugs work well together to improve alertness while reducing symptoms of anxiety when used in the right amounts. However, if too much CBD is used it may cause more symptoms of sedation which could offset the desired stimulation from caffeine.
CBD Oil Drug Interactions: The CYP450 Pathway
Many of the studied interactions between CBD oil and medications or other substances are related to CBD’s actions on the CYP450 pathway in the body.
What is the Cytochrome P-450 System?
The Cytochrome P-450 system describes the elaborate group of enzymes in the liver that are responsible for the metabolism of many drugs. Each enzyme has its own name; for example, the enzyme responsible for the metabolism of the most drugs is the CYP3A4 enzyme.
Why Does CYP450 Matter?
The CYP450 enzyme plays a huge role in the actions and metabolism of many substances that enter our body. Without these enzymes, these medications and other drugs would hang around in your body much longer, leaving you more vulnerable to the drug’s actions and side effects. Breaking down drugs for elimination from the body is not the only role of the CYP enzymes. There are some medications that need to be broken down by the CYP enzymes before they become active in the body. These medications are called prodrugs, and if they are unable to be metabolized by the CYP enzymes, they remain inactive and do not work. Any time medications block these enzymes or increase the production of these enzymes, it can make a huge impact on the metabolism of many other substances. That makes it very important to monitor this system and how it is impacted by drugs.
Effects of CBD in the Cytochrome P-450 System
The impact of CBD on the Cytochrome P-450 System is still being studied. Researchers have found that CBD inhibits the enzymes CYP3A4 and CYP2D6. These are both major metabolizing enzymes for our body, which means CBD has the potential to interact with many substances. CBD may impact other CYP enzymes in the body as well, but they are not well understood yet. More research is also needed to understand the relationship between the dose of CBD and its potential to impact these enzymes, as well as the differences in drug interactions between CBD oil and other preparations that include CBD. It is also unclear if the route that CBD is ingested impacts its ability to interact with other medications.
How to Use CBD Safely
As the laws around cannabinoids and CBD continue to change, CBD oil is becoming more accessible for people around the world. Because of this, CBD oil is becoming an attractive option for improving the treatment of many conditions. The safest way to use CBD products would be to include and have honest conversations with your healthcare providers about their risks and benefits. They can help you determine safe options for adding CBD to your current medication regimens while minimizing side effects or toxic drug levels. They can also help you find the appropriate amount of CBD to help with your condition. When used appropriately, you may find that CBD oil helps you improve your symptoms and reduce your use of other medications.