Cannabis has been loved for centuries by its users for the different types of effects it offers. Some cannabis enthusiasts have gone further by trying different means to augment these effects. Some for medical reasons, while some are exploring the possibility just for recreational purposes. While these combinations can really open users up to a different dimension of effects, it is important that care is taken while combining cannabis with other drugs. One such class of drugs that has been mixed with cannabis for desired effects are antidepressants. Read on as we look deeply into what occurs when cannabis is mixed with antidepressants.
Cannabis and Antidepressants
Antidepressants are a special class of prescription drugs that are used to help elevate the moods of people suffering from depression. An analysis by the American Psychological Association shows that 8 percent of people between the age of 20 to 39 are on antidepressant medication. There are different classes of antidepressants that work by different mechanisms. Examples of the classes include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), Tricyclic Antidepressants (TCA), and Monoamine Oxidase Inhibitors (MAO). Over 260 million people worldwide suffer from depression and many rely on these drugs for relief from its symptoms.
Cannabis has also be termed to be effective for dealing with depression. The natural herb contains cannabinoids such as THC and CBD which can help with mood elevation and promoting calm and relaxation. The ability of these cannabinoids to create euphoric feeling has been projected by many as a therapeutic answer to the symptoms of depression. Though there are limited clinical evidence to support this fact, however, anecdotal evidence point to its effectiveness. This reality has prompted the reality of patients on antidepressants combining the prescribed drugs with cannabis for better effectiveness.
The question we should ask is what exactly occurs when cannabis is mixed with antidepressants. Does it augment the effects of the antidepressants to treat the depression in synergy? Does it antagonize the effect of the antidepressants and reduce their therapeutic effectiveness. Read on as we provide answers to these questions.
Synergistic effect of Cannabis and Antidepressants
The general idea of using cannabis and antidepressants is to bring about synergistic action between the drugs. Though there are limited studies on the topics, early signs show the possibility of this effect. Cannabis works in the body through the endocannabinoid system which has a huge role to play in the regulation of mood in the body. The endocannabinoid system contains special cannabinoid receptors, endocannabinoids, and enzymes that work to modulate the system. Different cannabinoids from cannabis work through this system to help promote elevated moods and relaxation.
Some of the cannabinoids in cannabis also have structures similar to endocannabinoids in the system. This helps them to directly or indirectly affect the system. THC for example promotes elevated mood with a euphoric feeling while CBD gives rise to relaxed states. These effects of cannabis along with anecdotal evidence promote the proposed effectiveness of cannabis for depression.
This has prompted research into the synergistic role of cannabis with antidepressants. Danielle Romell Ph.D., a Director at the University of California, Irvine worked to show this effect in a particular study. While operating under the Centre for Study of Cannabis at the university, she researched if adding cannabis to 10mg or 20mg of Prozac or Paxil makes it more effective. The issue she was able to identify with the study was the dose of cannabis. For marijuana users that self medicate, they do not work with a particular dose making it hard to arrive at a definite conclusion of effectiveness. Using a dose that is too small can bring no therapeutic effect. Likewise using a dose that is too high can bring about other health risks.
This is why if cannabis users on antidepressants are going to use cannabis with it, it is advisable to start slow and work your way up. Expected effects when it comes to cannabis varies in terms of varieties of strain and quantity. While starting, it is best to use a strain with a balanced cannabinoid profile in terms of the ratio of THC and CBD. This will help to promote reproducibility of the effects experienced.
Relationship between cannabis and different classes of antidepressants
As stated earlier, there are different classes of antidepressants, and cannabis and its cannabinoids interact differently with these antidepressants. The antidepressants have different mechanisms of action which means that it can have a different types of interactions with the effects of cannabis. Cannabis can interfere with the metabolism of the drug thereby making it more available. This increases the potency of the drug because more of the drug is available in the system. Cannabis can also reduce the effectiveness of the drug by increasing the rate of excretion
Selective Serotonin Reuptake Inhibitors (SSRIs) ex. Prozac, Paxil
CBD increases the potency of SSRIs by reducing the rate of its excretion. This makes the antidepressant concentration in the body to be increased to bring about a therapeutic effect. SSRIs also have a low risk of potential side effects when combined with CBD. However, it is important to note that excess serotonin creates a condition known as Serotonin syndrome.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) ex. Cymbalta, Fetzima
THC reduces the effectiveness of this class of antidepressants because it increases its rate of excretion. This class of antidepressants has a low to moderate risk of potential side effects.
Tricyclic Antidepressants (TCA) ex. Imipramine, Amitriptyline.
This class of antidepressants has a high risk of potential side effects with cannabis. Side effects include dry mouth, high blood pressure, and constipation. It is advised that such a class of antidepressants is not to be mixed with cannabis.
Monoamine Oxidase Inhibitors (MOIs) ex. Phenelzine
This class of antidepressants has a high risk of potential side effects when combined with cannabis. Side effects can include fatigue, muscle aches, insomnia, and reduced libido. It is advised that this class of antidepressants is not to be mixed with cannabis.
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