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Nearly 13 percent of the people in the United States, aged 12 and older, takes some sort of antidepressant for depression, anxiety or other issues, according to the Centers for Disease Control and Prevention (CDC).
A 2018 study, published in the Annals of Internal Medicine, found that almost 15 percent of U.S. adults reported smoking weed in the previous year. With so many people taking prescription medications and smoking pot, it begs the question, is it safe to mix marijuana and antidepressants?
“Historically, the downsides of marijuana have been minimized. It’s use has been considered safe and without risk and that is not necessarily the case,” Dr. Michael Lynch, a toxicologist and medical director of the Pittsburgh Poison Center of the University of Pittsburgh Medical Center said in an interview with Reuters.
What is Known About Using Antidepressants and Weed Together?
Both doctors and patients alike are unsure about whether using marijuana together with antidepressants is harmful or safe because there hasn’t been any studies yet.
Here are five things we do know about mixing antidepressants and weed…
1. There Isn’t Much Data or Research
The greatest problem for doctors and users of marijuana is that everyone is dealing with a lack of research supporting the positive or negative health properties of marijuana.
At this point, nobody really knows for sure if it is safe or harmful, or to what degree. The general consensus is that it is relatively safe and may even have some positive health benefits.
But as far as the safety or efficacy of mixing it with other medications, there’s no real evidence yet to back any claims.
One of the biggest reasons there’s so little data about the combined effects of pot and antidepressants like Zoloft, Paxil, Lexapro, and others, is that cannabis is still listed as a Schedule I substance under federal law.
Because of that classification, it’s all but impossible to get funding for scientific research on the issue or other marijuana and medication-related questions.
Medical or recreational marijuana is now legal in almost every state in the country with less than a dozen states where it is still illegal in all instances.
With legal marijuana use in so many states, more research and data is essential for doctors to make informed decisions when prescribing medications that may cause negative interactions.
2. Doctors Won’t Prescribe Antidepressants to Patients Who Use Marijuana
Because of the lack of evidence-based research, most physicians do not recommend mixing marijuana and antidepressants.
In addition, many doctors will not even prescribe antidepressants to a patient they believe, or know is smoking pot or using edible marijuana.
Most medications have warning labels about adverse effects of drinking alcohol and mixing prescriptions when it applies, because there is research to back up the claim and a long history of patients who have had adverse reactions.
We don’t have that history with marijuana yet, so doctors must rely on sound medical judgment based on how antidepressants and marijuana work in the brain.
3.Lexapro and Weed Might Cause Problems
Lexapro is one of the most commonly prescribed antidepressants on the market, and has been known to cause problems for some people when it is mixed with marijuana.
Some healthcare professionals have speculated that it could cause seizures when the two are mixed.
But it’s not just Lexapro that could cause an adverse issue.
Antidepressants fall into several categories based on the way they interact with neurotransmitters and chemicals in the brain, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs).
The most common antidepressants fall into one of those categories and include:
Most of the time, these medications are used to control serotonin, dopamine, and norepinephrine levels, which impact our mood.
Marijuana also interacts with neurotransmitters, and mixing it with antidepressants can cause an overload of too much serotonin in the brain.
Doctors know that certain medications and antidepressants can’t be mixed, but they don’t quite know how they mix with marijuana yet.
They do know that both can increase serotonin levels, and too much of an increase can lead to Serotonin Syndrome, with one of the symptoms being seizures.
4. Marijuana Can Cause Anxiety
Marijuana is known to make the symptoms of anxiety worse, especially certain strains, or those that have high a THC content, the psychoactive ingredient in weed.
Many people use marijuana to self-medicate or cope with depression, anxiety, stress, and other mental health issues. For some it actually helps.
For others, it can induce paranoia or anxiety based on the way it interacts with their body. Just like some people have a negative reaction to drinking alcohol, the same can be said for weed.
The two main types of marijuana strains – indica and sativa – work differently in the body to produce different types of highs.
Indica strains are relaxing and might work best for most people with anxiety, but sativa strains produce a more energetic high that can actually increase anxiety or paranoia.
Some people have no idea what type of strain they use, which is why they can have a good experience one time and bad experience the next.
There is a lot of anecdotal evidence among regular pot-users that marijuana actually helps the symptoms of anxiety or depression.
However, there are plenty of others that experienced terrible weed-induced anxiety because they consumed too much of the drug or were unaware that they were sensitive to THC.
Edibles are notorious for causing anxiety, in part, because it is sometimes difficult to know how much THC has been ingested.
The goal of antidepressants is to regulate the brain’s chemistry and by adding marijuana to the mix could be counter-productive to using the medication.
5. Marijuana is Addictive and Might Contribute to Depression
There is also the matter of marijuana addiction, a common and often untreated disorder. Adolescents and young adults up to the age of 25 are especially vulnerable because their brains are not yet fully developed.
“[Around] 10 percent of adult users become addicted, while about 17 percent of adolescent users do. Those are not insignificant numbers when you consider that the overall numbers are increasing,” Dr. Lynch told Reuters, and data from the National Institutes of Health (NIH) support this.
An estimated 2.5 percent of adults, around 6 million people, met the criteria for marijuana use disorder in 2016 alone. An additional 6 percent met the criteria at some point in their lives, reports the NIH survey, and these numbers are very likely underreported.
Like other chronic drug use, long-term cannabis consumption that leads to addiction actually changes the structure and function of the brain and can cause the symptoms of depression to worsen.
Even though smoking pot may have once helped some people overcome depression symptoms, in the long run, daily use will eventually cause the symptoms to become worse in may cases.
One of the signs of addiction is an increased tolerance to a substance. Regular users of marijuana understand this and they have to smoke or eat more to get the same effect as they did when they first began using it.
This tolerance takes a toll on the brain, and what once worked well as periodic way to alleviate the blues from a bad day, is now necessary for a daily fix. Without smoking throughout the day, some users live in a regular state of depression and can’t feel happy without weed.
How to Deal With Depression and Marijuana
For habitual marijuana users who smoke daily and have developed an unwanted dependence, the only course of action is to stop smoking and let the brain return to a normal state of homeostasis, which can take months to happen, long after it is completely out of the system.
For those who suffer from depression and have been using marijuana to cope with the symptoms, it’s worth a try to see if antidepressant medication will be more effective.
But first, it’s necessary to stop using pot, because mixing marijuana and weed could cause adverse health issues, or at the very least, might make the medication ineffective at doing its job.
For now, health care experts do not know exactly what kind of negative side effects might occur from using antidepressants together with marijuana until more research is conducted.
From what we do know, it’s imperative to stop using marijuana for antidepressants to be used safely and effectively.