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A recent WHO publication shows that there is a significant increase in the global prevalence of depression. To combat this, many screening and treatment options exist and are still being developed to treat this condition.
Among these, the use of antidepressants like fluoxetine (Prozac) and sertraline (Zoloft) stands out as the most popular medications for depression. However, there are recent developments and ongoing research to explore the use of medicinal cannabis as an additional treatment option. But is combining Prozac and weed safe?
The challenge is that there is a potential danger in combining cannabis and antidepressants, a fact that many people are not aware of. Before the pandemic, more than 1 in 8 adults in the United States were using antidepressants, and this number has increased significantly today. Additionally, 49% of U.S. adults have reported using cannabis before.
It is, therefore, essential to understand the risks associated with combining these two substances to avoid any unpleasant health complications. This article explains everything you need to know about how cannabis and antidepressants like fluoxetine interact. Make sure you read till the end!
About Prozac and Cannabis
Prozac and cannabis affect the body in different ways. It’s essential to understand how they each interact with our bodily systems individually before analyzing their combined impact.
How Cannabis Affects the Body
Cannabis is a plant that contains tetrahydrocannabinol (THC), cannabidiol (CBD), and other compounds. While it is commonly used as a recreational substance, it has a lot of medical advantages. Cannabis is used to treat chronic pain, anxiety, post-traumatic stress disorder (PTSD), and some other neurological disorders with a healthcare provider’s recommendation.
Recent medical explorations have revealed the possibility of using cannabis to alleviate depression because of how it affects the brain and endocannabinoidome (eCBome). The antidepressant effects of THC may come from its CB1 receptor activity and CBD’s stimulation of serotonin receptors and endocannabinoids.
There are tiny receptors on brain cells called cannabinoid receptors. These receptors receive endocannabinoids that nerve cells naturally produce to connect our body and brain. When cannabis is consumed, it introduces phytocannabinoids that can mimic or alter levels of endocannabinoids, thus making it possible to influence the way the body and the brain communicate.
This understanding of the effect of cannabis on the brain serves as a pathway to unlock the therapeutic role it can play in handling depression.
Antidepressants are commonly used to treat depression. They work by increasing the levels of neurotransmitters or chemicals like serotonin, dopamine, and norepinephrine. These chemical messengers help improve a patient’s mood and emotions, thus dealing with the symptoms of depression.
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Antidepressants also find their application in treating other conditions like chronic pain, insomnia, migraines, obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). However, it is essential to note that antidepressants may come with common side effects like sexual dysfunction, drowsiness, dizziness, nausea, weight gain, insomnia, dry mouth, blurry vision, and tremors.
Types of Antidepressants
There are different types of antidepressants available today, and cannabis has a peculiar way of interacting with each of them. These types include:
- Selective serotonin reuptake inhibitors (SSRI): These types of antidepressants are the most commonly prescribed. And the most popular SSRI is fluoxetine (Prozac). Other examples include citalopram (Cipramil), paroxetine (Aropax), and sertraline (Zoloft).
The combination of high doses of THC (e.g., concentrate use) and SSRIs can prove severe or potentially lethal. For example, when Zoloft and cannabis are taken together, there can be a rise in serotonin levels in a patient’s system, which is potentially harmful depending on the dosages of each.
- Serotonin-norepinephrine reuptake inhibitors (SNRI): Common examples include duloxetine (Cymbalta), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima). The challenge with using them with cannabis is that cannabis can interfere with the potency of SNRIs.
- Tricyclic antidepressants (TCA): TCAs include Nortriptyline (Allegron), Amitriptyline (Tryptanol), Clomipramine (Anafranil) and Dosulepin (Prothiaden). Studies have shown that TCAs don’t do well with cannabis. Individuals stand the risk of delirium and heart palpitations when these antidepressants are used with cannabis. Also, other adverse effects like hallucinations, hypertension, dry mouth, and mood swings can occur or intensify.
- Monoamine oxidase inhibitors (MAOI): These were the first types of antidepressants developed. Tranylcypromine (Parnate), Phenelzine (Nardil), and Moclobemide (Aurorix) are typical examples of MAOIs. Although there isn’t much evidence on the adverse effects of using these antidepressants with cannabis, it is believed that the components in cannabis can inhibit the activity of MAOIs in the body.
Mixing Prozac and Weed
The Anxiety and Depression Association of America (ADAA) reported that at least 16 million adults in the U.S. are dealing with depression, and there are existing antidepressants to deal with the condition. However, with the increasing legalization of cannabis, it is expected to find patients using weed to cope with depression.
When used individually and separately as prescribed, Prozac and cannabis are considered relatively safe. Combining them, on the other hand, comes with potentially serious risks to look out for that are dose-dependent.
Research suggests it may be best for people with depression to avoid high-THC products like concentrates and potent edibles, especially in combination with high-dose antidepressants.
The Dangers of Prozac and Cannabis
- Weed can increase the side effects usually associated with using fluoxetine. These side effects include dizziness, confusion, drowsiness, dry mouth, and even difficulty concentrating.
- Older adults may experience impairment in thinking, judgment, and motor coordination that may lead to serious falls.
- Using Prozac and cannabis can introduce too much serotonin into the brain, leading to a severe condition called serotonin syndrome. The risk increases with the dose of either.
- Cannabis can slow the effectiveness of the liver to break down antidepressants, which leads to excess amounts of antidepressants in the blood.
- The risk of a clinically significant interaction or serotonin syndrome is greatest with high-dose antidepressants and concentrated THC (i.e., dabbing, potent edibles, and tinctures, or misusing vape pens).
The Benefits of Fluoxetine and Cannabis
Despite the risks associated with using SSRIs like Prozac and weed, some patients have reported positive results when mixing Prozac and cannabis, such as:
- Greater calming effect
- Improved mood
- Mood stabilization
However, there hasn’t been much research done to prove these claims sufficiently.
Cannabis generally has a lot of health benefits. However, you must be cautious when combining it with substances like antidepressants, alcohol, sedatives, or other narcotics. Severe cases of serotonin syndrome when using high THC and antidepressants are reported, but none have been fatal so far. However, the reality of drug interactions with potentially severe or fatal consequences cannot be eliminated.
It is vital to know prescription drugs that are compatible with the use of cannabis and those that are not. Whether it’s Prozac and cannabis or another pharmaceutical, thoroughly research whatever medication you are using and speak with a healthcare professional to make safe and informed choices.
If you’re interested in using medical cannabis for depression, talk to a medical marijuana doctor to determine a wellness plan that meets your needs.
Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.