CBD, or cannabidiol, is extracted from hemp seed. After THC, it is the best studied cannabinoid present in cannabis. CBD, unlike THC, does not bind to cannabinoid receptors (it is not an antagonist of these receptors), but has the ability to regulate the normal function of the endocannabinoid system. It is also distinguished from THC, which is produced from cannabis, in that it does not have intoxicating properties. Little has the ability to mitigate the effects of THC intake.
Research into the effects of CBD oils on the human body is ongoing and we continue to learn about its further health-promoting and therapeutic properties. It is also known that the use of CBD is safe. But can cannabidiol be used unreservedly with any medication, especially antidepressants?
CBD oil and taking medication
Studies show that CBD is a safe substance and that side effects are rare and not very distressing. Sometimes taking CBD oils in high doses causes increased drowsiness, temporary dry mouth, suppressed or increased hunger or a slight drop in blood pressure. So it can be seen that these are not very dangerous complaints. However, the situation with antidepressants and the combination of cannabidiol with them is somewhat different.
The interaction is mainly influenced by the dose as well as the concentration of the CBD oilwhich is taken. The higher the dose of a highly concentrated oil, the stronger the effect on the body. If one is systematically taking any kind of medication, especially antidepressants, before using the CBD oils, he or she must consult the attending physician. There will probably be some medics who will strongly oppose this, but awareness of the beneficial effects of CBD on the body is also growing among doctors, so there is a good chance that it will be possible to combine antidepressants with oil. In general, the doctor should have the final say in this matter.
How CBD is metabolised
If someone thinks that taking CBD oils will hide from their GP, then they need to be aware that the oils have an effect on the medication they are taking. And it is easy to explain what effect, where and why.
Any food consumed is broken down in the liver into such simple compounds that can be absorbed or disposed of by the body. Carbohydrates are broken down into sugars, proteins into amino acids and fats into triglycerides. The next stage is metabolism (with the aid of enzymes), which converts these compounds into metabolites. These, in turn, are further used by the organism for their intended purpose, e.g. as building blocks for various tissues or as fuel for cellular processes.
An analogous process applies to CBD, for example, which in the case of such substances is called drug metabolism and tells you how long CBD or drugs are broken down by the body to form individual metabolites and then how long these metabolites remain active in the body. That is, just like food, orally taken CBD oil has to pass through the digestive system to be absorbed through the intestines into the bloodstream. It then enters the liver with the blood, and this is how enzymes break it down into metabolites to enter the bloodstream in this form.
The metabolism, or metabolism, not only breaks down compounds, it also has another very important function, enabling the removal of toxins, which are supplied to the body, for example in the form of various drugs (so-called xenobiotics), but of course not only.
Cytochrome P450 system
Among others, the liver houses a group of liver enzymes, among which cytochrome P450 (CYP) plays a key role in metabolising drugs. It breaks down as much as 60% of each drug taken. What does this have to do with CBD? Well, a lot. This is because ingested cannabidiol starts to act as a competitive inhibitor (Latin inhibitio - inhibition). CBD, like drugs, is metabolised by cytochrome P450, but when taken, it begins to concentrate the action of CYP. This has the effect that other drugs are not broken down in the way and at the time they should be. And yet the dosage of antidepressants is closely linked to this. At the same time, it is not clear whether cannabidiol enhances or impairs the effect of drugs, including antidepressants. It is also unclear what concentration and length of time CBD will affect CYP, as none of the studies to date speak precisely of a dose that has a minimal and safe effect. Some studies speak of 25 mg, others of 40 mg calling it the limit dose.
Putting it figuratively, CBD pushes through the liver to achieve priority in metabolic processes. This means that it deactivates the effects of antidepressants. The more cannabinoids enter the bloodstream, the less field is left for other therapeutic compounds. Of course, if the dose of cannabidiol is small, the effect of the oil on the antidepressants will be negligible or even non-existent. But if the dose is high, it could mean that the drugs, not being metabolised, will linger in much higher concentrations in the body than they should and this could result in an overdose. The question is how high? Well, that is what is not yet known.
CBD oils vs antidepressants
It is therefore clear that, contrary to popular belief, cannabidiol is not a biologically inert substance and can react with psychotropic drugs, even those that are metabolised like CBD by the CYP system. In recent years, scientists have begun to look more closely at these interactions and interactions of CBD oils and drugs, including antidepressants.
If someone is taking antidepressants and would like to start taking CBD oils at the same time, they need to consult a doctor. This is because cannabidiol can, depending on the dose, the organism and other factors, affect the metabolism of the medication being taken. Your doctor will determine the dosage of the oil, and perhaps change the dosage of your medication. But this is already a decision for the attending physician.