Antidepressants and CBD - treatment options

If you are feeling down, empty, lacking motivation, and generally feeling that you are "not making it" in life, then know that you are not alone. These are symptoms of depression, which affects over 5% of the population in the Czech Republic and is one of the most common mental disorders in this country. Importantly, depression has a number of causes. However, the approach to treatment is usually the same. However, this approach does not respect the real world, where there are multiple types of depressive conditions.


CBD and antidepressants

CBD products have become a popular choice among people who suffer from insomnia, depression, anxiety and joint pain. In addition, in a recent survey, approximately 80% of people said that taking CBD was "very or extremely effective" for them.  Patients who find little relief from prescription antidepressants or experience intolerable side effects, sometimes worse than the original symptoms, are looking for alternatives.  Researchers are currently exploring alternative treatments for depression, including CBD and the use of CBD and antidepressants. The evidence is promising.


CBD and antidepressants: just the facts

Depression affects tens of thousands of Czechs. The current treatment of first choice is pharmaceutical antidepressants, which often have side effects. People are therefore increasingly turning to alternatives such as CBD, which they take instead of or alongside antidepressants.

Scientists have found that CBD oil has effects similar to antidepressants and affects several parts of the brain and its functions. Although research is just beginning, the results of animal studies are promising.


Antidepressants

The most commonly used antidepressants at present are serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft and Lexapro. Patients usually notice a change in their symptoms after 2-4 weeks.  Before SSRIs, tricyclic antidepressants were the treatment of choice for depression. Unfortunately, even at low doses, these drugs sometimes caused intolerable side effects and even caused seizures at high doses. 

Interestingly, SSRIs increase serotonin levels in the brain within a few hours of taking them, but it takes several more weeks before a person experiences antidepressant effects. This puzzling finding has led scientists to further study how antidepressants help depression and whether they are the best drug treatment for depression.

Depression in detail

Depression affects a patient's mood, memory, energy, sleep, and other areas of life. There is no laboratory test to diagnose depression. Instead, doctors ask questions about the patient's mood, thoughts, behavior, and other aspects of life, as well as how long the patient has been experiencing symptoms. 

 

The most common symptoms of depression

  • Feeling sad, depressed, hopeless or empty 
  • negative thoughts about oneself
  • irritability 
  • feelings of guilt or worthlessness
  • the patient stops enjoying the things they used to do
  • tiredness or slowness of movement
  • restlessness
  • difficulty concentrating, remembering or making decisions
  • changes in sleep patterns
  • changes in appetite or weight 
  • thoughts of death or suicide or suicide attempts 
  • joint pain, headaches, changes in digestion with no apparent cause

Our understanding of depression is evolving. It was previously thought that the cause of depression was low levels of serotonin in the brain, a neurotransmitter associated with mood, memory, appetite and other behaviours. We now understand that depression is much more complex. 


How SSRI antidepressants work

SSRI drugs have been on the market for over 25 years. There have been numerous clinical trials on SSRIs and depression, and research confirms that they are approximately 40-60% effective. This means that for a large number of people, depression will not improve when taking these medications. One of the main reasons people stop taking SSRIs is because of the side effects.


Common side effects of SSRIs

  • indigestion
  • sexual dysfunction
  • weight gain
  • sleep disturbances
  • changes in appetite
  • muscle pain
  • anxiety

Scientists have developed newer theories about the causes of depression, including changes in a part of the brain called the hippocampus, inflammation in the brain and problems with the endocannabinoid system.


Cannabis and CBD products for depression

Patients report that taking medical cannabis and CBD helps them with depression and with improving their overall mood. Although hemp as a whole and CBD oil have some things in common, there are significant differences between them. Both products contain cannabinoids, including cannabidiol, which is also known as CBD. CBD products usually come from the industrial hemp plant. 

This is important because, unlike illegal cannabis varieties, the industrial hemp plant contains very little tetrahydrocannabinol (THC), which is the psychoactive component of marijuana. It is THC that makes people feel 'high' when using marijuana. This is an important point because research shows that THC can worsen anxiety.


What the research says

Currently, most of the studies looking at CBD and depression are done on animals. These studies have found that CBD causes rapid and lasting improvement in depressive symptoms. Studies have been done on the mechanisms of how CBD may work in depression.

 

How CBD can help with depression

CBD affects a number of areas of the brain that are thought to be involved in depression.

 

The endocannabinoid system

Our brains and bodies are affected by the endocannabinoid system. This system contains receptors that, when stimulated, affect our emotions, behaviour, memory, decision making, pain perception and inflammation levels. 

Research shows that CBD activates CB1 and CB2 receptors in this system and has anti-anxiety and anti-depressant effects.


CBD and brain neurogenesis

The hippocampus is the area of the brain involved in the creation of new memories, learning and emotions. Chronic stress is thought to cause a reduction in the number of neurons in the hippocampus, resulting in negative changes in mood and mental well-being.

New evidence suggests that both CBD and antidepressants affect the hippocampus by promoting the growth of new neurons. This process is referred to as 'hippocampal neurogenesis'.


Serotonin receptors and CBD

Serotonin is a chemical in the brain that affects mood and behaviour. In animal models, scientists have found that cannabinoids, including cannabidiol (CBD), stimulate serotonin receptors (5-HT1a) in several parts of the brain. This means that CBD may help regulate serotonin levels. Interestingly, this is the same mechanism as the SSRI drugs.


Common use of CBD and antidepressants

There are a number of reports of people taking CBD and antidepressants together. In some cases, patients want to replace SSRI antidepressants with CBD products. However, there are several key points to consider when making this decision.

CBD and antidepressants: drug interactions

First, taking CBD and antidepressants together can cause potential interactions. For example, CBD can slow down the liver's processing of antidepressants, which means the drugs stay in the body longer. Second, official authorities do not regulate CBD products. Not all CBD companies may meet purity or quality standards. Buy all CBD products from companies that use third-party testing. Third-party testing helps ensure that the product you use is safe and meets certain quality standards.

Finally, antidepressants should never be taken "cold turkey" or without a doctor's recommendation. Sudden withdrawal of antidepressants can lead to sudden worsening of depression.


Are the products legal?

Cannabis products containing 1% THC or less have been legalised in the Czech Republic since the beginning of the year. However, the same situation does not apply in all countries. Some countries require CBD users to have a doctor's prescription, while others ban the sale of cannabis products altogether. When travelling abroad, we recommend checking the laws in all the countries you will be passing through.


Conclusion

Depression hurts. If you are one of the thousands of people who suffer from depression and current antidepressants are not bringing you relief, you should look into alternative therapies such as using CBD to treat depression. Emerging research suggests that CBD products are helpful for depression. However, you should consult your doctor first to determine if taking CBD for depression is appropriate for you. Also, if you are currently taking antidepressants, don't stop taking them or change your dosage without your doctor's help.

 

  

Photo: Shutterstock

 

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 1. Hemnia does not want to, nor can it, replace the professional care of your doctor.

2. Hemnia products are not drugs (aka medicines), so please don't treat them as such.

3. Hemnia offers cannabis products, but do not look for any narcotic or psychotropic substances. We do not offer or recommend them.

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