Cbd and anti-depressants

AlanKeni

Member
Hi everyone! I'm on mirtazapine 15 mg at night time for insomnia and recently i've started to vaoe cbd flowers and cbd oil 10%. In the first week of cbd oil use i've noticed that my body is more anxious, i had bad panic attacks when i'm driving or when i'm working out. Now i don't take cbd or vape anymore and i start to feel better.

Did anyone know if cbd can interacts with antidepressants? Any experience?
 
AlanKeni,

looney2nz

Research Geek, Mad Scientist
Hi everyone! I'm on mirtazapine 15 mg at night time for insomnia and recently i've started to vaoe cbd flowers and cbd oil 10%. In the first week of cbd oil use i've noticed that my body is more anxious, i had bad panic attacks when i'm driving or when i'm working out. Now i don't take cbd or vape anymore and i start to feel better.

Did anyone know if cbd can interacts with antidepressants? Any experience?

The only documented drug interaction for CBD is on the Cytochrome P-450 enzyme (a liver enzyme that metabolizes many different drugs), if the drug you're on uses that mechanism, it could very well show a difference in response. That said, I'm on Effexor XR and don't note a change. I haven't bothered to see if it uses that mechanism.

CBD itself is anti-anxiety and anti-depressant in its physiological response, so it is conceivable to augment your response in these areas.

The CYP-450 mechanism is in play for opiates in particular (one of the reasons for the 25% drop in OD and deaths via opiates in legal cannabis states).

Your doctor or pharmacist should be able to answer whether your medication uses this mechanism or not.
 

chris 71

Well-Known Member
The CYP-450 mechanism is in play for opiates in particular (one of the reasons for the 25% drop in OD and deaths via opiates in legal cannabis states).

That is a pretty big claim !! i have never heard of that as a reason to the stastisical 25 % drop that we hear about in opiod deaths in places were cannabis is legal . and i doubt very much that is the reason at all .

Anybody i know that has a opiod adiction and i know a few . they alreay smoke weed, and pretty much any drug they can get .

CBD works similar to grapfruit juice so if what you are saying was true people could just drink grapfruit juice for the same effect .

but here is the thing that effect is a potentiating effect mostly which means it maks it take longer for your body to get rid of the drug .

which leads to a build up of the drug in your system which is not a good thing espeicaly if you are a drug addict who is at risk of an overdose .

Its unlikly that this is any reason at all for a decline in opiod deaths . and if the 25 % reduction is even true at all its more likly that people are using cannabis as a replacement type of thing.

perhapes they are allready trying to get off the opiods and they are now able to get legal weed and it helps because they can reach for it first and in that way helps .

CBD could help people in pain lower there dose of opiods though but these are people that are probably not the ones at risk of death by overdose .

these are the people using opiods for legit reason . most of the deaths by overdose would be from addicts pushing the limits of the dose to the point of death .thats different . not to say that some of these people didnt get adicted to opiods for a legit reason to start with but ...

Also the few people i know who are adicted to opiods and and abusing them , the ones with the highest odds of winding up dead from there addiction would not be at all interested in CBD they are wanting something they can feel an effect from .

I also know someone who is using opiods for real pain reason and has been for quite some years . this person could possibly use less opiods with the help of CBD but they are not at any risk to beginn with .

Anyway as far as the oridginal posters question goes ..

I can tell you i have been experimenting with high CBD strain for about 5 years now and to me its a very strange thing .

We hear all the time how CBD is suppossed to be good for anxity im my experience it sometime has worked for me but other times it has agravated my anxity.

I have used strains with like 2 % thc and 8 % CBD that has incressed my issues one day and the next helped

I can say the same with thc i have used strains with very high thc that helped me one day and sent me through the roof the next .

Also if i use high cbd strains for extended periods of time they start tonmake me feel very wierd not plesant at all a sick and anxious feeling that i dont remember having before ever using CBD strains .

You have tobremember everybody is different and if you are taking some other meds that are working on receptors in your brain that are desinged to or suppossed have an effect on your personnallity and you mix with pther drugs who the hell knows what your getting into
 
chris 71,

looney2nz

Research Geek, Mad Scientist

we'll see if that actually quotes you...

>> The CYP-450 mechanism is in play for opiates in particular (one of the reasons for the 25% drop in OD and deaths via opiates in legal cannabis states).

That is a pretty big claim !! i have never heard of that as a reason to the stastisical 25 % drop that we hear about in opiod deaths in places were cannabis is legal . and i doubt very much that is the reason at all . <<

ok, do a search, it's a study that's been quoted many times in the last year.
what exactly are your doubts about this being the reason, or even A reason?

>>Anybody i know that has a opiod adiction and i know a few . they alreay smoke weed, and pretty much any drug they can get .<<

I'm not gonna play games about who's known worse addicts... where do most opiod addicts start their addiction? In their doctor's office. FACT. As for them using other substances, yep they sure do... a constant dance of what they can get hold of and how they can use that to keep them 'in balance' (in their minds).
These days, if you play in those waters, you better have NARCAN on hand with you and someone trained in how to use it!

>>CBD works similar to grapfruit juice so if what you are saying was true people could just drink grapfruit juice for the same effect .<<

CBD works NOTHING like grapefruit juice (aside from acting on that enzyme) and has activity throughout the body via the body's endogenous endocanniboid system (ECS) and all the cannabinoid receptors sprinkled throughout the body, particularly the brain/nervous system/gi tract. Grapefruit juice cannot and does not do what CBD does. It's a stretch to even call it a comparison.

>>but here is the thing that effect is a potentiating effect mostly which means it maks it take longer for your body to get rid of the drug .

which leads to a build up of the drug in your system which is not a good thing espeicaly if you are a drug addict who is at risk of an overdose .<<

exactly WHAT are you calling a 'potentiating effect'? and why would it take longer for the body to excrete the drug? are you inferring that CBD is somehow changing the half-life of drugs???

>> Its unlikly that this is any reason at all for a decline in opiod deaths . and if the 25 % reduction is even true at all its more likly that people are using cannabis as a replacement type of thing.

perhapes they are allready trying to get off the opiods and they are now able to get legal weed and it helps because they can reach for it first and in that way helps .<<

And you came to this conclusion through what mechanism of the scientific method?
Cannabis as a replacement for heroin or oxycodone, they'd be beating a path to your door.
Exactly WHAT is it that you think Cannabis would replace for an opiate addict?
I'll ask again, so what is it about 'legal weed' (with our without CBD, you haven't made any distinction), that you think 'helps' them? (I don't think reaching for an inferior alternative has ever been on an addicts mind)

>>CBD could help people in pain lower there dose of opiods though but these are people that are probably not the ones at risk of death by overdose .

these are the people using opiods for legit reason . most of the deaths by overdose would be from addicts pushing the limits of the dose to the point of death .thats different . not to say that some of these people didnt get adicted to opiods for a legit reason to start with but ...<<

You have an interesting idea of who's at risk of OD from opiates! By your own admission some of the folks you previously labeled as 'addicts' became that way under a doctors care :(
It is in fact these people who are at greatest risk of OD, 'cause as they get cut off from previously legal accessible means (this is impacting legitimate pain management patients across the country), they seek the next most accessible means - THIS is where they get tripped up, as SO many street opiates are now cut with fentanyl, and just a wee bit of fentanyl can kill a good sized man. literally the size of a grain of fine salt is enough to kill you. Someone makes a slight miscalculation and it's goodbye to the pale blue dot.

>> Also the few people i know who are adicted to opiods and and abusing them , the ones with the highest odds of winding up dead from there addiction would not be at all interested in CBD they are wanting something they can feel an effect from .<<

That's sad, but not uncommon to most addictions.
Here, here's a way out, no... it won't goose your dopamine reward system for 8 hours, sorry.
I've watched to many people take a fall from this shit, sadly some of them permanent... on the other end of the scale, a bunch of cool folks with 20-30 year chips.

>> I also know someone who is using opiods for real pain reason and has been for quite some years . this person could possibly use less opiods with the help of CBD but they are not at any risk to beginn with .<<

I AM a chronic pain patient (among other things), I've been through the entire gauntlet of modern pain management... ironically, NONE of the opiates work on me (blew their minds) and they ended sending me to my 1st medical cannabis doctor (who was a cool dude, who did his homework).
I have friends who have hardware in their backs and have been on oral morphine, etc. for decades...
NONE of them will tell you that it's all cool. Chronic constipation, serious GI problems from it, surgeries, etc.

I had one patient like this try a dose of CBD around 40mg, they were able to move in ways that hadn't been able to for years. Converted on the spot, BUT!!... they have Kaiser. They love all their other doctors, and are willing to put up with no CBD until they change.

>> Anyway as far as the oridginal posters question goes ..

I can tell you i have been experimenting with high CBD strain for about 5 years now and to me its a very strange thing .<<

how high in CBD and THC is it? are the genetics stable? do you have labs? 'cause I'm more interested in the overall picture and what possible entourage effects could be present.

>>We hear all the time how CBD is suppossed to be good for anxity im my experience it sometime has worked for me but other times it has agravated my anxity.

I have used strains with like 2 % thc and 8 % CBD that has incressed my issues one day and the next helped

I can say the same with thc i have used strains with very high thc that helped me one day and sent me through the roof the next .

Also if i use high cbd strains for extended periods of time they start tonmake me feel very wierd not plesant at all a sick and anxious feeling that i dont remember having before ever using CBD strains .

You have tobremember everybody is different and if you are taking some other meds that are working on receptors in your brain that are desinged to or suppossed have an effect on your personnallity and you mix with pther drugs who the hell knows what your getting into<<

A high CBD low THC strain should not cause anxiety issues. You certainly shouldn't feel much @ 2%
When you say 'increased your issues one day and helped the next', what issues and how did it affect them (positively and negatively)? Same when you're talking about highTHC strains.

I know of no precedent (not saying it doesn't exist and hasn't been documented) to this cummulative effect of the CBD you're presenting here. Are these plants being raised ORGANIC??

Yeah, everyone has a different biochemistry, but that's also part of why the bell curve was invented!
These aren't just receptors in your brain, and what makes you think they are DESIGNED to have an effect on your personality? (personality persists, alteration fades)

I'm current undergoing chemo (yeah, again, this kind of cancer always returns... typically with a mutation), and per my last labs, I'll be increasing my CBD intake this week. I've been using significant amounts of whole plant extract, including CBD & THC for probably about 11 or 12 years now with no issues.
Tell you one thing, a good whole plant extract that uses a cold or room temperature process that preserves all the compounds... wow, the entourage effect is a powerful thing, quite unmistakable!
 

chris 71

Well-Known Member
Dont mean no disrespect to you bud if it came accross that way sorry .

I dont belive even a 1/4 of what i read in any studies . you can find one that goes along with your particular view on just about anything . check this one out

https://www.google.com/amp/s/amp.sm...benefit-for-chronic-pain-20180702-p4zp0z.html

I found this one just by chance while looking for another one i found that said CBD did nothing for pain it was a study on CBD and THC and strains with both it found it was just the THC that helped .

Im full aware though i can find tonns of studies showing it does help .

Im doing this on my phone and it is gonna be to much work for me to try and pick apart everything you qouted from me and all questions you asked me but i willl just say a couple things . take it or leave it . im not trying to win anything hear .

I can say that the CBD strains im refering to having experience with are all medical canadian lp strains tested with knowen levels of thc and CBD .

I have also use strain that have less then 1 % thc like .5 and .3 things like that .

In my personnel experience cannabis dosent really do much at all for real pain . and i belive the placebo effect can be very very strong if you belive it anything can work . people still go to witch doctors and what not .

Stuides can all be picked apart im sure. like i said i dont belive any really just what makes common sence .

As for the opiod crisis i say BS ya sure all the poor pain patients who started from pills from the doc and then went to herion lol that is a joke . ya ok maybe 1 in a million .

My poor old mom has been taking opiods for years never abused them if the doc cut her off all the sudden she is not going to start looking for herion . that is BS .

You would have to have that personnality to begin with .

As far as the grapfruit thing ofcoarse im not saying grapefriut is the same as CBD lol and i know all about the ECS.

You stated that CBDs effect on the cpy enzymes were part of the reason for. Lowered opiod deaths in legal places .

I said that effect was the same sort of thing grapefuit does . not that grapefruit did anything to the ECS come on man lol

I honestly think that the reduced death rate thing has to do with people using it as a replacment drug or crutch type of thing not because cannabis is anything at all like opiods just because some people have addictive personalities.

And maybe they have the will to try and replace there wanting or needing a harmfull drug for a less harmfull one .

And if its more readly available there you go could be more of a reason to the lowerd rates of death .

Anyway this thread is about mental effects of cannabis which is something i belive cannabis has more potential then pain . and ofcoarse other thing like sezuries and antinaseus effect for cancer and what not more then a pain drug .

Im not the end all know all either and my views can change and i can be wrong and i wish you the best in your current treatment and if something works for you use it
 
chris 71,

AlanKeni

Member
The only documented drug interaction for CBD is on the Cytochrome P-450 enzyme (a liver enzyme that metabolizes many different drugs), if the drug you're on uses that mechanism, it could very well show a difference in response. That said, I'm on Effexor XR and don't note a change. I haven't bothered to see if it uses that mechanism.

CBD itself is anti-anxiety and anti-depressant in its physiological response, so it is conceivable to augment your response in these areas.

The CYP-450 mechanism is in play for opiates in particular (one of the reasons for the 25% drop in OD and deaths via opiates in legal cannabis states).

Your doctor or pharmacist should be able to answer whether your medication uses this mechanism or not.
Here in Italy they don't know shit about cannabis not even Cbd. Interesting that thing about Cytochrome p-450, i found that mirtazapine interacts modestly with Cytochrom p-450. So it can be that..

I have to say that i was taking a lot of Cbd, they say 4 drops twice a day but 4 drops wasn't enough for me so i tried different dosages and 8 drops take away all my anxiety and any tension in my body, i feel "fresh" and i can go out and chill. In addition to the 8 drops i was also vaping high Cbd weed like 0.6% Thc and 19%. Maybe the high dosage of Cbd caused a heap of mirtazapine in my blood (?).

But i have read that if you inhale Cbd it by-passes the metabolic system so it is not processed by the enzym Cytochrome p-450. Is that true?
 
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AlanKeni,
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chris 71

Well-Known Member
But i have read that if you inhale Cbd it by-passes the metabolic system so it is not processed by the enzym Cytochrome p-450. Is that true?

This is not true i talked in depth with my pharmacist about this infact you get about 4 times as much CBD per mg dose into your bloodstream with inhalation vs ingestion
 

DeeCee5

Livin' La Vida Loca in FL
@AlanKeni, YMMV, but my personal experience with 1:1 CBD to THC (Indica) and 2:1 CBD to THC (Indica) and fluoxetine is that it makes me calmer, less anxious and dulls my pain.

I'm not a doctor or pharmacist, but the questions that come immediately to mind:
1. Where are you purchasing the CBD; shop, mail order, street? (I'm a medical patient)
2. Are you using pure CBD or a mix of CBD:THC?
3. Sativa or Indica? Some people complain of Sativas making them anxious or paranoid. With a history of depression and anxiety, my Dr. advised me to stay away from Sativas.
 

looney2nz

Research Geek, Mad Scientist
This is not true i talked in depth with my pharmacist about this infact you get about 4 times as much CBD per mg dose into your bloodstream with inhalation vs ingestion

I think you're both asking fundamentally the same question, how is CBD metabolized?
I'm not the best person to answer that question (at least not right now, lol!), so I'll throw it open for others who DO use CBD in their treatment. I'm brain-farting on the equivalent of Delta-9 converting to the delta-11 metabolite?

Yes, inhalation has been the fastest and most efficient transfer to the bloodstream for both CBD and THC... but the effects are different. For me, while I use homemade 500-600mg brownies for most things, there are plenty of times where my vapes come into play... but the vaping will only work on me for 20-30 min, and the brownies work for 3-4 hours. Vape, pretty immediate... brownie, long lasting. Two very different ingestion vectors.

@AlanKeni, sadly you're probably running into the same snake oil sideshow in the EU over CBD...
Figuring out what the dose is, is intentionally made more difficult by how the labeling is done on the bottles :( , GOOD manufacturer's will include REAL meaningful data (like this from the US manufacturer I use): 1oz/30ml
5000mg of actual CBD
4.2mg per drop
167mg per 1ml dropperful
ingredients: organic MCT oil
CO2 distillate derived full spectrum CBD from CO grown hemp.
(this is a very good product, I'd say a starting dose for most folks would be 40mg)

p.s. I know folks in Napa, CA who grow cannabis along side their winery vines... have a friend with some vines? Organic of course.
 
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looney2nz,
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AlanKeni

Member
@AlanKeni, YMMV, but my personal experience with 1:1 CBD to THC (Indica) and 2:1 CBD to THC (Indica) and fluoxetine is that it makes me calmer, less anxious and dulls my pain.

I'm not a doctor or pharmacist, but the questions that come immediately to mind:
1. Where are you purchasing the CBD; shop, mail order, street? (I'm a medical patient)
2. Are you using pure CBD or a mix of CBD:THC?
3. Sativa or Indica? Some people complain of Sativas making them anxious or paranoid. With a history of depression and anxiety, my Dr. advised me to stay away from Sativas.

1: I buy Cbd cannabis in the legal cannabis stores. In Italy a cannabis with less than 0.6% Thc is legal.
2: I use Cbd Oil 1000mg with Thc less than 0.2%.
3: Doesn't make a difference since all strains that i use are Thc 0.6%, they are most sativa.

I think you're both asking fundamentally the same question, how is CBD metabolized?
I'm not the best person to answer that question (at least not right now, lol!), so I'll throw it open for others who DO use CBD in their treatment. I'm brain-farting on the equivalent of Delta-9 converting to the delta-11 metabolite?

Yes, inhalation has been the fastest and most efficient transfer to the bloodstream for both CBD and THC... but the effects are different. For me, while I use homemade 500-600mg brownies for most things, there are plenty of times where my vapes come into play... but the vaping will only work on me for 20-30 min, and the brownies work for 3-4 hours. Vape, pretty immediate... brownie, long lasting. Two very different ingestion vectors.

@AlanKeni, sadly you're probably running into the same snake oil sideshow in the EU over CBD...
Figuring out what the dose is, is intentionally made more difficult by how the labeling is done on the bottles :( , GOOD manufacturer's will include REAL meaningful data (like this from the US manufacturer I use): 1oz/30ml
5000mg of actual CBD
4.2mg per drop
167mg per 1ml dropperful
ingredients: organic MCT oil
CO2 distillate derived full spectrum CBD from CO grown hemp.
(this is a very good product, I'd say a starting dose for most folks would be 40mg)

p.s. I know folks in Napa, CA who grow cannabis along side their winery vines... have a friend with some vines? Organic of course.

What do you mean by "snake oil sideshow"?
 

looney2nz

Research Geek, Mad Scientist
1: I buy Cbd cannabis in the legal cannabis stores. In Italy a cannabis with less than 0.6% Thc is legal.
2: I use Cbd Oil 1000mg with Thc less than 0.2%.
3: Doesn't make a difference since all strains that i use are Thc 0.6%, they are most sativa.



What do you mean by "snake oil sideshow"?

In the U.S. the interest in CBD was followed by an explosion of folks trying to fill the market... sadly many of those weren't very ethical and some terrible quality oil has been foisted on the public. Hopefully that will largely end with the new regulations in California that go into play in 8 days. Not that it will stop the black market (or grey market even). But now you can finally get CBD made via CO2 distillation, and not just in oil, but as an isolate in slab or crystals that can be vaped. The new laws include more rigorous lab tests, I'll be curious to see if they implement a random cross testing system to keep the labs honest.
 

chris 71

Well-Known Member
I think you're both asking fundamentally the same question, how is CBD metabolized?
I'm not the best person to answer that question (at least not right now, lol!), so I'll throw it open for others who DO use CBD in their treatment. I'm brain-farting on the equivalent of Delta-9 converting to the delta-11 metabolite?

.

No im not asking any question in regards to how cbd is metabolized.

Im am referring to something i have also come across a few times online with people saying that the cpy enzme efects not being of concern .

because by inhalation you skip this . but this is not true . i presume because your blood still goes through your liver , and the enzymes are still effected .

and so this effect that it has , that i refered to as a similar effect that grapefruit has on these enzymes.

is still going to happen regardless as to weather you inhale or ingest .

My mentioning of how you get about 4 times as much cbd into your blood by inhalation vs ingestion is another thing all together i could find the links and post maybe later .

You only get 15 percent of the dose you take orally an example would be if you take 100mg cbd through ingestion you are only going to get about 15mg of usable dose in your blood

As compared to if you inhaled 100mg you should get 4 times that 15 percent which would equal 60 mg quite a difference
 
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chris 71,

chris 71

Well-Known Member
https://www.leafly.ca/news/health/vaping-cbd-oil-vs-ingesting

The artical mentions that enzymes in the first pass through the liver reduces levels of cbd that get into your blood . but dont mistake this to meaning anything at all the same as how the internet myth about the inhalation of cbd bypassing the the effects on the cyp450 because you inhaled instead of ingesting as i said and the pharmisits i talked to told me the effect on inhibiting the cpy 450 enzyme is still going to occur. Your blood is filtered through your liver weather a substance gets there through injection inhalation or your gut doesnt matter in that reguard

This means that the effect of slowing down the breakdown of other drugs that are broken down by the cpy 450 enzymes is still there
 
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chris 71,

AlanKeni

Member
So at the end, what gave me the panick attacks and increases the anxiety was the p-450. Basically it slowed down the mirtazapine to be metabolized and then i had a lot of mirtazapine in my blood, causing an increasing of side effects of the drug.
 
AlanKeni,

chris 71

Well-Known Member
So at the end, what gave me the panick attacks and increases the anxiety was the p-450. Basically it slowed down the mirtazapine to be metabolized and then i had a lot of mirtazapine in my blood, causing an increasing of side effects of the drug.

Maybe could also have to do with sativa as DeeCee5 mentions or could be juat like me and others that sometimes CBD just makes you feel weird im not so sure i belive all the CBD hype my self

It would be really hard to know for sure ask your doc or pharmisit they might be able to help

To give you an idea how hard it is to get legit info online i can tell you i take another med .

and online it says not to take with grapefruit juice so i was concerned about cbd and the cpy thing . when i talked to the pharmisit he told me that the info was wrong that it was fine .

so if you want better info i would as a phamisist or doc but sometimes even they dont know .

I took ssri a couple times and they made my probs worse every body is different maybe just do a process of elimination

Or best is talk with doc and or pharmisist
 
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chris 71,
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AlanKeni

Member
Maybe could also have to do with sativa as DeeCee5 mentions or could be juat like me and others that sometimes CBD just makes you feel weird im not so sure i belive all the CBD hype my self

It would be really hard to know for sure ask your doc or pharmisit they might be able to help

To give you an idea how hard it is to get legit info online i can tell you i take another med .

and online it says not to take with grapefruit juice so i was concerned about cbd and the cpy thing . when i talked to the pharmisit he told me that the info was wrong that it was fine .

so if you want better info i would as a phamisist or doc but sometimes even they dont know .

I took ssri a couple times and they made my probs worse every body is different maybe just do a process of elimination

Or best is talk with doc and or pharmisist
Like i said there are cannabis strains mostly sativa but they have less than 0.6% Thc and a lot of Cbd so there is no difference between sativa and indica in this case. Doctors and Pharmacistes don't know shit about cannabis in Italy. I asked you guys because maybe you live in some of those US countries where cannabis is legal and you have more informations about it.
 
AlanKeni,

C No Ego

Well-Known Member
Like i said there are cannabis strains mostly sativa but they have less than 0.6% Thc and a lot of Cbd so there is no difference between sativa and indica in this case. Doctors and Pharmacistes don't know shit about cannabis in Italy. I asked you guys because maybe you live in some of those US countries where cannabis is legal and you have more informations about it.
maybe this article can help clear up a few things for you https://www.projectcbd.org/science/cannabis-pharmacology/cbd-drug-interactions-role-cytochrome-p450
 
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