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Updated 12/6/2024
What happens when you combine the antidepressant Zoloft with weed? Are there health dangers to consider? The answer to that question affects millions of Americans.
Zoloft-marijuana interactions affect millions of Americans. What happens, exactly, when you combine the antidepressant Zoloft and weed? Are there health dangers to consider?
Widely prescribed since it received FDA approval in 1999, Zoloft reduces symptoms of major depressive disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and severe social anxiety disorder. Zoloft is also approved for treating OCD in children 6 to 17 years of age. Over 14.4% of adults aged 40–59 take antidepressants, according to the Centers for Disease Control (CDC).
Meanwhile, more Americans than ever are smoking pot, whether for medicinal or recreational purposes. Now, researchers are looking into the possible dangers of taking antidepressants like Zoloft while smoking marijuana. For more of an answer and to understand how and why mixing Zoloft and weed could cause health issues, it first helps to have some knowledge about how both substances affect the brain.
How Zoloft Works to Treat Depression and Anxiety
Zoloft is the brand name for sertraline, a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain. People with depression, OCD, PTSD and anxiety disorders have abnormally low levels of serotonin due to receptors preventing the release of the neurotransmitter into the brain.
Doctors aren’t sure why receptors “reuptake” (retain) serotonin in depressed or anxious individuals but suspect it’s due to impaired activity within the serotonin pathways in the brain. But does depression cause serotonin levels to drop, or does depression begin after receptors stop releasing serotonin?
Side Effects and Timeline for Relief
Zoloft doesn’t start relieving depression anxiety right away. Most people taking Zoloft report feeling better after 3 to 4 weeks of being on the drug. Initial side effects of Zoloft that usually resolve within several weeks include:
- Nausea (but not vomiting)
- Agitation (the sudden increase of serotonin can make some people feel jittery)
- Shakiness
- Insomnia or sleepiness
- Feeling tired or slightly drowsy during the day
- Feeling more anxious than usual
Risks and Warnings for Zoloft Use
Although Zoloft helps millions of people cope with depression and anxiety disorders, it can also cause serious side effects that require emergency treatment. In 2004, the FDA put warnings on all SSRIs about the risk of suicidal ideation in people taking these medicines. However, research indicates that children and adolescents are most at risk for suicidal thoughts due to “peculiar responses” to antidepressants early in their treatment. There’s no definitive evidence, though, that Zoloft or other SSRIs lead some individuals to attempt suicide.
What Happens When You Smoke or Consume Marijuana?
The brain’s endocannabinoid system contains thousands of receptors that are activated by THC and other chemicals in marijuana. Because this endocannabinoid system oversees appetite, memory, mood and pain relief, using marijuana intensifies the endocannabinoid system’s regulation of pain, mood, etc. In addition, THC is a psychoactive chemical that alters your mental, physiological and emotional states.
Like Zoloft, marijuana doesn’t affect everyone the same way. The most common side effects of THC include:
- Euphoria
- Drowsiness/relaxation
- Mild distortion of perceptions
- Increased hunger
- Dizziness
- Short-term memory problems
- Anxiety
- Tachycardia (rapid heartbeat)
- Paranoia/delusional thinking
Depending on the grade and type of weed smoked, side effects could be minimal or could cause such severe reactions that the user seeks emergency medical treatment.
Self-Medicating by Mixing Zoloft and Cannabis
A lot of people understandably think that marijuana, or one of its derivatives, such as CBD oil, can reduce the negative side effects of SSRIs. In the real world, this most often takes the form of people using cannabis and antidepressants at the same time or mixing Zoloft and cannabis products. It’s also common for marijuana users to conceal their use of cannabis from the doctor prescribing them Zoloft. The U.S. Food and Drug Administration (FDA)’s Adverse Event Reporting System (FAERS) has tracked both the recreational use of marijuana and people who are trying to self-medicate with it and found a significant risk of adverse events.
There’s still a lot to learn about the Zoloft-marijuana interaction. One potential problem is that marijuana can interfere with how the body metabolizes Zoloft, which reduces its effectiveness and could lead a doctor to increase the dose if ignorant of the patient’s marijuana use. It’s also possible that Zoloft, as an SSRI, can work against the depressive or relaxing effects of the marijuana, making that less effective, too, and encouraging heavier use.
Always tell your doctor about any drugs you take, including marijuana and related cannabis products. Self-medicating with street drugs is almost never safe to do without medical supervision, and the results can be unpredictable.
3 Potentially Dangerous Zoloft-Cannabis Interactions
1. Higher Risk of a Bad Reaction to Zoloft
Cannabis has been shown to inhibit liver enzymes needed to metabolize Zoloft. This means the body doesn’t disperse and eliminate Zoloft like it should, leaving a higher-than-normal level of Zoloft in the bloodstream. Consequently, any adverse reaction to Zoloft a person may have had in the past could reemerge as an aggravated reaction.
2. Too Much Serotonin
One of the reasons marijuana causes euphoria is that it increases the production of serotonin in the brain. Doctors prescribe different milligrams of Zoloft to treat mild, moderate or severe anxiety or depression. The number of milligrams essentially dictates how much serotonin the brain receives. When people combine sertraline with weed, they’re flooding the brain with too much serotonin. Symptoms of excessive serotonin include vomiting, agitation, severe headache, confusion, fast heartbeat and muscle twitching.
3. Compromised Therapeutic Response
With Zoloft and marijuana counteracting each other’s effects on the brain and body, doctors and their patients won’t know if Zoloft is actually helping them feel better. Additionally, people who use pot while taking Zoloft may come to the conclusion that Zoloft isn’t working and stop taking it altogether. This could worsen their depression and anxiety and lead them to rely more on weed to relieve symptoms of their mental illness.
What Happens When You Combine Sertraline and Weed?
Currently, there’s a lack of studies investigating possible interactions between antidepressants and Zoloft. Although no clinically reported known drug interactions are available in academic literature, doctors assert the danger of combining Zoloft and weed does exist.
For example, a person’s physical and/or psychological reaction to Zoloft or weed can’t be predicted. If you take Zoloft for panic disorder and smoke pot, the THC content of weed could worsen your anxiety. Some individuals with OCD may harbor paranoid thoughts that may also worsen after using pot.
Why Doctors Are More Concerned Today About the Dangers of Combining Zoloft and Weed
The recent legalization of both recreational and medicinal marijuana has significantly increased the number of people in the United States who use weed and take antidepressants. Prior to 2010, only a handful of states had legalized medicinal or recreational pot. Compounding that fact is the recent uptick in doctors writing prescriptions for Zoloft and other antidepressants due to the stress of the COVID-19 pandemic worsening rates of depression, anxiety and psychiatric disorders.
People who mix Zoloft with weed may not be at risk for an overdose, but they are at risk for exacerbating symptoms of their depression, anxiety, OCD or panic disorder. Additionally, smoking pot and taking antidepressants can disrupt brain chemistry in ways researchers are only beginning to uncover.
Zoloft has been clinically proven to help people cope with depression and anxiety. But when the inability to stop smoking pot interferes with the ability of Zoloft to treat mental illness, it may be time to seek help for a marijuana problem. Call FHE today if you or someone you know is struggling with a mental illness and combining antidepressants with weed.
