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Weed and Antidepressants: What You Should Know Before Smoking a Phat One

Don’t worry, we’re not going to tell you to flush your stash

As a guy burdened by the Big Sad, I know the feeling of chasing antidepressants with a bong rip. I also know that blending weed and antidepressants probably has the potential to be at least kinda bad. So, eager to light up, I asked Heather Free, PharmD, spokesperson for the American Pharmacists Association, to teach me more about weed and antidepressants. Here’s what you and I need to know… 

We’re Still Learning

The first thing you should know about weed and antidepressants is, well, we don’t know  a whole lot. One extensive review of what scant research we have found that there has been a “lack of reports on interactive adverse effects between psychotropic medications and drugs of abuse,” which essentially means, if people have had a bad time combining  weed and antidepressants, they haven’t reported it much. There could be several explanations for this, but one is, “They either don’t happen or they’re relatively rare.”

While these findings appear to suggest that combining weed and antidepressants is, for the most part, safe, there have been a small number of case reports that lend credence to an increased risk of hypomania, a mild form of mania, in vulnerable populations, such as persons with bipolar disorder.

There are also a few case reports that show a potential for racing heartbeat, or tachycardia, when combining weed and tricyclic antidepressants, an older class of antidepressants that have been largely replaced by newer ones with fewer side effects.

But overall, from what we know so far, considerable adverse effects like these when mixing weed and antidepressants are few and far between.

Newer Antidepressants Are Safer…

…in many ways, including how they interact with weed. “Older antidepressants have a higher incidence of drug-cannabis reactions than the newer antidepressants,” Free says. “It’s important to work closely and openly with your provider and pharmacist around how much cannabis you take, and to check for drug-cannabis reactions.” 

So yeah, be honest when your doctor asks if you 420 blaze it, bro.

Free provides the following chart, where you can see whether your antidepressant is likely to result in adverse effects when consumed alongside cannabis, so you can make the appropriate decision depending on your needs:

It Depends on the Patient

Treating mental disorders requires a delicate symphony of tools and medications, which need to be personalized for each patient. Sometimes, weed simply shouldn’t be part of the equation. “Antidepressants are used for many conditions,” Free explains. “Each condition is different. Cannabis has been questioned, being problematic to adherence to medications for bipolar disorder and severely depressed patients.” That means, again, you must talk with your provider about whether weed is safe for you to consume.

If You Get a Pass, Start Sober, Then Toke

When you begin antidepressants, it’s essential that you closely evaluate changes to your mood, and being ludicrously high all the time can make that tricky, as you might imagine. Therefore, Free says, “It’s important to not start both an antidepressant and cannabis at the same time. It’s really difficult to determine the correct dose and assess the efficacy of the antidepressant. The more substances a patient is combining, the more difficult it is to isolate the effects of each. That’s why physicians often start a patient on one drug and add others later.”

That said, if you’re a heavy smoker and considering antidepressants, you don’t want to quit cold turkey, because that can result in some nasty side effects as well. Try to taper off instead.

Finally, Remember, Weed Isn’t a Cure-All

Sure, weed does have the potential to help with depression, but don’t expect it to replace your antidepressants. “Cannabis can help to relax people, make them less stressed, and most importantly, happier,” says Free. “Antidepressants, depending on the type one takes, potentially can have the same effects. It’s important to know that, even though cannabis and antidepressants may have some of the same effects, cannabis is not a substitute for an antidepressant.”

Now go forth on your quest to feel good, my dude. And just so you know, yeah, I’m gonna smoke this bong.