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Reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Cannabis and antidepressants: the two symbols that would flesh out an official flag if millennials wanted one more way to distinguish themselves. As far as we’re concerned, it’s a good thing that society has made progress in the acceptance of antidepressants and THC in our lifetimes, but that doesn’t mean we shouldn’t be vigilant about mishandling them.
After all, has anyone really read about the dangers of mixing Prozac and weed before capping off a weekend with doses of both?
Should regular cannabis users avoid certain types of antidepressants like Prozac when they’re smoking? Should you stop smoking if you’re on Prozac? These are important questions for an increasing number of adults who are over the stigma of both.
Knowing what to be careful about can help you combine weed and Prozac safely if you wish. Let’s start with some basics about what happens when you’re on both.
SSRIs are a type of prescription drug that treats mood disorders by balancing neurotransmitter levels in your brain.
Essentially, a neurotransmitter (in this case, the one called serotonin) is a chemical that keeps your moods from dipping into one extreme or another.
You have a lot of these floating around, and from time to time your brain reabsorbs the extra supply.
An SSRI “balances” your mood by ensuring that your brain doesn’t reabsorb too many of these neurotransmitters, which keeps higher levels of serotonin on standby.
More of the neurotransmitter serotonin means your lows aren’t so low, which makes depressive episodes less intense.
Weed (also known as marijuana, cannabis or “the Devil’s lettuce”) is considered a medication in many parts of the U.S., a recreational drug in many parts of the U.S. and throughout the world can be seen as either an acceptable vice with beneficial effects for some individuals, or a scourge and a “gateway drug” for others.
Cannabis has been used in an off-label capacity to treat major depression, depressive disorders, anxiety and several other forms of mood disorder, and there is research to suggest it can help certain people with certain symptoms.
It may also be beneficial in pain management and in the treatment of other symptoms of diseases, but that’s a topic for another time. What you’re here to learn about is how these two medicinal compounds interact with one another.
Like neurotransmitters, cannabinoids also have receptors in your brain — sort of dedicated packing spots where the compounds can latch on and cause effects, including the psychoactive effects of THC.
These medications don’t react like baking soda and vinegar in your brain — there’s no eruption, explosion or another catastrophic event when you mix the two. But recent studies have found that compounds found in cannabis can slow the metabolism of SSRIs in your brain.
The result of this is that, over time, your brain can behave as if it has been taking well beyond the recommended dosage of an SSRI, even though your intake has stayed the same.
So are you in danger if you’re combining Prozac with cannabis? Not exactly.
If we venture all the way back to 1991, we can find a single published case report that argued combining Prozac and marijuana caused a mild form of mania, but no significant data has shown that this is a specific danger.
A 2021 article explained that recent findings when looking at cannabis and SSRI use in adolescents found that cannabis can increase the concentrations of these medications in the body and that decreased cannabis use can likewise decrease concentrations.
The big adverse effect risk you have to look out for is that CBD and THC can increase the concentrations of these medications in your body, and that can increase your risk of listed side effects from Prozac.
Given what some of those side effects are, it makes logical sense that you might want to avoid regular weed use if you’re already seeing side effects — that’s the recommendation that was made by the study authors, anyway.
Likewise, mania is both a potential side effect of both antidepressant medication and cannabis, and recent studies have shown that, as people have been increasingly using cannabis, cases of mania have increased.
It would be fair to say that there’s a correlation between the use of cannabis and risk of mania, and between the use of common antidepressants and risk of mania, but no hard and fast proof that combining both will predictably cause mania.
What we know is that the National Library of Medicine (NLM) also has conflicting evidence.
In addition to the information we mentioned in the last section, the NLM separately states that cannabinoids can exacerbate mood disorders, and that some experts consider cannabis a contraindication — something that doesn’t mix well — for mood disorders and psychotic disorders like schizophrenia.
And that’s far from a ringing endorsement.
So, should you avoid mixing Prozac and weed? Realistically, this is one of those questions best left to you and your healthcare provider.
Don’t get us wrong — there are plenty of reasons to avoid cannabis if you’re dealing with mental health conditions. Cannabinoids can exacerbate depressive disorders and anxiety, and cannabis is a big red flag for schizophrenia sufferers.
And using the two in tandem at regular intervals may potentially cause your brain to accumulate a build-up of SSRIs like Prozac, which could lead to issues down the road.
But that’s not necessarily a dealbreaker, particularly if your individual mental health care needs are being effectively met by Prozac and you feel that your cannabis use has a positive effect on your mental health.
After all, studies say it can treat symptoms of anxiety and depression in some cases (and in an off-label capacity).
It might be the case that a smaller dose of Prozac combined with cannabis may be just what you need — but it may also not be the case.
If weed is a big part of your life, it may be worth talking to a healthcare provider about trying other medications, but we’re here to warn you: changing antidepressants isn’t as easy as changing weed strains, and it’s, again, a conversation best suited for you and your healthcare provider.
Prozac and weed can both come with some unpleasant side effects, and dangerous interactions could come from regularly using both. But even the current wisdom is somewhat split on whether you can smoke on antidepressants.
For our piece in this, we’re firm believers that it’s better to be safe than sorry, so if you see yourself having some unpleasant side effects from combining weed and Prozac, it may be time to stop — or, at the very least, contact your healthcare provider.
Self-medication isn’t a great way to address mental health issues and mood disorders anyway. If you’re concerned about your mental health and ready to make some progress in taking back control, consider online therapy as one way to get started on your journey today.
Still have questions about the best ways to address your mental health issues? It might be time to speak to someone about mental health before things get out of control.
Start your mental wellness journey today.