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CBD & Lexapro: Can CBD Replace Lexapro As An Effective Anti-Depressant?

Lexapro is the brand name for the generic drug Escitalopram that belongs to a class of anti-depressants, known as selective serotonin reuptake inhibitors (SSRIs). It’s meant to treat patients with Major Depressive Disorder, Generalized Anxiety Disorder, and other similar mental health issues.

Like all SSRIs, Lexapro is known to affect the brain by blocking the reuptake of the neurotransmitter, serotonin, that generally drops in people with depression or anxiety disorders.

Most pharmaceutical drugs, however, come with several side-effects, and Lexapro is no exception.

Its benefits are accompanied by adverse events, like insomnia, sweating, fatigue, upset stomach, nausea, loss of libido, heartburn, ejaculation disorders, impotence, etc.

In rare cases, Lexapro may even aggravate the symptoms, besides causing other side-effects, like manic behavior, serotonin syndrome, abnormal bleeding, cognitive impairment.

It’s due to these adversities that people often switch to natural, safe, and yet effective alternatives like cannabidiol (CBD).

And rightly so!

You have every right to be aware of all the medications, their chemical makeup, and their potential side-effects.

After all, it’s YOUR health we’re talking about!

Can CBD Be An Effective Anti-Depressant?

If you’re here, you must be well aware of cannabidiol (CBD)’s promising therapeutic effects.

CBD is one topic that has taken both the medical fraternity and the masses by storm. Even as we speak, more research is being done to understand its manifold health benefits and effects on patients suffering from different health conditions.

A non-psychoactive, non-intoxicating compound that doesn’t produce tolerance or dependence, CBD is found in cannabis plants. CBD oils are usually extracted from hemp and not marijuana, as hemp extracts don’t contain THC (tetrahydrocannabinol) levels that are high enough to give you a ‘high’.

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The human body has a complex cell-signaling system, known as the endocannabinoid system (ECS), which is responsible for regulating several bodily functions and processes, like sleep, memory, appetite, reproduction, pain, and immune response.

ECS’s primary role is to maintain the chemical and physiological balance within the body, known as homeostasis.

One of the three main components of the ECS are endocannabinoids that bind with the second component of the ECS, cannabinoid receptors (CB1 and CB2 receptors) found in the nervous system. The third component is the enzymes that break down endocannabinoids.

While researchers aren’t entirely sure about how CBD interacts with the ECS, they have, however, confirmed that CBD doesn’t directly bind with cannabinoid receptors, like THC. Instead, it directly triggers the production of endocannabinoids in the body, inhibits its breakdown, and indirectly inhibits the eCBRs from breaking them down.

Here are some things we DO know about CBD and ECS:

Ø A 2002 review, published in the Journal of Clinical Pharmacology, Raphael Mechoulam’s team discussed CBD’s anti-convulsive, anti-anxiety, anti-psychotic, anti-nausea and anti-rheumatoid arthritic properties – a clear indication towards CBD’s anti-depressive properties as well. The study also focused on its inhibition of anandamide reuptake and hydrolysis, as well as its anti-oxidative effects.

Ø A 2004 paper, published in Nature Reviews Drug Discovery, which studied the physiological function of the ECS and its interaction with cannabinoids, pointed to the potential of cannabinoids in therapeutics.

Ø In a 2016 study, available with the Current Clinical Pharmacology, scientists discussed how CBD influences and interacts with the ECS, with particular focus on the therapeutic potential of the ECS.

Ø A 2018 study published in the International Journal of Molecular Science indicated how cannabinoids modulate cell signal transduction pathways and impact the central nervous system. The research focused on the therapeutic significance of cannabinoids in the body.

Now that we understand the inner workings of the ECS and CBD’s therapeutic effects, let’s ascertain the connection between CBD and depression.

Ø A 2017 study, published in the Frontiers in Pharmacology, discusses CBD’s neuroprotective properties in cases of several psychiatric disorders, like anxiety, psychosis, and depression. This study was, however, conducted on rodents, with the assumption that CBD may induce similar plastic changes in humans.

Ø Other studies, published in Progress in Neuro-Psychopharmacology & Biological Psychiatry (2018) and Neuropharmacology (2012), indicated that CBD has antidepressant-like effects by activating the serotonergic mechanism and 5-HT system. The second research takes reviewers through the pathways CBD takes in the brain to trigger its antidepressive effects and other neuropsychiatric disorders.

Ø According to a 2013 research, published in the Current Neuropharmacology, CBD encourages neurogenesis and cell regeneration and is believed to modulate symptoms of depression and anxiety.

Ø Another 2016 study, published in the Pharmacological Research, showed that CBD exhibits neuroprotective effects over patients with neurodegenerative and neuropsychiatric disorders.

Ø A 2019 study, published in the Journal of Chemical Neuroanatomy, presents an overview of the anti-depressant effects of CBD in animal models. “CBD has a complex pharmacology…ability to interact with multiple neurotransmitter systems involved in depression, including the serotonergic, glutamatergic, and endocannabinoid systems… CBD induces cellular and molecular changes in brain regions related to depression neurobiology…as well as increases neurogenesis (neuron production) in the hippocampus.”

There’s also some evidence of CBD actually helping people with depression, anxiety, and substance abuse.

Ø A 2020 trial, published in the Neuropsychiatrie: Clinical, Diagnostic, Therapy, and Rehabilitation, exhibited that a teenager with multiple substance-abuse disorder, severe depression, and other psychiatric diseases showed significant improvement when treated with CBD, following unsuccessful treatment with antidepressants.

Ø A 2019 study, published in the Frontiers in Psychology, indicated that repeated use of CBD exhibits anxiolytic properties in teenagers with social anxiety disorders.

A few studies also highlighted the potential role that CBD can play in psychiatry.

Ø For instance, a 2019 review, published in Evidence-Based Complementary and Alternative Medicine, studied CBD’s effects on patients with schizophrenia and generalized social anxiety disorder. The review also delved into CBD’s efficacy in treating epilepsy, Alzheimer’s disease, Huntington’s disease, Parkinson’s disease, and other neurodegenerative diseases.

So far, we have evidence that indicates that CBD alleviates depression, encourages neurogenesis, and helps treat neurodegenerative disorders when treatment with prescription drugs fail. However, there is a lack of documented research on how exactly it does so.

But don’t worry!

Considering the increasing popularity of CBD, we should soon have more proof in the days to come.

CBD & Lexapro: Any Potential Drug Interactions?

We know that CBD is effective in relieving certain symptoms. But it also tends to interact with some pharmaceutical drugs, owing to its inhibition of some liver enzymes (Cytochrome P450 or CYP450) required to metabolize all drugs and foreign substances.

This may either slow down the metabolism of the drugs or that of CBD, causing an increase in the levels of the drug or CBD in the bloodstream, in a mechanism quite similar to the grapefruit effect.

This could lead to potential risks, including severe side effects. However, there are also some instances of CBD enhancing the effects of drugs in a way that is better for the health of a person.

Now, here’s what we know of Lexapro & CBD metabolism:

Þ  According to a 2002 study, published in the Primary Care Companion to the Journal of Clinical Psychiatry, escitalopram activates CYP isozymes CYP3A4 (34%), CYP2D6 (30%), CYP2C19 (36%) of the CYP450 group of enzymes to metabolize.

Þ  Now, most of these CYP isozymes are inhibited by CBD in the liver, specifically, CYP3A4, CYP2C9, CYP2D6, and CYP2C19.

Þ  In this case, the interaction seems pretty obvious. Isoenzymes CYP3A4, CYP2D6, CYP2C19 are all required to metabolize escitalopram (Lexapro) as well as CBD. This interaction may cause side effects that include dizziness, drowsiness, confusion, and difficulty concentrating. In some cases, older patients may also experience impaired thinking abilities, poor judgment, and motor coordination.

What the research says…

Ø A 2017 animal study, published in the Cannabis and Cannabinoid Research, indicates that while CBD is useful in managing anxiety, depression, and other psychiatric issues, it can potentially interact with SSRIs.

However, there are no studies on the exact interaction between Lexapro with CBD. More research into the toxicological parameters of CBD and other drugs, enzymes, and hormones is needed.

Ø A 2009 study, published in the Advances in Psychiatric Treatment, points out that patients are often put on multiple anti-depressants when they fail to respond to monotherapy. However, the exact interaction and effects of combining any two treatment plans are yet to be studied more elaborately.

Last word: Can CBD Replace Lexapro?

If you’re planning to try CBD as an adjunct treatment with Lexapro, you must speak with your doctor about the potential risk of drug interactions.

You need to understand that research on CBD and its impact on human medical conditions is still largely in its developmental phase. You must ensure you’re in the clear before you make the switch or think of combining the two.

If you’re planning on switching, it’s best to gradually wean off your anti-depressant medications, of course under your doctor’s supervision, before starting on a CBD regimen.

Before we sign off…

  • Do your research on all CBD-based consumer or medical products available in the market before you buy.
  • Don’t quit your antidepressants on your own
  • CBD may not work on you as it would on others; so, keep your fingers crossed and don’t expect magic
  • Speak to your doctor before you change your medications

It’s after all your health that we’re talking about!

It’s better safe than sorry, right?

Ivan writes about Cannabis at The Cannabis Radar. He has a degree in Nutrition Sciences from University of Oklahoma Health Sciences Centre. He likes to spend his spare time reading to his daughter or spending time with his wife.

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