Some Anxiety Medications Are Dangerous with CBD

The purpose of this post is not to promote or denounce anxiety medication or cannabidiol (CBD), as taking medication and supplements is a personal decision to be made with medical advice. Instead, it's to inform you of a potentially dangerous interaction that not even all medical professionals are fully aware of: CBD is not safe to ingest if you take a medication that carries a grapefruit warning. 

If you take any prescription medication and also take (or are considering trying) CBD for wellness, check the label on your medication. If it carries the grapefruit warning, then taking CBD in addition to that medication could make you sick. Here is a look at why, as well as a list of some anxiety medications that interact with grapefruit and CBD. 

Why Grapefruit and CBD are Dangerous with Some Anxiety Medications

You might have noticed that some medications come with what is known as "the grapefruit warning" and sport a label, stating that you must avoid grapefruit and grapefruit juice while you're taking the medication. This is because grapefruit blocks a group of enzymes in the body known as cytochrome P450 (CYP450), including CYP3A4.^1,2 The CYP450 enzymes are largely responsible for breaking down substances like medication.

The formula of some medications interacts with these enzymes, so the body cannot metabolize the medication properly.³ The medication may then either accumulate to toxic levels in the body or will not be absorbed at all. As a result, you will end up with too much or not enough medication in your system, which can make you sick by intensifying the side effects, causing toxicity, and/or interfering with the medication's ability to treat you. 

Researchers have discovered that CBD contains the same property as grapefruit that interferes in the body's ability to metabolize some medications properly.^1,4 Many, but not all, medications for a variety of purposes interact with grapefruit and CBD. Some anxiety and mood medications also carry the grapefruit warning, making them unsafe for use with CBD. 

Some Anxiety and Depression Medications that Are Dangerous with CBD

Not all mental health medications, such as prescriptions for anxiety and depression, interact with CBD and grapefruit. This is a partial list of some that carry the grapefruit (and, thus, CBD) warning.^3,5

• Zolpidem (Ambien)
• Buspirone (BuSpar)
• Trazodone (Desyrel)
• Ziprasidone (Geodon)
• Triazolam (Halcion)
• Haloperidol (Haldol)
• Lurasidone (Latuda)
• Diazepam (Valium)
• Midazolam (Versed)
• Sertraline (Zoloft)

If you take any type of anxiety medication, or depression medication, or mood medication, check the label to see if it contains a warning to avoid grapefruit. If it does, know that CBD also applies. If you are uncertain, check with your doctor or pharmacist. Also, look up your medication online to learn about all interactions. 

I discovered this recently because I had been taking CBD for overall health and wellness, and was gradually and steadily feeling worse, experiencing a host of unpleasant symptoms. Curious about the timing with my starting CBD, I investigated and discovered that medications with the grapefruit warning are also unsafe with CBD.

I take a grapefruit-clashing medication for microscopic lymphocytic colitis, a type of inflammatory bowel disease. Before starting CBD, I checked with two of my doctors. Both gave me the go-ahead despite my prescription medication. This is why I'm sharing this information with you: It is vital that we take charge of our own health and safety.

Research into CBD is new and much of the findings are not widely known. Plus, doctors are rushed and harried, which can cause them to forget some details like what medication a patient is taking. Doctors are necessary and important components of our physical and mental health, but ultimately, we are responsible for gathering as much information as we can and staying informed. 

Just as grapefruit by itself is safe for many people, CBD is believed to be as well. However, the combination of CBD with certain medications can be dangerous to your health. Being informed about anything you put into your body can increase your health and wellbeing. Managing anxiety can be tricky, but the more you know, the more empowered you are. 

Have you felt worse after starting CBD while taking an anxiety medication or a medication with a grapefruit warning? Please share your story in the comments.

Sources

1. Chesak, J., "CBD and Drug Interactions: What You Need to Know." Healthline, November 15, 2019. 
2. U.S. Food and Drug Administration (FDA), "Grapefruit Juice and Some Drugs Don't Mix." July 18, 2017. 
3. Harvard Health Publishing, "Grapefruit and Medication: A Cautionary Note." Harvard Medical School, October 13, 2020.
4. DiSalvo, D., "What CBD and Grapefruit Have in Common When It Comes to Drug Interactions: Risks You Should Know." Forbes, June 30, 2019. 
5. Thorpe, M., "Grapefruit Warning: It Can Interact with Common Medications." Healthline, May 7, 2020.