Can you use marijuana if you take Lexapro?

Cannabis is often used to help promote relaxation and wellness. However, taking cannabis with escitalopram (Lexapro) — a medication prescribed for depression — is generally not recommended. In rare cases, this combination can cause serotonin syndrome, a potentially fatal condition.

If you take Lexapro, it’s important to understand the risks of mixing it with cannabis.

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What is Lexapro?

Lexapro is a type of prescription medication known as a selective serotonin reuptake inhibitor (SSRI), which is a common type of antidepressant. It can be used to treat conditions such as:

• Major depressive disorder (MDD)
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (PDD), a severe form of premenstrual syndrome (PMS)
• Panic disorder
• Social anxiety disorder
• Obsessive-compulsive disorder (OCD)

How does Lexapro work?

SSRIs like Lexapro work by increasing levels of serotonin, the “happy hormone,” in your brain. Serotonin also plays a role in balancing:

• Appetite
• Motivation
• Energy levels
• Sleep

Lexapro and other SSRIs can help treat certain mental health disorders. But they can also cause side effects, including:

• Diarrhea
• Dizziness and fainting
• Confusion
• Fatigue
• Headache
• Decreased sex drive
• Sweating
• Suicidal thoughts (especially at the beginning of treatment)

Work with your doctor to decide on a treatment plan that works best for you while also minimizing the risk of side effects.

Is it safe to mix Lexapro and weed?

Combining cannabis with SSRIs like Lexapro may also cause:

• Dry mouth
• Drowsiness
• Dizziness
• Anxiety
• Nausea
• Insomnia
• Rapid or irregular heartbeat
• Problems with memory, judgment, and concentration

Cannabis may lower the levels of liver enzymes that break down and metabolize medications like Lexapro in the body. This can lead to increased levels of medication in the bloodstream, which may increase the risk of side effects and impact the effectiveness of the medication.

Mixing cannabis with Lexapro can also lead to a rare but serious side effect known as serotonin syndrome.

Serotonin syndrome is a potentially fatal condition that happens when serotonin levels are too high. Symptoms include:

• High fever
• Fast heartbeat
• High blood pressure
• Loss of muscle coordination
• General weakness
• Insomnia
• Panic attacks
• Agitation and confusion

Some case reports have found that cannabis may raise serotonin levels. Findings from one case in particular suggest that combining high doses of cannabis with serotonin-increasing medications like SSRIs may increase the risk of serotonin syndrome.

Can I use CBD with Lexapro?

Cannabidiol (CBD) is a nonintoxicating compound found in cannabis. It’s commonly used to help with:

• Sleep
• Anxiety
• Pain
• Inflammation

CBD can make you feel drowsy. Combining it with Lexapro can increase this effect.

CBD may also lower levels of liver enzymes in your body. This can interfere with how Lexapro is metabolized, which may increase your risk of side effects and alter the effectiveness of the medication.

Are there benefits to using cannabis with Lexapro?

Cannabis may also offer benefits to people who take Lexapro, such as:

• Relieving certain side effects: Cannabis could relieve some side effects of Lexapro, such as insomnia and nausea.

• Reducing your medication intake: Self-reported studies show that some people who use cannabis are able to take lower doses of antidepressants.

How to take Lexapro and marijuana

If you’ve been prescribed Lexapro, talk with your doctor before using it with cannabis. Together, you can establish a safe dosing plan.

Follow these safety tips (with your doctor’s approval) if you plan to take cannabis and Lexapro together:

• Start low and go slow: Start out with low doses of both cannabis and Lexapro, as recommended by your doctor, to see how they affect you. Increase your doses gradually as needed, under the guidance of your doctor, until the desired results are achieved. If you experience any unwanted side effects, lower your dosages and talk to your doctor about next steps.
• Be mindful of timing: Consider taking Lexapro and cannabis at different times of day to reduce their interaction. Take into account when the effects tend to peak for each. For example, the effects of Lexapro can peak after 5 hours and last for around 24 hours. Cannabis edibles can take 2 to 3 hours to peak and last for about 8 hours. When inhaled, the effects of cannabis can peak in 15 to 30 minutes and last for a couple of hours.
• Ask about other medications: If you’re taking other medications, ask your doctor if they’re safe to mix with cannabis and Lexapro. Discuss the potential interactions or side effects, and make a plan to limit your risk.

The takeaway: Ask your doctor if it’s okay to mix Lexapro and cannabis

Both cannabis and Lexapro can be used to help relieve symptoms of depression and anxiety. But mixing them together carries certain risks, including serotonin syndrome in rare cases.

To learn more about how cannabis might interact with Lexapro, speak with your doctor or a healthcare professional at Leafwell.

Resources

• Antidepressant and anxiolytic effects of medicinal cannabis use in an observational trial. https://pmc.ncbi.nlm.nih.gov/articles/PMC8458732/
• Cannabinoids and cytochrome P450 interactions. https://pubmed.ncbi.nlm.nih.gov/26651971/
• Escitalopram. https://www.ncbi.nlm.nih.gov/books/NBK557734/
• Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample. https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00520-5
• Serotonin syndrome. https://www.ncbi.nlm.nih.gov/books/NBK482377/
• Serotonin syndrome and cannabis: A case report. https://pmc.ncbi.nlm.nih.gov/articles/PMC10809727/
• Serotonin syndrome versus cannabis toxicity in the emergency department. https://pmc.ncbi.nlm.nih.gov/articles/PMC7220016/
• The clinical pharmacokinetics of escitalopram. https://pubmed.ncbi.nlm.nih.gov/17375980/

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