CBD and Lexapro: Interactions and Risks

CBD and Lexapro interaction
By Halla Mannering Updated March 8th

Fact-checked by Alexandra Arnett, MS

Medically reviewed by Dr. Brian Kessler, MD

Mental health issues are prevalent in the United States and medication is commonly used in their treatment. Understanding various mental health medications and their interactions – including their interactions with natural substances, like CBD – is important when it comes to using them safely.

Lexapro, pharmaceutically known as escitalopram, is used in the treatment of anxiety and depression. With Generalized Anxiety Disorder (GAD) impacting 6.8 million adults in the U.S., Lexapro is a common prescription.

While Lexapro is a common part of anxiety and depression treatments, there are many different options to consider. For some, CBD has been reported to help relieve the symptoms of these disorders. If you’ve recently been prescribed Lexapro, you may be wondering if it’s safe to use it alongside CBD. Before you go any further, it's good to be aware of any possible interactions that can come from combining CBD and Lexapro.

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What is Lexapro?

Escitalopram, also known as Cipralex or Lexapro, is most commonly used by those who have depression and anxiety. Lexapro is a prescription medication that's typically taken daily. Dosages can vary based on symptom severity and various biological factors.

Lexapro belongs to a class of drugs called SSRIs. Many people know this class of drugs as antidepressants, but they can also be used in the treatment of anxiety.

This medication works by blocking the reuptake of serotonin in the brain.1 The goal of Lexapro is to restore the brain’s healthy serotonin levels so that individuals have reduced anxiety and depression symptoms.

When taken as prescribed, Lexapro is generally considered to be safe. However, there are some side effects that individuals may experience. Common side effects include:

  • Dry mouth
  • Heartburn
  • Difficulty sleeping
  • Increased sleepiness
  • Diarrhea

Less common side effects include:

  • Bloating and discomfort
  • Muscle aches and joint pain
  • Itching, prickly, or pins-and-needles feeling
  • Loss of appetite
  • Sweating
  • Gassiness
  • Stuffy or runny nose and sneezing
  • Drowsiness or "brain fog"
  • Soreness around the eyes and cheekbones
  • Pain in the shoulders and neck
  • Shivering
  • Strange dreams

Severe side effects requiring immediate medical attention include:

  • Decreased libido
  • Inability to perform sexually
  • Inability to reach orgasm
  • Confusion
  • Increased thirst
  • Dizziness
  • Trouble breathing
  • Fast or unusual heartbeat
  • Cramps and muscle pain
  • Swelling in the face, hands, and ankles
  • Reduction in urination
  • Seizures
  • Coma

These are just some of the side effects that can result from using Lexapro. Each individual has their own reaction to this medication, and that’s important to keep in mind. If you are taking this medication and you’re concerned about any side effects you’re experiencing, it’s best to speak with a doctor as soon as possible about your concerns.

CBD and Lexapro: Interactions and Risks

CBD and Lexapro effects

If you’re wondering about potential interactions between CBD and Lexapro, you’re not alone. There are many people who wonder if these two substances are safe to take together.

You should always speak with your doctor before changing your health and wellness routine. Your doctor will be able to provide personalized advice and ensure you’re on the right track when it comes to combining substances.

While it may be considered safe to combine Lexapro with CBD according to a doctor’s guidance, there are some things you should keep in mind. You should start with a low dose of CBD; only ever take the amount of Lexapro you’re prescribed, and make sure that your doctor approves of this combination. 

There hasn’t been extensive research that has examined how CBD can impact the effects of Lexapro, but there are some important studies to note. A review from 2021 examined the metabolism of CBD via the CYP450 enzymes, specifically the CYP2C19, and found that concurrent use of CBD and Lexapro may lead to increased concentrations of Lexapro. However, they noted that the participants did not experience any adverse side effects.2 

There is also some overlap between the potential side effects of CBD and the potential side effects of Lexapro. Drowsiness is an example of a side effect of both of these substances. Taking Lexapro and CBD at the same time can result in increased drowsiness, which can make it dangerous to do things like driving. 

Overlapping side effects are one of the biggest risks that can result from combining CBD and Lexapro. If you’re going to be using both of these substances simultaneously, make sure that you’re aware of the possible side effects and keep an eye on how you’re feeling. While there has never been a reported fatal overdose of CBD, it is possible to experience negative effects (like increased side effects) from combining CBD with SSRIs like Lexapro.

CBD and Lexapro: Are There Any Benefits to Taking Both?

There hasn’t been much research that’s looked at the potential benefits of combining CBD and Lexapro, but there are anecdotal accounts. Using CBD alongside Lexapro could mean that you experience exaggerated effects, such as feeling more tired or more relaxed. 

There needs to be more research to understand the potential implications that can come from combining CBD and Lexapro. While it is possible to experience increased benefits, it’s also possible to experience increased adverse side effects. There’s currently no way to guarantee how someone will react to using CBD, so it’s important to be aware of the adverse effects so that you can watch out for them.

When in doubt, it’s best to speak with a medical professional before combining SSRIs with cannabis. The best way to avoid possible adverse effects is to avoid combining the two. If you’re not sure whether Lexapro or CBD is the right choice for you, your doctor is your best resource.

Can CBD Be an Alternative to Lexapro?

CBD vs Lexapro

Whether or not CBD can replace Lexapro will depend on a variety of factors, including an individual’s biology and their specific reaction to CBD.

One study found that a single dose of CBD was enough to significantly reduce symptoms in those with social anxiety disorder (SAD).3 This suggests that CBD could be a possible option for reducing symptoms in those with anxiety.

Further research supports the idea that CBD could be an effective treatment for anxiety and depression.4 One often appealing aspect of CBD is that it may have lower sedative effects compared to other substances. The majority of the research that exists in this area has examined acute CBD use, and there is a need for more studies to examine long-term CBD use. 

Some people prefer CBD because it may have fewer side effects than Lexapro. However, the side effects that someone experiences from either medication can vary greatly. If you think that CBD might work for you, then you should speak with your doctor about your options before making any changes to your treatment regimen. This is a good way to ensure that you’re staying safe and making the best decisions for your mental health.

Safety Tips When Using CBD While Taking Lexapro

If you’re going to combine CBD with Lexapro, there are a few different things you should know.

One of the most important things to do is start with a low dose and then slowly increase it over time until you reach your desired effects. Starting with a low dose is a good way to understand how your body will react to the combination before you increase your dose. An increased dose has the possibility to elicit stronger negative side effects, so it’s best to play it safe and start with a lower dose.

If you want to avoid combining these substances, you may wonder how long CBD remains in the body. The answer to this question can depend on a variety of biological factors, including age, weight, and metabolism, as well as how often a person uses CBD. If you are a frequent CBD user, then you’ll most likely need to take a longer break in order for it to leave your system. 

While it's hard to say exactly how long CBD stays in the body, it typically stays in the body between 4 to 10 days.5,6 If you want to avoid this substance combination, then it’s most likely best to wait at least 10 days before using CBD.

So, are there specific CBD products that you should stay away from if you’re on Lexapro? 

If you’re worried about the potential side effects of combining these two substances, then it’s best to stay away from edible or smokable options. Topical cannabis products, with the exception of transdermal cannabis products, may be an ideal option for many as they do not cross over into the blood-brain barrier7, which would lead to the potential interaction of CBD and Lexapro.

If you’re considering combining Lexapro and CBD, make sure that you speak with your doctor. It’s always a good idea to consult with your physician before you mix substances, so that you can be sure you’re doing it in a safe way. 

Seek medical help immediately if you experience concerning side effects. Reaching out for medical attention is never a bad idea if you’re concerned about your health. 

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  1.  Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. PubMed. Published May 1, 2023. https://www.ncbi.nlm.nih.gov/books/NBK554406/
  2.  Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol. Journal of Clinical Psychopharmacology. 2021;41(5):525-533. doi:https://doi.org/10.1097/jcp.0000000000001427 ↩︎
  3.  Wright M, Di Ciano P, Brands B. Use of Cannabidiol for the Treatment of Anxiety: A Short Synthesis of Pre-Clinical and Clinical Evidence. Cannabis and Cannabinoid Research. 2020;5(3). doi:https://doi.org/10.1089/can.2019.0052 ↩︎
  4.  Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. doi:https://doi.org/10.1007/s13311-015-0387-1
  5.  Lucas CJ, Galettis P, Schneider J. The pharmacokinetics and the pharmacodynamics of cannabinoids. British Journal of Clinical Pharmacology. 2018;84(11):2477-2482. doi:https://doi.org/10.1111/bcp.13710
  6.  Bansal S, Paine MF, Unadkat JD. Comprehensive Predictions of Cytochrome P450 (P450)-Mediated In Vivo Cannabinoid-Drug Interactions Based on Reversible and Time-Dependent P450 Inhibition in Human Liver Microsomes. Drug Metabolism and Disposition. 2022;50(4):351-360. doi:https://doi.org/10.1124/dmd.121.000734
  7.  Hess C, Krämer M, Madea B. Topical application of THC containing products is not able to cause positive cannabinoid finding in blood or urine. Forensic Sci Int. 2017;272:68-71. doi:10.1016/j.forsciint.2017.01.008 ↩︎

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.

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