According to the National Institute of Mental Health Disorders, approximately 9.5% of adults in the United States experience depressive illnesses. Additionally, around 19% of adults suffer from anxiety disorders.
Zoloft (sertraline) is one of the most frequently prescribed antidepressants in the United States. It's used to support individuals with depression, anxiety, PTSD, and related conditions. Between 2004 and 2020, Zoloft prescriptions rose by 10 million, totaling over 38 million in 2020 alone.
At the same time, CBD has gained popularity. According to NuggMD’s 2022 Annual Cannabis Conditions Report, nearly 19% of surveyed medical cannabis patients reported using cannabis for anxiety, and about 12% for PTSD.
With both substances being widely used, it’s natural to ask whether taking them together is safe. While research on this interaction is still developing, some early findings may help guide conversations with your healthcare provider.
Find natural, lasting relief with our comprehensive (and completely free) patient’s guide to medical cannabis for stress and anxiety.
What is Zoloft?
Sertraline, the generic name for Zoloft, is classified as a selective serotonin reuptake inhibitor (SSRI). This type of antidepressant medication is relatively new and functions by blocking the brain from reabsorbing serotonin, enabling more serotonin to accumulate, and alleviating various symptoms linked to low serotonin levels. Many of these symptoms are linked to depression and anxiety.
The FDA has approved Zoloft for adults seeking treatment for the following conditions:
- Major Depressive Disorder (MDD)
- Obsessive-Compulsive Disorder (OCD)
- Panic Disorder
- Posttraumatic Stress Disorder (PTSD)
- Premenstrual Dysphoric Disorder (PMDD)
- Social Anxiety Disorder
In addition, Zoloft has the potential to help manage several disorders, such as body dysmorphic disorder, binge eating disorder, bulimia nervosa, premature ejaculation, and generalized anxiety disorder.
Combining Cannabis and Zoloft: What the Latest Research Says
Zoloft (sertraline) and cannabinoids like CBD are both processed in the liver by CYP2C19 enzymes. CBD is known to inhibit these enzymes, which may interfere with how the body metabolizes medications like Zoloft. This could increase sertraline levels in the bloodstream and raise the risk of side effects such as diarrhea, dizziness, or fatigue.1
A 2021 animal study on PTSD found that CBD, either alone or combined with sertraline, influenced behavior and neurochemical changes.2 Another preclinical study published in April 2023 found that CBD produced a stronger antidepressant effect in mice than either Zoloft alone or the combination of the two.3 However, since these studies were conducted on animals, human clinical trials are needed before drawing any conclusions.
While some sources suggest that CBD and Zoloft can be used together, others recommend caution due to the potential for drug interactions. Because cannabinoids can affect how Zoloft is processed, this combination may raise the risk of side effects or, in rare cases, contribute to conditions like serotonin syndrome.
Due to limited research and the possibility of increased side effects, patients should always speak with their healthcare provider instead of combining CBD with Zoloft or any other prescription medication.
Are You Considering Using Cannabis and Zoloft?
Combining cannabis with any substance or medication carries its own risks. Cannabis research is still in its earliest stages, and there is a lot that researchers still don't know. That leaves the door open for unexpected interactions with other substances. If you are considering combining cannabis with any other substance or medication, speak to your doctor for proper medical guidance.
Likewise, stopping the use of a prescribed medication can lead to unintended consequences. Many medications take time to build up in the body. Stopping suddenly can cause unpleasant and potentially serious or even fatal side effects. If you'd like to stop using or replace a medication, you need to follow the guidance of your medical provider to make any approved adjustments safely.
Find natural, lasting relief with our comprehensive (and completely free) patient’s guide to medical cannabis for stress and anxiety.
References
- MacCallum CA, Lo LA, Boivin M. "Is medical cannabis safe for my patients?" A practical review of cannabis safety considerations. European Journal of Internal Medicine. 2021;89:10-18. doi:https://doi.org/10.1016/j.ejim.2021.05.002
↩︎ - Gasparyan A, Navarrete F, Manzanares J. Cannabidiol and Sertraline Regulate Behavioral and Brain Gene Expression Alterations in an Animal Model of PTSD. Frontiers in Pharmacology. 2021;12. doi:https://doi.org/10.3389/fphar.2021.694510
↩︎ - García-Gutiérrez MS, Navarro D, Austrich-Olivares A, Manzanares J. Unveiling behavioral and molecular neuroadaptations related to the antidepressant action of cannabidiol in the unpredictable chronic mild stress model. Frontiers in Pharmacology. 2023;14. doi:https://doi.org/10.3389/fphar.2023.1171646
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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.