Janet asked
Can I use a low dose of hemp oil if I take 50mg of Paxil? My goal is to cut down the Paxil. I am 58 and of good health. I take 10mg of Lipitor daily too.
Answer
There are no documented interactions between CBD (cannabidiol) oil and Paxil (paroxetine).
However, this may simply be due to the lack of reporting on the matter. Looking into how CBD oil works and affects metabolism, there is a theoretical interaction between CBD oil and Paxil, but the clinical significance is not known.
CBD Oil
CBD, also known as cannabidiol, is a major component of cannabis (i.e. marijuana).
While THC (delta-9-tetrahydrocannabinol) is likely more well-known due to its psychoactive and euphoric effects, CBD makes up almost 40% of cannabis extracts and has a wide range of potential benefits when used medicinally, although more studies are needed to better understand the compound.
The dosing of CBD explored in studies is highly variable (from 1 mg to over 600 mg) but there is preliminary positive evidence for a variety of indications, including:
- Anxiety
- Dystonia
- Chronic Pain
- Epilepsy
- Multiple Sclerosis
- Insomnia
- PTSD
- Parkinson's Disease
Further adding to the potential benefit of CBD, is the fact that it is considered CBD is considered "non-euphoric", even at high doses. In fact, studies have shown that CBD may improve tolerably of high THC cannabis formulations, which may be of great benefit to medical cannabis patients.
CBD has recently has exploded in popularity, with multiple products available at a large number of natural health food and supplement stores.
With this, it is important to consider potential drug interactions with prescription medication. Due to the relative recent nature of CBD use for medicinal purposes, there are a distinct lack of studies when it comes to potential drug interactions between CBD and SSRIs (selective serotonin reuptake inhibitors), such as Paxil.
CBD Drug Interactions
The two main constituents of marijuana, THC and CBD, are known to be metabolized by the cytochrome P450 system, the major enzymes involved in drug metabolism.
Specifically, studies have shown that CBD can inhibit the following CYP metabolizing enzymes:
- CYP2C9
- CYP2C19
- CYP3A4
- CYP2D6
- CYP1A1
Metabolizing enzyme inhibition often leads to increased concentrations of drugs that are substrates for a particular enzyme. In the case of Paxil, which is metabolized by CYP2D6, there is a potential drug interaction to be aware of.
Taking Paxil With CBD
Paxil (paroxetine) is a SSRI (selective serotonin reuptake inhibitor) that is used for the treatment of depression and panic disorders. Paxil is metabolized by Cytochrome P450 2D6 (CYP2D6).
If this enzyme is inhibited, by CBD for instance, concentrations of the drug could theoretically increase, leading to an increased risk of dose related side effects such as:
- Headache
- Nausea
- Diarrhea
- Dizziness
- Serotonin syndrome (rare)
Until studies are completed that specifically look at how CBD interacts with Paxil, we can only make educated guesses. There are many studies that postulate that while CBD does inhibit metabolizing enzymes, it is not significant and the blood concentrations needed to affect these metabolizing enzymes in humans far exceeds what is possible with usual dosing.
In addition, there are some studies that indicate that CBD may help depressive symptoms and could potentially augment the effects of antidepressants such as SSRIs.
Overall, the potential interaction between CBD and SSRI medications such as Paxil appears to be relatively low for most individuals based on the available data.
Nevertheless, it is always a good idea to speak with your doctor about adding CBD to your medication regimen to look out for any potential side effects, interactions and changes to your disease state.
