Anxiety Medication and Marijuana

August 14, 2020
cannabis plant in hands, Therapeutic Medical Conditions for Cannabis
cannabis plant in hands, Therapeutic Medical Conditions for Cannabis

Are there interactions or contraindications with Anxiety Medication and Marijuana?

With both anxiety and cannabis being very common in the US and indeed with many users of medical marijuana or recreational weed are using it for treatment of stress and anxiety. As such the potential for drug interactions are high as many of these same users – also use prescribed medications such as

  1. Benzodiazepines (e.g. Lorazepam/ativan, Klonopin/clonazepam etc.)  which are used for many types of anxiety including panic disorder and generalized anxiety disorder. Side-effects include drowsiness,  balance and memory issues and there is a great deal of abuse of benzos as they work well and can also be addictive. As such shorter-term use is recommended as withdrawal can be severe.
  2. SSRI’s – selective serotonin reuptake inhibitors (e.g. Zoloft/sertraline, Paxil/paroxetine) – initially used for depression (a common often alongside anxiety) – the use of SSRI’s has proven effective in relieving patients from panic attacks and other forms of anxiety disorders.
  3. Older medicines and classes of medicines that are less frequent such as MAOIs,  tricyclic medications, Beta blocker and others like Buspirone

Each class of medicine and specific medication can have their own side-effects as well as potential interactions with cannabis and cannabinoids.

Accentuation of side-effects

If taking medications please consult with your physician whether using THC, CBD or Delta 8 THC for anxiety (or other related compounds).

Sometimes taking cannabis with a medication that has similar side-effects such as Buspirone that can cause drowsiness, fatigue, dizziness and dry mouth can add to the perception of those side-effects by e.g making the mouth drier or the person more tired.

Other  higher risk medicines that require greater caution as cannabis could magnify negative effects such as increased heart rate as well as blood pressure include:

  • Sedatives (e.g., Xanax, Klonopin, Ambien).
  • Tricyclic antidepressants (e.g., imipramine/Tofranil, amitriptyline, doxepin, trimipramine/Surmontil).
  • MAOIs (e.g. tranylcypromine/Parnate, phenelzine/Nardil, isocarboxazid/Marplan).

Time to take effect and duration of action vs cannabis.

Each class of medicine has different mechanisms of action with some like benzodiazepines being more immediate and others that take longer to take effect – like buspirone.  Additionally each medicine has a different profile for how the body absorbs and eliminates that medicine and that can also affect how long the compound will affect anxiety.

Due to the half-life of cannabinoids and their mechanism of action cannabis and related specific cannabinoids may also provide immediate relief. Smoking in particular delivers cannabinoids into the bloodstream very rapidly – and therefore the effects on the brain and central nervous system can be felt almost immediately in most individuals. The effects come faster with smoking and also dissipate more rapidly.

Other forms of administration such as edibles and capsules have a less immediate effect due to their need to be absorbed but the results can be felt for longer.

Other ways of managing anxiety

Anxiety can range from  being a mild form felt occasionally and slightly uncomfortable to being constant and debilitating. Each individual is different with different underlying causes and conditions. While medications and cannabis may serve to help it is important to consider lifestyle choices that can also help.

These choices include:

  1. Avoiding products and situations that can increase stress. This includes caffeine.
  2. Exercise – according to the ADDA (Anxiety and Depression Association of America) exercise can be helpful in the management of and reduction of stress and enhances ones overall sense of well-being. Even moderate exercise can lead to significant improvements in many individuals.
  3. Meditation/Yoga even as little as 15 minutes focusing on deep breathing and relaxation can significantly help reduce stress.
  4. Herbal remedies and supplements such as chamomile are often used by people experiencing anxiety and have been for at least centuries drinking chamomile tea. Recent clinical trials have shown a 0.5 gm dose of chamomile supplement taken 3 times a day lead to a statistically and clinically significant improvement in recipients vs placebo.
  5. Aromatherapy with essential oils such as lavender, tangerine and chamomile can also help.


Oftentimes medications are prescribed for symptoms of an underlying disease rather than the condition itself. This is an important consideration, especially when combining medications with medical marijuana, therefore there could be other changes or interactions you may notice that may or may not be related to the medication interactions. It’s always best to check with your healthcare provider and other experts to ensure you are being careful when adding to your regimen. It’s also good to speak with cannabis experts to select the right strain for your needs and interests.

You can overviews on Leafly for more details on just how marijuana may connect with antidepressants as well as various other medications.