Unless your shrink is also a medical marijuana doctor in a green state, it can be awkward to ask how cannabis might impact the effects of other psychiatric medications. One of the results of prohibition is that there’s little information about contraindications between cannabis and other prescription or illicit drugs.
While cannabis is often used to treat anxiety or depression, many who use it for these conditions might also be taking a pharmaceutical medication. One study from the University of Connecticut Health Center found there to be few negative effects from combining psychoactive drugs, like cannabis, which get you high, with psychotropic drugs like Zoloft, which treat a psychiatric condition over time without an immediate buzz.
“New psychotropic medications have a relatively high therapeutic index,” the researchers wrote, meaning that they’re less likely to cause adverse reactions. However, they also suggested that patients who do experience adverse reactions on account of mixing cannabis with their prescription pills might be afraid to disclose their experience for fear of admitting to their pot use.
One issue that might come up is that cannabis could obscure a physician’s ability to properly prescribe the right pill or dosage. If a patient isn’t starting from a sober place and is already self-medicating with weed, it might be hard for their doctor to figure out what’s truly going on or if a psychiatric medication is actually working.
In cases in which a patient is severely anxious or depressed, they’re also more likely to misuse or heavily use cannabis. One study found people who suffer from anxiety or depression might use cannabis two to eight times more than people who don’t suffer from these conditions.
Still, according to psychiatrist Dr. Lester Grinspoon, retired professor at Harvard Medical School and medical marijuana expert, there’s little convincing evidence that cannabis compromises other substances. “I have not seen anything that has appeared to be a red flag, such as ‘Oh, don’t use it if you’re using this drug,'” he tells Jane Street. “One of the amazing facts about cannabis as a medicine is its remarkable freedom from toxicity. As an extension of that, it seems not to tread on the heals of any other medicine that I know of.”
Things can be more complicated however with conditions like schizophrenia or bipolar disorder. “Empirically, cannabis seems to be useful for people with bipolar,” Grinspoon says, however he notes that there are no controlled studies looking into it as an official medication to treat the condition. However, in those who are already predisposed to schizophrenia, cannabis (or other psychedelic drugs) might trigger its onset. That said, these patients might also be more likely to use cannabis to begin with.
It’s also important to note, however, that anecdotally, cannabis may intensify the effects of other psychoactive drugs — depending on the strain. In some cases, a mellower kind of cannabis might calm a person down if they’re having a difficult experience, but in others it might make them feel even higher. Nonetheless, adding cannabis to whatever else you’re taking won’t be lethal, so long as you also take a safe amount of the secondary substance.