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lithium and cannabis

Does cannabis interact with antidepressants or lithium?

Cannabis and antidepressants

Cannabis or marijuana can interact with tricyclic antidepressants (TCAs), such as amitriptyline, imipramine and dothiepin.

Both cannabis and TCAs can cause an abnormally fast heartbeat (tachycardia) and high blood pressure (hypertension). There’s also a risk of other side effects, such as confusion, restlessness, mood swings and hallucinations.

There’s a risk that using cannabis while you’re on any of these medicines could lead to problems such as tachycardia, even if you don’t already have a heart condition.

Little research has been done into the interaction of cannabis with other types of antidepressants, such as SSRIs.

Cannabis and lithium

Lithium is used to treat bipolar disorder, a condition where people can switch between depression and extreme excitement and agitation (mania).

There’s little evidence to suggest that people who use cannabis should normally not take lithium, but this hasn’t been properly researched.

Side effects of cannabis

It’s not clear how often cannabis itself can cause anxiety or depression, but research suggests this can happen.

It’s therefore recommended that if you’re anxious or depressed and you use cannabis regularly, you should try giving up and see if that helps.

Tachycardia, dizziness, anxiety, drowsiness, nausea and vomiting, difficulty sleeping and confusion are all possible side effects of cannabis.

These side effects can also be caused by certain antidepressants, so using cannabis at the same time can make them worse.

Getting advice

If you have any concerns about the medicines you’re taking, talk to your GP or pharmacist.

You can also phone NHS 111 or Talk to Frank, a friendly confidential drugs helpline, on 0300 123 6600.

Further information:

  • Antidepressant drugs
  • Can I drink alcohol if I’m taking antidepressants?
  • Depression
  • Medicines information

Page last reviewed: 27 March 2018
Next review due: 27 March 2021

Cannabis or marijuana is usually smoked and typically mixed with tobacco. It can interact with certain types of antidepressants, such as tricyclic antidepressants (TCAs), which share similar side effects.

Lithium carbonate in the management of cannabis withdrawal: a randomized placebo-controlled trial in an inpatient setting

Affiliation

  • 1 Discipline of Addiction Medicine, University of Sydney, Camperdown, NSW, 2050, Australia.
  • PMID: 24880749
  • DOI: 10.1007/s00213-014-3611-5

Lithium carbonate in the management of cannabis withdrawal: a randomized placebo-controlled trial in an inpatient setting

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Authors

Affiliation

  • 1 Discipline of Addiction Medicine, University of Sydney, Camperdown, NSW, 2050, Australia.
  • PMID: 24880749
  • DOI: 10.1007/s00213-014-3611-5

Abstract

Rationale: Preclinical studies suggest that lithium carbonate (lithium) can reduce precipitated cannabinoid withdrawal in rats by stimulating release of the neuropeptide oxytocin, while two open-label studies indicate lithium may ameliorate cannabis withdrawal symptoms in humans.

Objectives: This study was conducted to examine the efficacy and safety of lithium in the inpatient management of cannabis withdrawal and to determine whether lithium affects plasma oxytocin and the rate of elimination of plasma cannabinoids during abstinence.

Methods: Treatment-seeking cannabis-dependent adults (n = 38) were admitted for 8 days to an inpatient withdrawal unit and randomized to either oral lithium (500 mg) or placebo given twice a day under double-blind randomized controlled trial (RCT) conditions. Primary outcomes included withdrawal severity [cannabis withdrawal scale (CWS)], rates of detoxification completion, and adverse events. Plasma cannabinoids, plasma oxytocin and serum lithium levels were measured repeatedly over admission. Follow-up research interviews were conducted at 14, 30, and 90 days postdischarge.

Results: Lithium did not significantly affect total CWS scores relative to placebo, although it significantly reduced individual symptoms of “loss of appetite,” “stomach aches,” and “nightmares/strange dreams.” No significant group differences were found in treatment retention or adverse events. Lithium did not increase plasma oxytocin levels nor influence the rate of elimination of cannabinoids. Both placebo- and lithium-treated participants showed reduced levels of cannabis use (verified by urinalysis) and improved health and psychosocial outcomes at 30- and 90-day follow-up relative to pretreatment baselines.

Conclusions: Despite the strong rationale for the present study, the efficacy of lithium over placebo in the management of cannabis withdrawal was not demonstrated.

Despite the strong rationale for the present study, the efficacy of lithium over placebo in the management of cannabis withdrawal was not demonstrated.