Last updated: 11 November 2026
CBD can change how your body handles some antidepressants. It is broken down by the liver enzymes CYP3A4 and CYP2C19, which also process many antidepressants, and in a small study CBD raised citalopram levels. Ask your GP, prescriber or pharmacist before starting CBD, and never stop or change an antidepressant yourself.
Below: what is known for each common antidepressant, serotonin syndrome, and what to ask. This is general information, not medical advice.
Can you take CBD with antidepressants?
Some people do, but only after checking with the person who prescribes the antidepressant or a pharmacist. Research is thin: one small study in six patients, plus lab tests and predictions. The best evidence is for citalopram and escitalopram, where CBD raised blood levels. Drowsiness can also add up, especially with mirtazapine or amitriptyline.
The Food Standards Agency (FSA) advises, as a precaution, that people taking any medication should not use CBD unless under medical direction. For all medicines, see which medicines interact with CBD.
How CBD and antidepressants affect each other
- CBD slowing your antidepressant’s breakdown. CBD blocks the enzyme CYP2C19 in people: it raised the active breakdown product of the epilepsy medicine clobazam three to four-fold. Citalopram, escitalopram, sertraline and amitriptyline all rely partly on CYP2C19. CBD also slowed CYP1A2 in a caffeine study, which matters in theory for duloxetine.
- Your antidepressant changing CBD. CBD is processed by CYP2C19 and CYP3A4, so antidepressants that block CYP2C19, such as fluvoxamine and, less so, fluoxetine, could raise CBD levels. St John’s wort lowers CBD and shouldn’t be taken with SSRIs anyway (see St John’s wort interactions).
- Side effects adding together. The product information for Epidyolex, the UK’s licensed CBD medicine, lists sleepiness as common and warns that sedating medicines and alcohol can add to it.
CBD made no difference to midazolam, the standard CYP3A4 test, in healthy volunteers, so the CYP2C19 route matters most here.
Antidepressants and CBD: what is known
Moderate evidence means a small study in people; limited means lab data or prediction only. “No studies” doesn’t mean safe.
| Antidepressant | Main enzymes | What is known with CBD | Evidence | What to do |
|---|---|---|---|---|
| Citalopram, escitalopram (SSRIs) | CYP2C19, CYP3A4 | CBD at 200 to 800mg a day raised citalopram levels in 6 patients | Moderate | Ask your prescriber first |
| Sertraline (SSRI) | CYP2B6, CYP2C19, CYP3A4 and others | Little effect in lab tests; no studies in people | Limited | Ask your GP or pharmacist first |
| Fluoxetine, paroxetine (SSRIs) | Mainly CYP2D6 | Little effect on fluoxetine in lab tests; fluoxetine may raise CBD a little | Limited | Ask your GP or pharmacist first |
| Venlafaxine (SNRI) | Mainly CYP2D6 | No studies | Limited | Ask your GP or pharmacist first |
| Duloxetine (SNRI) | CYP1A2, CYP2D6 | No studies; could rise in theory via CYP1A2 | Limited | Ask your GP or pharmacist first |
| Mirtazapine | CYP2D6, CYP1A2, CYP3A4 | Little effect in lab tests; drowsiness adds up | Limited | Ask first; don’t drive until you know how you feel |
| Amitriptyline, nortriptyline (also low doses for pain or sleep) | CYP2C19, CYP2D6 | No studies; could rise in theory; drowsiness and dizziness add up | Limited | Ask your GP or pharmacist first |
Enzyme details come from each medicine’s product information. This isn’t a complete list.
Can you take CBD with sertraline?
There are no studies of CBD with sertraline in people. In lab tests CBD had little effect on how sertraline is broken down, which is mildly reassuring, but sertraline partly uses CYP2C19, the enzyme CBD blocks. Ask your GP or pharmacist first, and report new side effects such as feeling shaky, sweaty or more anxious.
iThe NHS says to tell your doctor about any supplements you take with sertraline. Sleep problems on it? See sertraline and insomnia.
CBD with citalopram or escitalopram
This combination has the clearest signal. In an Australian study, six people on stable citalopram or escitalopram took added CBD, rising from 200mg to 800mg a day over 12 weeks, and their citalopram levels rose significantly. It was unclear whether side effects increased.
Why it matters: the MHRA warns that citalopram and escitalopram can affect heart rhythm in a dose-related way, so their maximum doses are capped, and lower for people over 65. More in our guide to anxiety medication in the UK.
Will CBD make me drowsy on antidepressants?
It might. Sleepiness is a common side effect of prescription CBD, and mirtazapine, amitriptyline and trazodone cause drowsiness too; fluoxetine can make some people tired (see does fluoxetine make you tired?). See how you feel before driving (CBD and driving) and go easy on alcohol.
Can CBD cause serotonin syndrome?
We found no well-documented case of CBD on its own causing serotonin syndrome with an antidepressant. Published cannabis cases involved THC-rich products. CBD acts on a serotonin receptor (5-HT1A) in lab studies, but that hasn’t been shown to cause serotonin syndrome in people. Still, know the signs: the NHS lists a fast heartbeat, sweating and shaking (see when to get help).
Does the amount of CBD matter?
Yes. The citalopram study used 200 to 800mg of CBD a day, and the clobazam and caffeine findings came from prescription doses of 1,500mg a day or more. The FSA’s advice for healthy adults is no more than 10mg a day, which is 20 to 150 times lower.
A 2023 review suggested relevant CBD interactions are likely only above about 300mg a day, but supplement amounts haven’t been tested with antidepressants. See our CBD dosage guide.
Should I stop my antidepressant to try CBD?
No. Never stop or cut down an antidepressant without your prescriber. The NHS warns that stopping suddenly can cause withdrawal symptoms, and coming off is usually done by reducing the dose slowly over weeks or months.
CBD isn’t a treatment for depression or anxiety: Epidyolex, the only licensed CBD medicine in the UK, is for certain rare epilepsies. For the research, see CBD and depression and CBD and anxiety.
What to ask your GP or pharmacist
iA pharmacist can check this free in a few minutes. Take the CBD product, or a photo of the label, and ask:
- Is my antidepressant processed by CYP2C19 or CYP1A2?
- Is CBD reasonable with my medicine, and at what amount?
- Which side effects should I watch for, and should I avoid driving at first?
If you then use CBD, keep the amount and timing steady and tell your prescriber if you start, stop or change it. Suspected side effects can be reported to the MHRA Yellow Card scheme.
Other medicines too? See CBD and blood thinners, CBD and blood pressure medication and CBD for older adults. Taking ashwagandha too? See ashwagandha and antidepressants.
When to get help
Stop CBD and call NHS 111 if you get a fast heartbeat, sweating, shaking, twitching, agitation or confusion (possible serotonin syndrome). Call 999 for a very high temperature, a fit, fainting or severe dizziness.
If you have thoughts of harming yourself, call 999 or go to A&E if you’re in danger now, or call NHS 111 and choose the mental health option. You can also call Samaritans free on 116 123, day or night.
For CBD’s own side effects, see CBD side effects.
If your GP or pharmacist says CBD is OK
The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
Alongside an antidepressant, a fixed, measured amount you can tell your prescriber about is the simplest place to start.
Next step
CBD Capsules Broad Spectrum
Only with your prescriber’s or pharmacist’s OK: Broad Spectrum CBD Capsules give a measured dose, one 10mg capsule, in a vegan capsule with 0% THC, alcohol-free and third-party lab tested. 30 capsules per jar.
Add Broad Spectrum CBD Capsules 10mg to bag or choose another strength
Subscribe and save 25% on your first order, then 20%. New to Evopure? Join our emails for 20% off a one-off first order. Free UK delivery over £40. The FSA advises healthy adults to take no more than 10mg of CBD a day: one 10mg capsule gives 10mg. Adults only. If you take an antidepressant or any other medicine, check with your GP, prescriber or pharmacist first. We don’t recommend our products during pregnancy or breastfeeding.
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View productSources 9
- emc. Epidyolex 100 mg/ml oral solution: summary of product characteristics (sections 4.4, 4.5 and 5.2). Revised June 2026.
- Anderson LL et al. Citalopram and cannabidiol: in vitro and in vivo evidence of pharmacokinetic interactions relevant to the treatment of anxiety disorders in young people. J Clin Psychopharmacol, 2021.
- Vaughn SE et al. The impact of marijuana on antidepressant treatment in adolescents: clinical and pharmacologic considerations. J Pers Med, 2021.
- Herdegen T, Cascorbi I. Drug interactions of tetrahydrocannabinol and cannabidiol in cannabinoid drugs. Dtsch Arztebl Int, 2023.
- MHRA. Citalopram and escitalopram: QT interval prolongation. Drug Safety Update.
- NHS. Sertraline.
- NHS. Antidepressants.
- MHRA. Yellow Card scheme.
- Food Standards Agency (GOV.UK). Cannabidiol (CBD) guidance.
