Can I take Cannabis and Sertraline together?

It is generally advised that you avoid using cannabis while taking sertraline. Combining them can increase the risk of side effects such as extreme drowsiness, dizziness, and confusion.

Cannabis can sometimes worsen the anxiety or depression that sertraline is being used to treat.

Why this happens

Both substances affect brain chemicals. Sertraline increases serotonin levels, and cannabis may further influence this, potentially leading to an overload (serotonin syndrome).

Cannabis can also slow down the liver enzymes (specifically CYP2C19) that break down sertraline, causing the medication to build up to higher-than-intended levels in your bloodstream.

What you should do

• If you do choose to use it, do so with extreme caution, start with a very low amount, and ensure someone is with you.

• Seek medical help immediately if you experience a rapid heartbeat, severe shivering, or confusion.

• Discuss your use with your GP or pharmacist, as they may need to monitor your sertraline dose more closely.

Important precautions

Serotonin syndrome

Combining cannabis and sertraline can cause a dangerous build-up of serotonin. Seek urgent medical help if you experience high fever, agitation, confusion, or severe muscle stiffness.

Mental health disorders

Cannabis can significantly worsen symptoms of depression or anxiety and may trigger psychosis, potentially counteracting the therapeutic effects of sertraline.

Psychosis or schizophrenia

You must not use cannabis if you have a personal or strong family history of schizophrenia or other psychotic disorders, as it can trigger or worsen these conditions.

Driving and operating machinery

It is an offence to drive if your ability is impaired by cannabis. Even if you do not feel 'high', the drug stays in your system and can result in a drug-driving conviction.

Bleeding risk

Sertraline increases your risk of bleeding. Seek medical advice before taking anti-inflammatory painkillers such as ibuprofen or aspirin, as the combination can cause serious stomach bleeding.

Food and drink warnings

Alcohol

You should avoid drinking alcohol while taking sertraline. Alcohol can increase the sedative effects of the medicine, making you feel more drowsy, dizzy, or uncoordinated. It can also worsen the symptoms of depression or anxiety that you are being treated for.

Drinking alcohol while using cannabis can significantly increase the sedative effects, leading to extreme drowsiness, dizziness, and impaired coordination. It may also increase the levels of THC in your blood, making the 'high' more intense or unpredictable.

Grapefruit juice

Grapefruit and grapefruit juice can interfere with how your body breaks down certain compounds in cannabis (particularly CBD). This can lead to higher levels of the medicine in your system, potentially increasing side effects.

Grapefruit juice can increase the levels of sertraline in your blood by slowing down how your body breaks it down. This may increase the risk of side effects. It is best to avoid drinking large amounts of grapefruit juice while taking this medication.

Fatty meals

If you are taking cannabis in oral forms (like oils or capsules), eating a high-fat meal can significantly increase the amount of the drug absorbed into your system. This can make the effects much stronger than usual. It is best to be consistent with how you take it in relation to food.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.