Can Cannabis Cause Serotonin Syndrome: The Relationship Between Cannabis and Serotonin



Many people who react badly to SSRIs and other drugs that increase serotonin in one direction are wary of anything that could lead to negative effects of those drugs. Cannabis has shown strong effects on serotonin pathways in anxiety, depression, and various problems. This brings the question. Can marijuana cause serotonin syndrome? A secondary question also arises. Can cannabis help serotonin syndrome? Let’s see what the research shows.

Cannabis alone does not cause serotonin syndrome. It definitely not does that by itself. Serotonin syndrome occurs when there is excess serotonin in the brain. Usually, it is caused by a combination of medications such as SSRIs, SNRIs, triptans, and other drugs that inhibit serotonin. The degree of inhibition receptors of reuptake is genetic. This means you cannot be sure about how much serotonin actually causes serotonin syndrome. But as I said earlier, cannabis alone does not lead to the occurrence of serotonin syndrome.



Although THC increases serotonin, it is different from drugs known to cause serotonin syndrome. Cannabinoids and serotonin actually have a strange effect that isn’t fully understood. Cannabinoids appear to have a homeostatic effect on serotonin. For example, when you have low serotonin levels, THC levels increase. If you have too much serotonin, a high dose of THC will lower serotonin. The degree of increase in decline is genetic and also appears to affect the sexes differently.

This is actually quite interesting because cannabinoid receptors are located on the serotonergic neuron in the brain. There is a lot to learn! But to answer your question, don’t worry about cannabis-associated serotonin syndrome. Ask your doctor if the medications you are taking are causing any strange effects on you. However, this has never happened before and I have no doubt it will ever happen in the future.

Can Cannabis and Antidepressants Together Cause Serotonin Syndrome?


THC and cannabidiol (CBD) can inhibit enzymes involved in the metabolism of SSRI antidepressants. This can create the possibility of SSRI serum elevations that can lead to serotonin syndrome, a life-threatening condition if there is too much serotonin in the body. Fortunately, extremely high amounts of CBD will be required to create this dangerous situation. Some patients using SSRIs are also concerned about their long-term effects on the liver. As cannabis is considered neuroprotective, there is currently no evidence of a link between marijuana use and liver toxicity.

While scientists don’t yet know what causes depression, imbalances in the body’s neurotransmitters, particularly low serotonin levels, are believed to be important factors. SSRI antidepressants work by preventing the body from reabsorbing serotonin, making it more suitable for neurotransmission. But as many people with depression know, antidepressants are not a comprehensive solution for depression. There is currently no way to measure serotonin levels in the brain, and scientists do not yet know whether antidepressants added to the bloodstream actually increase serotonin levels in the brain.



When using cannabis as a supplement to treat a disorder, it is imperative to work with your doctor, explain your use of cannabis, and look for products that are regulated and tested to make sure you use cannabis as a clean and safe product. If you are taking antidepressants and want to include cannabis in a general health program, you should start very slowly and document your results. If you are a marijuana user and want to try antidepressants, talk to your doctor and, if applicable, your therapist or psychologist. As little research has been done on the interaction between cannabis and antidepressants, it is important to understand what some of the risks might look like. These risks are low to moderate for those taking SSRI antidepressants but increase significantly for patients using other types of antidepressants. Here are some tips to help you decide whether to combine antidepressants and marijuana:

  • Let your doctor/counselor know your intention to try antidepressants and marijuana.
  • Do not try adding cannabis to a new antidepressant prescription until you are fully accustomed to your medication and have a steady dose.
  • On the other hand, if you are already using marijuana and adding an antidepressant to your health regimen, you should stop using marijuana until you adjust your dosage.
  • Accurately document your marijuana use. Write down the type of product you take, the dose, and how often you take it.
  • Start your cannabis regime slowly or continue even if you are an experienced user. Try micro-dosing for a safe and smooth transition.
  • Keep in mind that low doses of marijuana are much less likely to cause negative side effects.
  • Remember that cannabis is not a unique product. What works for a friend or family member may not work for you, and this is perfectly normal.
  • If you feel your depressive symptoms are overwhelming, never forget to contact your friends, family, or psychologist.

Some doctors believe that cannabis and antidepressants are not a good combination, mainly because they combine two drugs that can have psychoactive effects. At this point, there is practically no way of knowing. However, other doctors disagree and find that small amounts of cannabis can be beneficial for people with depression if taken strategically and carefully. As regular cannabis users may be less sensitive to dopamine, the pleasure-pain neurotransmitter, excessive marijuana use can sometimes lead to increased depressive symptoms. Another study points to a research project in which the researchers administered high doses of tetrahydrocannabinol (THC) to animals, resulting in a decrease in serotonin.



While people may react differently, research suggests a simple rule: If you use marijuana to increase antidepressants or treat symptoms of depression without medication, less is definitely more. Because of the side effects and sometimes limited effectiveness of antidepressants, a significant number of people replace cannabis with various antidepressants. According to a 2017 study of 2,774 people who used cannabis in the previous 90 days, 12.7% of respondents said they used cannabis instead of antidepressants. A previous survey of 1,429 participants reported that 50% of cannabis users used cannabis for depression.

The Mechanism Behind the Serotonin Syndrome


Serotonin syndrome is a condition caused by taking medications that cause high levels of chemical serotonin to accumulate in the body. Serotonin helps to transmit signals between nerve cells. Serotonin is found in platelets, the central nervous system, and the digestive system, which allow blood to clot. Serotonin is a substance that affects many parts of the body, from emotions to motor skills related to movement. Serotonin is considered a natural mood stabilizer. It is a chemical that helps to sleep, eat, digest, breathe, and regulate body temperature. Serotonin also helps:

  • Reducing depression
  • Reduce anxiety
  • Healing wounds
  • Maintaining bone health

Serotonin syndrome is usually caused by the simultaneous use of more than one serotonin-containing drug. The use of such serotonin containing drugs together and for a long time causes the accumulation of serotonin in our body more than it should. This causes our body to react negatively to this chemical. Serotonin syndrome can often be caused by anti-depressants and migraine medications. This syndrome can occur especially when we are just starting a drug with serotonin or when we increase the dose of a drug we are currently using. In addition, using more than one drug containing serotonin in the same period may cause serotonin syndrome.

Although serotonin is a substance produced in the body and plays a role in many functional processes, too much serotonin can cause mild symptoms such as shivering and diarrhea, and severe symptoms such as muscle stiffness, fever, and seizures. Even a severe serotonin syndrome can lead to death if left untreated.



Serotonin syndrome can occur when the dose of certain drugs is increased or a new drug is used. Some illegal drugs and nutritional supplements are also associated with serotonin syndrome. Milder forms of serotonin syndrome improve within a few days after discontinuation of the medications that cause symptoms or taking serotonin-blocking drugs. Serotonin syndrome symptoms usually occur within a few hours after taking a new drug or increasing the dose of a drug that is already taken. The symptoms of serotonin syndrome can be listed as follows:

  • Agitation or restlessness
  • Clouding of consciousness
  • Increased heart rate
  • Increased blood pressure
  • Large pupils
  • Loss of muscle coordination or muscle twitching
  • Muscle stiffness
  • Excessive sweating
  • Diarrhea
  • Headache
  • Shake
  • Goosebumps

Severe serotonin syndrome can be life-threatening. The symptoms that can be seen in this case can be listed as follows:

  • High fever
  • Having a seizure
  • Irregular heartbeat
  • Loss of consciousness

The main reason for serotonin syndrome is to use more than one drug that can rapidly increase the serotonin level in our body. In addition, taking a nutritional supplement that can increase our serotonin levels while using one of these drugs may also cause our serotonin levels to rise suddenly. For example, taking a migraine medication to relieve migraine pain in addition to a regularly used depression medication will cause our serotonin levels to rise suddenly. Another example is the use of an illegal drug while taking an antidepressant can also cause serotonin syndrome. Serotonin syndrome is a condition that should not be taken lightly. If the sick person is not treated in a short time, this syndrome can be fatal.



Although it is possible that taking a single drug that increases serotonin levels can cause serotonin syndrome in susceptible individuals, this condition is most likely caused by taking certain drugs together. For example, taking an antidepressant along with migraine medication can cause serotonin syndrome. This can also occur with taking an antidepressant with opioid-type pain medication. Another cause of serotonin syndrome is the deliberate overdose of antidepressant medications. A number of over-the-counter and prescription medications can be associated with serotonin syndrome, particularly antidepressants. Illegal drugs and dietary supplements can also cause the condition. Drugs and supplements that could potentially cause serotonin syndrome can be listed as follows:

  • Antidepressants such as selective serotonin reuptake inhibitors with active ingredients such as citalopram, fluoxetine, sertraline
  • Antidepressants such as serotonin and norepinephrine reuptake inhibitors with active ingredients such as duloxetine
  • Antidepressants and tobacco addiction drugs with Bupropion active ingredient
  • Tricyclic antidepressants with active ingredients such as amitriptyline and nortriptyline
  • Antidepressants such as monoamine oxidase inhibitors with active ingredients such as isocarboxazid, phenelzine
  • Migraine medications such as almotriptan, naratriptan, sumatriptan, carbamazepine, valproic acid, and triptans
  • Opioid-type pain relievers with active ingredients such as codeine, fentanyl, hydrocodone, oxycodone, and tramadol
  • Lithium, a mood-stabilizing drug
  • Drugs that can be considered illegal drugs, such as cocaine
  • Some coconut herbal supplements with a dense base
  • Cough medicines with dextromethorphan active ingredient
  • Nausea medications with active ingredients such as metoclopramide, droperidol, ondansetron
  • Antibiotic with Linezolid active ingredient
  • Ritonavir, an anti-retroviral drug used in HIV treatment

Some people are more sensitive to drugs and supplements that cause serotonin syndrome than other people. However, serotonin syndrome can occur in anyone. However, people with the following conditions have an increased risk of serotonin syndrome:



  • To start taking a drug that is known to increase serotonin levels recently or to increase the dose of an existing drug
  • Taking several drugs together probably will increase the serotonin levels
  • Using herbal supplements known to increase serotonin levels

Since serotonin syndrome usually disturbs the person with acute symptoms, that is, sudden symptoms, people who experience this condition usually apply to the emergency department of hospitals. Urgent interventions can be made here. Then a neurologist can examine the patient to determine the progress of follow-up and treatment. Depending on the symptoms, help can be obtained from other department physicians when necessary. Since serotonin syndrome is a condition that needs to be diagnosed, even mild symptoms should be admitted to the hospital. Because the person should stop the drug that causes serotonin syndrome. For this, the first diagnosis should be made.

Serotonin Syndrome and Antidepressants


Publications in both international and national scientific journals indicate that the number of patients using antidepressants from different classes is increasing, while almost all drug interaction programs more frequently report drug-drug interactions known as serotonin syndrome (SS), which potentially lead to severe toxicity. It is claimed that the fact that SS is an increasingly common clinical entity is a reflection of the increase in the number of serotonergic agents used in clinical practice in recent years. For example, cases from freelance physicians, inpatients, and emergency services were examined by the Toxic Exposure Surveillance System in the USA in 2004, and it was found that selective serotonin reuptake inhibitors caused significant toxic effects in 8187 people (103 of whom resulted in death).

It is clear that psychotropic drugs have an important place in today’s clinical practice. Although drug therapy is accepted as the first-line approach in the treatment of mental disorders, it is a fact that it is in a remarkable position due to serious and potentially fatal side effects. Serotonin plays a key role in treating depressed mood. SSRIs increase the level of serotonin in the synaptic cleft and are widely used because they are safer than older antidepressants. However, excessive accumulation of serotonin in the synaptic cleft can cause serious side effects. The most serious side effect is SS, which can result in death.



Generally, SS is an unwanted, life-threatening drug reaction that occurs due to pharmacological interactions between drugs after the concomitant use of 2 or more drugs that increase serotonin levels at synapses. Triple clinical changes — cognitive, neuromuscular, and autonomic — characterize this syndrome. The effects include restlessness, blood pressure fluctuations, delirium, diarrhea, diaphoresis, agitation, mydriasis, confusion, tachycardia, nausea, hyperpyrexia, or muscle spasms. Although the actual incidence of the syndrome is unfortunately not known, research has drawn attention to the fact that SS develops on average 14-16% of individuals who use SSRI at high doses.

The available findings indicate that the real incidence of SS and the associated morbidity are likely to be very high. Considering the fact that SSRIs are not solely responsible for SS, situations, where this syndrome cannot be diagnosed, might be more than expected. Considering that, as claimed, more than 85% of doctors are unaware of SS as a clinical diagnosis or do not have enough knowledge and experience about SS; The difficulties of conducting epidemiological studies in SS and why the results obtained from epidemiological studies conducted so far are controversial will be understood more easily. Polypharmacy, which means the use of more than one drug, is pandemic, this case is shown among the reasons for the incidence of SS. It is also clear that this situation carries greater risks, especially for countries with low education, such as ours, where drugs can be purchased without a prescription.

Various factors arising from both drugs and the patient can contribute to the toxicity of SSRIs. Different drugs can increase serotonin levels in the body. The risk of SS increases when these drugs are used together. These include drugs used to treat migraine (eg triptans); antidepressants (eg SSRIs, serotonin-noradrenaline reuptake inhibitors, buspirone, tricyclic antidepressants, monoamine oxidase inhibitors); antipsychotics; anticonvulsants; anti-Parkinsonian agents; analgesics (eg meperidine, tramadol); some over-the-counter cough medicines that contain dextromethorphan; herbal products (eg St. John’s Wort) and antibiotics (eg linezolid).



Sensitivity to SS may also depend on patient-dependent factors such as the capacity to metabolize drugs. The combined use of drugs that interact with serotonergic drugs by inhibiting the cytochrome P450 pathway may contribute to SS. Since the CYP2D6 system, which is one of the key enzymes associated with adverse drug reactions, exhibits a high degree of genetic polymorphism, the risk of SS increases when a second serotonergic agent is administered to a poor metabolizer patient in addition to a drug metabolized by this enzyme. An example of this was reported for 4 elderly patients in whom significant SS developed as a result of the interaction between tramadol and mirtazapine, which showed genetic polymorphism. Sensory and visual hallucinations, myoclonus, hypertension, and behavioral changes were observed in the patients.

Serotonin syndrome seems to be a life-threatening phenomenon and its incidence is much higher than expected. In this regard, training of physicians on SS and its effects is vital. Since SS can have a fatal course, physicians should always closely monitor patients using serotonergic drug combinations and be alert to the possibility of an excessive increase in serotonergic activity. It should not be forgotten that the sales of these drugs from pharmacies without a prescription is an important factor that increases the risk.

Cannabis And Serotonin: Can This Relationship Treat Anxiety?


As cannabis users, we’ve all seen how it can improve our mood and help us relax. But these days, we’re beginning to see how these properties can actually help reduce symptoms of depression and anxiety, and serotonin seems to play a role. Serotonin is one of the neurotransmitters produced in the brain and gut. It controls mind-set, queasiness, craving, bone wellbeing, rest, feelings, and even sexual capacity. The vast majority are in the gastrointestinal system.

Serotonin is produced by a conversion process from the essential amino acids tryptophan and tryptophan hydroxylase. Tryptophan is found in common foods like cheese, red meat, and nuts. Lack of this amino acid in our diet causes a decrease in serotonin levels. This is linked to anxiety, depression, and other mood disorders. Because of these factors, our diet is very closely related to our mood and emotions. The relationship between marijuana and serotonin is very interesting. Cannabinoid receptors are not only found in serotonergic neurons but can also be seen in the corresponding inhibitory receptors.



This leads to the conclusion that cannabinoids can raise serotonin levels in certain conditions and lower them in others. For example, migraine is a condition associated with increased serotonin levels in the brain. In this case, activation of inhibitory receptors would be the best solution to the problem. When you consume THC in high doses, it triggers the inhibition of serotonin receptors. A few strokes from Jay make the migraine worse. Once you understand the importance of serotonin in mood disorders and the effects of cannabis on serotonin production, it is easy to see how cannabis can help patients with certain mental illnesses.

A study was conducted in 2016 where a chemical mimicking CBD was applied to mice. This led to the antidepressant effects that could be expected from this calming cannabinoid. Interestingly, the effects were no longer felt when the researchers blocked the serotonin receptors. It also suggests that cannabinoids and the serotonergic system are actually related. Five years ago, an article was published showing how increasing levels of endocannabinoids in the body increase the effectiveness of antidepressants. The study also found that blocking CB1 receptors would prevent antidepressants from working fully.

It shows how the endocannabinoid and serotonergic systems work together to maintain homeostasis. It also shows that if a drug is to be developed, these two systems should be stimulated in a balanced and interdependent manner. Is marijuana the future of antidepressants? Comparing the anxiety levels of 50 people who regularly smoked cannabis versus 50 people who never smoked, one study found some interesting results. Patients who drank marijuana were much less afraid than non-smokers. A 2012 article attempted to evaluate several studies examining CBD as an anti-anxiety drug. They concluded that CBD is an effective treatment for this mental condition, although the dosage and mechanism of consumption continue to be factors that need further investigation.



Before embarking on a cannabis healing journey, it is important to know what you are doing. Not all strains have the same effect on different people. It’s important to keep track of how you feel in some kind of “marijuana journal”. This will help you know which strains are your favorite, as well as your ideal dose and frequency of consumption. THC is another factor to consider. It is not always the best treatment for anxiety; CBD is what you really want. Look for strains that have a CBD profile or are CBD dominant.

As long as you stay alert and watch how you feel, there may be a decrease in anxiety over time. As with many other scientific questions about cannabis, much more research is needed to safely provide advice on how cannabis can be used to treat a variety of mental disorders. However, it is encouraging that cannabis is a non-toxic substance that clearly appears to interact with serotonin as well. We are confident that this relationship will continue to evolve in the future.

Cannabis and Antidepressants: Is It a Bad Idea?


It is not a good idea to mix cannabis with other drugs such as antidepressants. Most medications should not be mixed with antidepressants. Pot is no exception. Antidepressants are prescribed to treat psychiatric disorders such as anxiety, depression, PTSD, and other mental disorders. Many people use green when taking self-contained antidepressants to relieve mental health problems. This is not the solution. In fact, mixing cannabis and antidepressants can make the situation worse. Cannabis, for example, causes anxiety in many people. People with a generalized anxiety disorder or similar conditions may feel more anxious when using cannabis.

Some antidepressants are often prescribed to treat anxiety. Combining these antidepressants with cannabis can render the medications ineffective and improve anxious thoughts and feelings. Some research has shown that chronic cannabis use can lead to depression. This is ironic because many people believe that higher levels improve their condition. The problem is that the effects of the drugs diminish. The user then uses more cannabis to feel better. There may be a vicious circle. Wellbutrin, Celexa, and Paxil are often prescribed to treat depression.



The mixture of weeds and these antidepressants prevent the medication from working properly. Some doctors do not prescribe antidepressants for people using cannabis. It’s important to note that taking antidepressants and cannabis at the same time makes it nearly impossible for your doctor to help you recover. If you are under the care of a psychiatrist, the psychiatrist will monitor your progress and determine whether your prescription medications are working. If you use cannabis and antidepressants at the same time, you won’t know which substance has which specific effect. Medication adjustments and changes are usually out of the question as they have a completely opposite effect. Many doctors will not treat you if you mix these two ingredients.

There are three different types of antidepressants that can interact negatively with cannabis: SSRIs, SNRIs, and MAOIs. Mixing the herb with different antidepressants can create various side effects and problems. Let’s talk about this. Drugs such as Lexapro, Zoloft, Prozac, Wellbutrin, and Paxil are examples. These medications help treat depression caused by other mental health problems by increasing the amount of serotonin released in the body. Serotonin is a natural neurotransmitter for healthy living. It promotes well-being and satisfaction.

Studies have shown that weeds also help release serotonin in the brain. Therefore, mixing cannabis and Prozac, combining cannabis and Wellbutrin, or storing them with other antidepressants can have serious consequences. Too much serotonin in particular can lead to serotonin syndrome. It occurs when the brain cannot handle the number of chemicals it has to process. People with serotonin syndrome have a range of symptoms ranging from mild to severe. These are restlessness, restlessness, mental confusion, rapid heartbeat, high blood pressure, sweating, vomiting, and diarrhea. Also, be careful: Cannabis and SSRI use can lead to life-threatening conditions such as high fever, seizures, shock, irregular heartbeat, and loss of consciousness. Also, many people use the antidepressant Wellbutrin to combat cravings for harmful substances. It is sometimes prescribed to people who quit smoking or are recovering from heroin addiction.



Mixing cannabis and Wellbutrin like other SSRIs is not a good idea for the reasons we’ve explained. Effexor is a serotonin-norepinephrine reuptake inhibitor (SNRI). Other SNRIs are Cymbalta and Pristiq. These antidepressants work similarly to SSRIs. Persons prescribed for an IRSN should not confuse them with cannabis. THC and CBD (two of the main compounds in cannabis) and SNRIs may have an impact on how serotonin is regulated in the brain. Combining these can lead to unpredictable results. Those who have been prescribed an SNRI and added cannabis to the mix may feel extremely confused. You are also prone to developing serotonin syndrome. Although monoamine oxidase (MAO) inhibitors such as Nardil are not commonly prescribed these days (most patients are prescribed to take SSRIs or SNRIs instead), those taking these medications should not smoke cannabis. . MAOs interact with cannabis in ways that raise the sedative properties of cannabis to dangerous levels.

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Savaş Ateş

I like cannabis. I read a lot about cannabis usage in the medical field. I researched a lot about planting it. I have started a cannabis business and i want to share my experiences with you.

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