Those who use Prozac are very familiar with fluoxetine. It is used to treat specific mental conditions like depression and even bulimia. Similarly, fluvoxamine is an antidepressant that is mainly used by people with obsessive-compulsive disorder.
Other drugs that belong to this category are phenytoin, phenobarbital, and St. John’s wort.
These two drugs are primary examples of CYP2C19 inhibitors. As it is with these medications, CBD’s bioavailability increases upon interaction. The risk of adverse effects may increase as a result, which is why lower CBD doses are advised.
But, when CBD enters the party, the liver stops metabolising other drugs that rely on cytochrome P450 enzymes, and shifts its attention to CBD.
CBD’s drug interactions largely stem from the cytochrome P450 system. This group of liver enzymes is mainly responsible for breaking down toxins, drugs, and other foreign substances in our system. These enzymes basically dissect these substances to make them easier to eliminate from the body.
Cannabinoids, including CBD, are metabolised by the liver with the help of cytochrome P450 enzymes. CBD is then broken down and distributed throughout the entire body, where it can get to work promoting balance.
Substrates are essentially drugs that are metabolised by cytochrome P450 enzymes. CYP3A4, specifically, is an enzyme in the liver and intestines that oxidises toxins or drugs for easier excretion from the body.
At the United European Gastroenterology conference in Vienna, October 2018, Naftali reported her latest findings. Forty-six people with moderately severe CD were randomized to receive wither cannabis oil (15% cannabidiol and 4% THC) or placebo for 8 weeks.” The group receiving the cannabis oil had a significant reduction in their Crohn’s disease symptoms compared with the placebo group, and 65%met strict criteria for clinical remission (versus 35% of the placebo recipients).”
Her second study in 2014, was a prospective placebo-controlled study with 21 patients with CD who did not respond to therapy with steroids, immunomodulators, or anti-tumor necrosis factor-α agents. They were divided into two groups, one given cannabis, twice daily for 8 weeks, in the form of THC-containing cigarettes or placebo containing cannabis flowers from which the THC had been extracted. “Complete remission (CDAI score, <150) was achieved by 5 of 11 subjects in the cannabis group (45%) and 1 of 10 in the placebo group (10%; P = .43). A clinical response (decrease in CDAI score of >100) was observed in 10 of 11 subjects in the cannabis group and 4 of 10 in the placebo group. Three patients in the cannabis group were weaned from steroid dependency. Subjects receiving cannabis reported improved appetite and sleep, with no significant side effects.
Other symptoms include
— "I wouldn’t be able to do [the show] if I didn’t smoke weed"
Naftali and her colleagues in Israel have presented several studies on the response of patients with CD to cannabis. The first, a retrospective observational study in 2011, interviewed 30 patients with CD who had been prescribed cannabis. Disease activity before and after cannabis was estimated using a Harvey Bradshaw index (a simplification of the Crohn’s Disease Activity Index-CDAI). They found that “Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 ± 6.7 to 7 ± 4.7 (P < 0.001). The need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use.
What is Crohn’s Disease?
Researchers estimate that more than half a million people in the United States have Crohn’s disease. Studies show that, over time, Crohn’s disease has become more common in the United States and other parts of the world. The reason for this increase is unknown.
Crohn’s disease can develop in people of any age and is more likely to develop in people
The medications and substances highlighted in the following section have the potential to have an interaction with CBD, as many are processed by the cytochrome P-450 system. This list is not exhaustive and there are many other medications that may interact with CBD.
If your body’s cytochrome P-450 system is busy metabolising CBD rather than your medication, it can cause the medicine to remain in your system for longer than it is meant to. In some cases this may result in the medication accumulating or building up in the body to potentially toxic levels.
These are some common chemotherapy drugs which are processed by the cytochrome P-450 system and could strongly interact with CBD:
CBD and chemotherapy
CBD interacts with many chemotherapy drugs. CBD can increase the amount of time it takes for the body to process the chemotherapy drugs, resulting in a toxic buildup.
Consulting your doctor before treating epilepsy with CBD is crucial, as CBD interactions with epileptic medicines have been proven.
In November 2017 the World Health Organisation (WHO) released its assessment of CBD, where it described the substance as having a “good safety profile” and noted that there were “no public health related problems associated with the use of pure CBD”. Despite this good safety profile, CBD does impact how your body processes other drugs and medications, which, if unaccounted for, can cause your body harm.
CBD-rich strains of cannabis are an exciting product of the CBD and medicinal cannabis movement. Hemp buds offer an alternative to CBD oil as a source of CBD that can be smoked, vaped or used to make edibles and ingested.