Is there a natural alternative to the prescription antidepressant paroxetine (brand name: Paxil)?
Hemp-derived cannabidiol (CBD) might be one. Research suggests CBD may have therapeutic potential for people with depression, and it’s safe and well-tolerated in humans.
However, CBD isn’t a proven treatment for depression, so it should be used as a supplement to, rather than a replacement for, Paxil and other prescription antidepressants.
But CBD may supplement Paxil, these two drugs shouldn’t be taken at the same time. Doing so may cause increased adverse side effects, such as dizziness, drowsiness, confusion, and difficulty concentrating.
In this article, we’re going to take an in-depth look at CBD and Paxil, from the benefits that each has to offer to the ways in which they work.
What is Paxil?
Paroxetine (we’ll use “Paxil” from here for simplicity) is an antidepressant that’s part of a class of drugs known as selective serotonin reuptake inhibitors (SSRIs).
SSRIs work by increasing the amount of serotonin, a natural chemical, in your brain. Increased levels of serotonin causes an increase in positive emotions and feelings.
While Paxil has been shown to have benefits as an antidepressant, research also shows that it’s one of the most dangerous SSRIs and tends to create more adverse effects than other similar drugs.
Because of this, many people who get prescribed Paxil go on the hunt for alternatives, both natural (e.g. CBD) and not (e.g. other SSRIs).
Benefits of Paxil for Depression
Research suggests Paxil may have a variety of antidepressant benefits.
A 1992 study found that paroxetine showed benefits for both moderate and severe depression, as well as depression caused by both internal and external factors.
The study also found that paroxetine is effective at treating depression-related anxiety [1].
And this is just one study of many: Paxil is approved by the FDA for many types of depression, so there is a decent amount of research backing its benefits.
However, other studies advise caution around the prescription and use of Paxil.
In a study titled “Paroxetine—The Antidepressant from Hell? Probably Not, But Caution Required,” researchers found that “the problems and risks associated with paroxetine appear to possibly make it the least safe of all SSRIs.”
The study mentioned research that had associated the use of paroxetine with negative effects on male fertility, birth defects, weight gain, and other adverse events [2].
Based on the research, it’s safe to say that Paxil is beneficial in some situations, but potentially detrimental in others.
This isn’t to say that you shouldn’t use Paxil if you’ve had it prescribed to you; your doctor weighs the benefits and the downsides against each other when prescribing medicine.
How Does Paxil Work for Depression?
Paxil (paroxetine) is a selective serotonin reuptake inhibitor (SSRI). SSRIs work by preventing the reuptake of serotonin, a natural brain chemical that creates positive emotions.
Reuptake is the process by which neurotransmitters are absorbed back into your nerve endings — preventing reuptake causes serotonin to stay in between your nerve endings for longer, therefore allowing it to render its effects more intensely and for a longer period of time.
When your serotonin levels are normal, your mind feels at ease. But if your levels are too low, you may feel an overwhelming number of negative emotions, including depressive symptoms.
There is an observed correlation between serotonin deficiency and anxiety, depressed mood, aggression, panic disorder, and social anxiety disorder.
By increasing your serotonin levels, SSRIs like Paxil work to reduce depressive or anxious symptoms.
What is CBD?
Cannabidiol (CBD) is a naturally-occurring cannabinoid in the cannabis sativa plant (hemp is cannabis sativa that contains less than 0.3% THC by dry weight).
While CBD is just one of more than 100 cannabinoids found in hemp, it’s one of the most-researched because of its high natural abundance and potential therapeutic benefits.
CBD has been researched for depression, anxiety, and stress, as well as pain, inflammation, epilepsy, and more.
Unlike tetrahydrocannabinol (THC), CBD is not inebriating. CBD is technically psychoactive because it affects the mind, but it creates mild feelings of calm and relaxation rather than the feelings you’d normally associate with a high.
Benefits of CBD for Depression
There is some research to suggest that CBD may have antidepressant effects.
A 2019 study on rats found that CBD induces “fast and sustained antidepressant-like effect[s],” and that CBD may have the potential to be developed into an antidepressant medication [3].
Additionally, a 2018 survey of CBD users indicates that many people use CBD for depression. Out of 2,409 participants, more than one in six reported using CBD for depression, and nearly two-thirds reported that it worked “very well by itself” [4].
Anecdotally, many people use CBD for seasonal affective disorder (SAD) (also called seasonal depression).
Overall, research suggests that CBD may have antidepressant properties, which indicates that it may be beneficial for people with depression. However, CBD isn’t an FDA-approved antidepressant and isn’t as proven as pharmaceutical drugs.
Because of this, it’s best regarded as a natural supplement, rather than a replacement for prescription antidepressants.
How Does CBD Work for Depression?
CBD works by supporting your endocannabinoid system (ECS). The ECS is a receptor system in your body that’s responsible for regulating your vital functions, including your mood.
There are two main types of receptors in your ECS:
- CB1 receptors, which produce mental effects when interacted with
- CB2 receptors, which produce physical effects when interacted with
CBD doesn’t bind to the CB1 or CB2 receptors as many cannabinoids do, but research suggests that it supports the function of your ECS by preventing the breakdown of its processes [5].
Research also suggests that CBD may increase your body’s levels of serotonin, a neurotransmitter, similar to how SSRIs do [6]. An increase in your serotonin levels is associated with a reduction in depressive symptoms.
More research is needed before we fully understand CBD’s mechanism of action as an antidepressant. Nonetheless, the studies we have so far suggest that CBD has therapeutic potential in this area.
CBD vs. Paxil: Side Effects
While CBD and Paxil both have potential benefits for depression, they also may cause adverse effects.
Side effects of Paxil may include:
- Acid or sour stomach
- Belching
- Decreased appetite
- Heartburn
- Pain or tenderness around the eyes and cheekbones
- Passing gas
- Problems with urinating
- Runny or stuffy nose
- Sleepiness or unusual drowsiness
- Stomach discomfort or upset
- Trouble sleeping
Side effects of CBD may include:
- Dry mouth
- Drowsiness
- Diarrhea
- Reduced appetite
- Fatigue
Pros and Cons of Paxil for Depression
Here are some pros and cons you’ll want to keep in mind when considering Paxil for depression:
Pros
- FDA-approved: Paxil is an antidepressant drug that’s FDA-approved as a treatment for depression and related problems. As part of this approval, Paxil has had to pass clinical trials and undergo regulatory processes to ensure it’s effective for these uses.
- Science-backed: Compared to the scientific literature on CBD, there is more clinical evidence to prove Paxil is an effective antidepressant and there is more research on its side effects, so it’s a more reliable option for treating depression than CBD is.
Cons
- May cause relatively severe side effects: Paxil creates more side effects than most other SSRIs, and it certainly creates more side effects than CBD. Common side effects of Paxil include pain and tenderness around the eyes and cheekbones, belching, heartburn, and problems urinating, among other things.
- May cause drug interactions: Paxil may interact adversely with many drugs, including drugs that also affect serotonin like buspirone, fentanyl, lithium, and tryptophan. Taking these drugs together may lead to an overabundance of serotonin (called serotonin syndrome), which may cause nervousness, nausea, vomiting, diarrhea, dilated pupils, and tremor, among other things.
Pros and Cons of CBD for Depression
Here are some pros and cons you’ll want to keep in mind when considering CBD for depression:
Pros
- Research-backed: Multiple studies suggest CBD has therapeutic potential for depression. Anecdotal evidence suggests it may promote a calm, healthy, balanced mind. However, as compared to Paxil and other FDA-approved drugs, CBD isn’t as proven as an antidepressant. More research is needed before CBD can be regarded as a viable depression treatment.
- Has fewer side effects than many traditional drugs: The potential side effects of CBD include dry mouth, drowsiness, diarrhea, reduced appetite, and fatigue. Compared to the side effects of Paxil, these side effects are very minor. Often, these side effects aren’t felt at all.
Cons
- Poorly regulated: The CBD industry isn’t regulated by the FDA as the pharmaceutical industry is, and the vast majority of products you’ll find online and in-store have not been evaluated by clinical trials. Therefore, you’ll need to employ careful shopping techniques to ensure the CBD product you’re buying is of high quality.
- May interact with prescriptions: CBD may affect how your body metabolizes certain medications, including SSRIs like Paxil. Using CBD together with Paxil may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
- Not legal in all states: Every form of CBD may not be legal in every state in the US, and as a result, you may have trouble legally purchasing and using the product you prefer.
CBD-Paxil Interaction: Can You Take Them at the Same Time?
No, you should not not take CBD and Paxil (paroxetine) at the same time. Using paroxetine with CBD may increase side effects like dizziness, drowsiness, confusion, and difficulty concentrating.
CBD may supplement Paxil and other prescription medications, however, this should be done under the guidance of a doctor. They’ll be able to advise you on how much of each you should take, and how far apart you should space them to avoid an increase in adverse effects.
Conclusion: Is CBD A Good Alternative to Paxil?
Studies suggest that CBD may have antidepressant properties, and many researchers believe it’s a promising candidate for being developed into an antidepressant medication.
However, there isn’t yet enough clinical research on CBD for it to be regarded as a proven depression treatment, so as of right now, we recommend taking a cautious and experimental approach to using CBD for depression and similar conditions.
Start with small doses of CBD and avoid taking it at the same time as prescription medications. Additionally, consult your doctor before using CBD for any condition for which you’ve already been prescribed medications.
Learn more about CBD and SSRIs:
CBD vs. Paxil: Frequently Asked Questions
Here are some questions our customers frequently ask us about how CBD and Paxil compare.
Can I take CBD while taking paroxetine?
No, you should not take CBD and paroxetine at the same time. However, you might be able to use them together, but on separate days. Still, we do not recommend doing this without guidance from your doctor.
Is CBD more effective than antidepressants?
Some people find that CBD works better than antidepressants, while others don’t. There isn’t any comparative research on CBD and antidepressants, so it’s hard to say which is more effective. More clinical research is needed before CBD can be regarded as a proven treatment for depression.
Is CBD a good alternative to anxiety medication?
CBD may render many of the same benefits as anxiety medications by promoting a calm, healthy mind. However, research hasn’t yet proven CBD’s efficacy as an anxiety treatment, so it should be used as a supplement, not a replacement, for prescriptions.
Can you take CBD on antidepressants?
Using CBD while also using antidepressants is possible, but it should only be done under the care of a doctor. They will be able to help you determine when to take CBD versus your antidepressants to ensure you don’t experience unnecessary adverse effects.
Sources
[1] Montgomery, S A. “The advantages of paroxetine in different subgroups of depression.” International clinical psychopharmacology vol. 6 Suppl 4 (1992): 91-100. doi:10.1097/00004850-199206004-00015
[2] Nevels, Robert M et al. “Paroxetine-The Antidepressant from Hell? Probably Not, But Caution Required.” Psychopharmacology bulletin vol. 46,1 (2016): 77-104.
[3] Sales, Amanda J et al. “Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex.” Molecular neurobiology vol. 56,2 (2019): 1070-1081. doi:10.1007/s12035-018-1143-4
[4] Corroon, Jamie, and Joy A Phillips. “A Cross-Sectional Study of Cannabidiol Users.” Cannabis and cannabinoid research vol. 3,1 152-161. 1 Jul. 2018, doi:10.1089/can.2018.0006
[5] Haney, Margaret. “Cannabis Use and the Endocannabinoid System: A Clinical Perspective.” The American journal of psychiatry vol. 179,1 (2022): 21-25. doi:10.1176/appi.ajp.2021.21111138
[6] De Gregorio, Danilo et al. “Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain.” Pain vol. 160,1 (2019): 136-150. doi:10.1097/j.pain.0000000000001386
