HelloMD

How do I wean my son off all the antidepressant anti anxiety meds and start him on cannabis?


If your son is on two different medications; anxiety medication and anti-depressant medication, then it can be a little tricky.

I would suggest high CBD:THC ratios for his anxiety, but for his depression I would recommend the opposite. However, high levels of THC can trigger anxiety.

First, I would choose to taper off his anxiety medication, and then after time attempt to do the same with the other.

For anxiety: I would recommend tapering off the medication and at the same time purchasing a 24:1 ratio CBD vaporizer pen and using that as needed combined with the decrease in pharmaceutical medication. If a vape cartridge is not enough you make need to try different forms and higher concentrations of CBD.

For depression (but after anxiety symptoms have subsided): I would recommend that your son goes to a dispensary and tries whatever he likes that is high in THC content. He should follow his eyes and in particular trust his nose when selecting various strains of flowers as individual people have individual needs and the best smelling flower may be his path away from depression.

As always, you should speak to a doctor before following my advice :)

BartSmart


This will depend specifically what kind of meds he is on. Some may require a psychiatrist's supervision to properly titrate the meds safely. Bart's answer pretty much takes it all from there :)

ryan


I'm not a doctor, but involved in research and also write on clinical cannabis for Leafly. Most of the research out there on THC and CBD for depression and anxiety is preclinical (either small human studies or lab studies). In preclinical studies on THC for depression there have been some conflicting findings, but it does seem THC produces biphasic responses whereby low/moderate doses can be helpful, whilst high doses can exacerbate symptoms. For example, high doses of THC can exacerbate anxiety. Likewise, I know of at least one animal study in which low dose THC boosted serotonin, while high doses depleted it (an animal study, and of course "mice are not men," but in absence of clinical research, important to take note.)

CBD, on the other hand, seems to be effective not just for anxiety, but for depression as well. CBD is a 5-HT1A agonist (5-HT1A is a subtype of the serotonin receptor), so it functions in some ways similarly to SSRIs. Likewise, individuals with depression often suffer hippocampal degradation, and CBD has been shown to promote neurogenesis, restoring some of the loss suffered from depression.

I would be highly cautious around using high THC for depression as we have studies that in those who genetically predisposed, THC can trigger or exacerbate certain psychiatric disorders.

I've written a couple of articles you may find useful:

Also, important to note: CBD does appear to interact with with some drugs like Depakote by inhibiting the activity of cytochrome P450. And, finally, when considering "weaning off" of a prescribed medication, I would always consult with a physician knowledgeable in cannabis-based treatments. I've heard of (and personally know of) some bad outcomes by people who didn't follow proper protocols and hopped off their meds without professional supervision.

jeremykossen


Thanks, Jeremy! He is indeed correct about his study results about CBD and THC. In addition, there's also the aforementioned entourage effect at the CB1 receptor that shows that other receptor types (including serotonergic receptors) are also activated when CBD and THC are both at the receptor. However, the problem is that these are molecular bio studies and like Mr. Kossen has already mentioned, a lot of the research in only at this level or the animal-study model. May I offer another perspective as a clinician who has seen a lot of mental illness? Many of my patients actually do better when combining low doses of cannabis with low doses of anti-depressant medications, another type of synergy at work! In any case, please do not attempt to wean off antidepressant meds unless under an MD supervision (there is a documented antidepressant withdrawal syndrome that can occur). If your son is being weaned off these meds, I would also highly recommend that a behavioural therapy treatment plan is in place (CBT/DBT/gestalt etc). Please keep in touch and let us know how things are going!

drpark