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Antidepressants

Antidepressants

Monamine Oxidase Inhibitors (MAOI)
Isocarboxazid (Marplan)
Parnate         (Tranylcypromine)
Phenelzine (Nardil)

Selective Serotonin Reuptake Inhibitor (SSRI)
Fluoxetine (Prozac)
Fluvoxamine maleate (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)

Tricyclic antidepressants
Amitriptyline (Elavil)
Desipramine (Norpramin)
Doxepin (Sinequan)
Imipramine (Tofranil)
Nortriptyline (Pamelor)

Other Antidepressants
Bupropion (Wellbutrin)
Trazodone (Desyrel)
Venlafaxine (Effexor)

Nutritional Considerations:

Limit caffeine. (Pronsky 1999)

Folate levels may play a role in depression. Levels should be monitored periodically. (Wesson 1994) (Fava 1997)

The use of any antidepressants except MAOI's may deplete riboflavin. Discuss possible supplementation with your physician or pharmacist. (Pinto 1987) (Tinguely 1985)

Avoid alcohol. (Facts and Comparisons 1999)

Avoid high-tyramine foods with the monoamine oxidase inhibitors. (e.g. aged cheese or wine, bean curd, protein extracts, etc.) (Brown and Bryant 1988) (McCabe 1986)

Avoid tryptophan with SSRI's (supplements have been banned but it is present in some foods). Ask your pharmacist about foods that may contain tryptophan. (Facts and Comparisons 2000) (Pronsky 1999)

Ask your pharmacist concerning supplementation with the following nutrients while taking tricyclic antidepressants: CoQ10, vitamin B1, vitamin B2, and vitamin B6. (Bell 1992) (Edelbroek 1984) (Pinto 1987) (Brinker 1998) (Kishi 1980)

Herbal Considerations:

Hops and St. John's Wort are contra-indicated in patients with depressive illness and they may have additive effects if combined with other antidepressants. Avoid these herbs with the above drugs. (Brinker 1998)(Newall 1996)(Demott 1998)(Gordon 1998)

Avoid gingko when taking antidepressants because it may have additive effects if used together. (Chermat 1997)

California poppy, Nutmeg, and Yohimbe may increase the effects of the MAO inhibitors and should not be used together. (Brinker 1998)

Tobacco speeds the elimination of tricyclic antidepressants. Avoid this herb with these drugs. (Brinker 1998)

References:

Bell IR, Edman JS, Morrow FD, et al: Brief communication - Vitamin B1, B2, and B6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive function, J Am Coll Nutr, 1992, 11(2):159-63

Brinker, Francis,N.D. Herb Contraindications and Drug Interactions. 1998.

Brown CS & Bryant SG, "Monoamine oxidase inhibitors: safety and-efficacy issues", Drug Intell Clin Pharm 1988; 22:232-235.

Chermat R, Brochet D, DeFeudis FV, Drieu K. Interactions of Ginkgo biloba extract (EGb 761), diazepam and ethyl beta-carboline-3-carboxylate on social behavior of the rat. Pharmacol Biochem Behav. 1997 Feb;56(2):333-9.

Demott K. St. John's wort tied to serotonin syndrome. Clinical Psychiatry News 1998;26:28.

Edelbroek PM, Zitman FG, Schreuder JN, et al: Amitriptyline metabolism in relation to antidepressive effect, Clin Pharmacol Ther, 1984, 35(4):467-73

Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000.

Fava M et al. Folate, vitamin B12 and homocysteine in major depressive disorder. Am Journal Psychiatry, 1997 Mar 154:3, 426-8.

Gordon JB. SSRIs and St. John's wort: possible toxicity? Am Fam Physician 1998;57:950.

Kishi T, et al: Inhibition of myocardial respiration by psychotherapeutic drugs and prevention by Coenzyme Q10, Biomedical and Clinical Aspects of Coenzyme Q10, 1980, 2:139-54

McCabe BJ. Dietary tyramine and other pressor amines in MAOI-regimens: a review. J Am Diet Assoc 1986; 86:1059-1064.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996

Pinto, J.T. & Rivlin, R.S. : Drugs that promote renal excretion of riboflavin. Drug Nutrient Interactions, 1987, 5: 143-151.

Pronsky, Zaneta. Food Medication Interactions. 11th edition. 1999.

Tinguely D, Jonzier M, Schopf J, et al: Determination of compliance with riboflavin in an antidepressive therapy, Arneimittelforschung, 1985, 35 (2):536-8.

Wesson VA et al., Change in folate status with antidepressant treatment. Psychiatry Res, 1994 Sept. 53:3, 313-22.