Nutritional Considerations

• Take with food or milk to decrease stomach upset. Dilute concentrated forms before use.

  1. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  2. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000

• Chlorpromazine may deplete Co-Q-10 levels in the body. Supplementation may be helpful.

  1. Folkers K. Basic chemical research on coenzyme Q10 and integrated clinical research on therapy of diseases. As cited in Lenaz G (ed.). Coenzyme Q. New York: John Wiley and Sons, 1985
  2. Kishi T, et al, Inhibition of Myocardial Respiration by Psychotherapeutic Drugs and Prevention by Coenzyme-Q, Biomedical and Clinical Aspects of Coenzyme Q, Yamamura Y, Folkers K, and Ito Y, eds, Elsevier/North Holland Biomedical Press: Amsterdam, 1980, Vol 2, 139-54.

• Vitamin B2 or riboflavin may be depleted with phenothiazines like Chlorpromazine.

  1. Bell, IR, Edman JS, Morrow FD, et al, B1,B2, and B6 Augmentation of Tricyclic Antidepressant Treatment in Geriatric Depression with Cognitive Dysfunction, J Amer Coll Nutr, 1992, 11(2):159-63.
  2. Pinto, J, Huang YP, and Rivlin RS, Inhibition of Riboflavin Metabolism in Rat Tissues by Chlorpromazine, Imipramine, and Amitriptyline, J Clin Invest, 1981, 67(5):1500-6
  3. Pronsky, Z Food Medication Interactions, 11th edition, 1999

• Take magnesium supplements or antacids separated by at least 2 hours from the drug.

  1. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
  2. Pronsky, Z Food Medication Interactions, 11th edition, 1999

• Chlorpromazine may reduce the absorption of vitamin B12, monitor with long term use of the drug.

  1. Pronsky, Z Food Medication Interactions, 11th edition, 1999

• Vitamin E may be helpful in reducing the incidence of tardive dyskinesia associated with phenothiazine use.

  1. Adler LA, et al. Long term treatment effects of vitamin E for tardive dyskinesia. Biol Psychiatry 43: 868-872, 1998
  2. Adler LA, et al. Vitamin E treatment of tardive dyskinesia. Am J Psychiatry 150: 1405-1407, 1993.
  3. Inada T: [Recent research trends in diagnosis, treatment, and prevention of drug-induced extrapyramidal symptoms seen in psychiatric patients.] Nihon Shinkei Seishin Yakurigaku Zasshi, 1996 Oct, 16:5, 181-5.

• Avoid alcohol intake.

  1. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
  2. Pronsky, Z Food Medication Interactions, 11th edition, 1999

• Avoid phenylalanine supplements while taking phenothiazines because the risk of tardive dyskinesia may increase.

  1. Mosnik DM, Spring B, Rogers K, and Baruah SL. Tardive dyskinesia exacerbated after ingestion of phenylalanine by schizophrenic patients. Neuropsychopharmacology 16(2): 136-146, 1997.
  2. Richardson MA. Amino acids in psychiatric disease. Washington, DC: American Psychiatric Press, 1990.

• Avoid tobacco, it may increase metabolism of the drug.

  1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.

• Avoid caffeine with phenothiazines because the effect of the drug could be changed if caffeine is taken within 40 minutes of the drug.

  1. Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998