Antidepressants
See Subgroups: Monoamine Oxidase Inhibitors (MAOI's), Tricyclic Antidepressants (TCA's), Selective Serotonin Reuptake Inhibitors (SSRI's)
Miscellaneous Antidepressants
Generic Names and Trade Names
| Bupropion | Wellbutrin | |
| Nefazodone | Serzone | |
| Trazodone | Desyrel | |
| Venlafaxine | Effexor |
Description
The exact mechanism of action of antidepressants is unknown, however it is believed that the medications somehow regulate norepinephrine and serotonin reuptake. Previously, the focus was on immediate effects of neurotransmitter reuptake results, now however there has been a shift to the long term effects of these drugs on the brain. Long-term treatment with these agents produces many complex changes in the sensitivities of the receptor sites, thereby producing recovery from the depressive episodes by normalizing neurotransmission efficacy. (Facts and Comparisons 1999)
Nutritional Considerations
Avoid alcohol. (Facts and Comparisons 1999)
Food decreases absorption of Nefazodone by 20%. (Pronsky 1999)
Folate levels may play a role in depression. (Wesson 1994, Fava 1997)
There may be an increased requirement for riboflavin. (Pinto 1987)
There may be correlation between calcium and magnesium levels and depression. (Linder 1989)
Anorexia or apetite changes are possible with these drugs. (Facts and Comparisons 1999)
Herbal Considerations
Dong quai, elecampane, greater celandine, guarana, kelp plant, lobelia, marigold, Passion flower, pulsatilla, sage, silverweed, skunk cabbage, slippery elm, southernwood, squill, St. John's wort and yohimbe should be used with caution in conjunction with CNS depressants. (Brinker 1998)(Blumenthal 1998)(Newall 1996)
Other authors state that hops and St. John's wort are contra-indicated, entirely, in patients with depressive illness. (Brinker 1998)(Newall 1996)
Ginger may cause malabsorption of psychoactive or other oral medications. (Brinker 1998)
It is sometimes easy to overlook weight loss products, often described as "Thermogenic", that contain ma huang (or similar products) as it may be listed in very small print, or appear under its alternative names: ephedra, or ephedrine, however, these agents may theoretically interact with antidepressants. (Brinker 1998)
References
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Brinker, Francis: Herb Contraindications and Drug Interactions, 1998.
Facts and Comparisons Clinisphere 2.0, Wolters Kluwer Company, 1999.
Fava M et al. Folate, vitamin B12 and homocysteine in major depressive disorder. Am Journal Psychiatry, 1997 Mar 154:3, 426-8.
Linder J et al. Calcium and magnesium concentrations in affective disorder: difference between plasma and serum in relation to symptoms. Acta Psychiat Scand, 1989 Dec. 80:6 527-37.
Marco LA & Randels RM: Drug interactions in alcoholic patients. Hillside J Clin Psychiatry 1981; 3:27-44.
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
Osol, Arthur. 1980. Remington's Pharmaceutical Sciences. Mack Publishing Company, Pennsylvania.
Pinto, J.T. and Rivlin R.S., Drugs that promote renal excretion of riboflavin. Drug Nutrient Interactions, 1987 5:143-151.
Pronsky, ZM: Food Medication Interactions, 11th edition. 1999.
Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Tricyclic Compounds. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1990.
Tinguely D, Jonzier M, Schopf J, et al: Determination of compliance with riboflavin in an antidepressive therapy, Arzneimittelforschung, 1985, 35(2):536-8
Wesson VA et al., Change in folate status with antidepressant treatment. Psychiatry Res, 1994 Sept. 53:3, 313-22.
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