Interactions of antidepressants, mood-stabilisers and antipsychotics with food

Abstract

Aim: The aim of the paper was to review and analyse the literature addressing interactions between food and antidepressants, mood stabilisers and antipsychotics. Literature review: The observed food and drug interactions are mutual and might lead to a decrease of the therapeutic effect, an increase of the drug toxicity or changes in the nutritional status. Drug and food interactions can modify the pharmacokinetic (e.g. absorption, metabolism) and/or pharmacodynamic properties of drugs. The food intake alters the absorption of trazodone XR, sulpiride, ziprasidone, lurasidone and quetiapine XR. Coffee, tea and possibly turmeric influence CYP1A2 in a dose-dependent manner. Fruit juices (grapefruit, Seville orange, blueberry), curcumin and piperine inhibit CYP3A4. In human studies, significant interactions between food and sertraline, clomipramine, clozapine and carbamazepine were found. Food containing tyramine was shown to interact with MAO inhibitors altering their pharmacodynamic properties. Both malnutrition and obesity may have an impact on the pharmacokinetic properties of some mood stabilisers and antipsychotics. On other hand, the majority of antipsychotics, mood stabilisers and some antidepressants induce weight gain. Changes in taste perception can occur during pharmacotherapy with some antidepressants (tricyclics, selective serotonin reuptake inhibitors), antipsychotics (risperidone) and mood-stabilisers (lithium, valproate). Conclusions: Appropriate care and consideration must be taken when attempting to extrapolate results of in vitro or animal studies to humans. To evaluate the clinical significance of a specific food and drug interaction, it might be necessary to measure the concentration of the pharmaceutical compound and its metabolites in blood serum.