Supplement, Food, Marijuana, and Herb Interactions with Medication
Some supplements and herbs can interfere or prevent the metabolism of drugs which can lead to overdose or other serious problems (like mania and serotonin syndrome) or the return of illness symptoms with limited ways to get the symptoms quickly under control. Often herbal plants are added to popular drinks and snacks without consumers being fully aware unless they read the fine print.
The combination of drugs and certain herbal plants can be severe and life threatening. The purpose of the information on this page is to provide awareness to help in making informed choices about the use of supplements and herbs in mental illness treatments.
The combination of drugs and certain herbal plants can be severe and life threatening. The purpose of the information on this page is to provide awareness to help in making informed choices about the use of supplements and herbs in mental illness treatments.
Daily Marijuana Use And Highly Potent Weed Linked To Psychosis
a new study published Tuesday in the The Lancet Psychiatry shows that consuming pot on a daily basis and especially using high-potency cannabis increases the odds of having a psychotic episode later.
Link to full article
a new study published Tuesday in the The Lancet Psychiatry shows that consuming pot on a daily basis and especially using high-potency cannabis increases the odds of having a psychotic episode later.
Link to full article
Grapefruit Interactions With Bipolar Drugs
A number of psychotropic drugs, including those used treat anxiety, depression, and psychosis, are among the 85 agents grapefruit juice is known to interfere with. This is because grapefruit contains furanocoumarins, an organic compound which blocks an enzyme that normally breaks down certain medications. Medications used to treat everything from high cholesterol and arrhythmia to allergies, HIV and even Viagra are complicated by the otherwise healthy effects of grapefruit. This effectively means that the drug concentration levels in the blood will be higher than expected. In some cases, this will mean that the intended effect and/or side effects will be stronger, even intolerable. At other times, it could be dangerous. Read more here www.verywellmind.com/why-shouldnt-i-drink-grapefruit-juice-with-my-meds-380358.
List of Psychotropic Medications Affected by Grapefruit
All told, there are 15 drugs commonly used to treat symptoms of bipolar disorder that are known to be affected, in differing degrees, by grapefruit:
A number of psychotropic drugs, including those used treat anxiety, depression, and psychosis, are among the 85 agents grapefruit juice is known to interfere with. This is because grapefruit contains furanocoumarins, an organic compound which blocks an enzyme that normally breaks down certain medications. Medications used to treat everything from high cholesterol and arrhythmia to allergies, HIV and even Viagra are complicated by the otherwise healthy effects of grapefruit. This effectively means that the drug concentration levels in the blood will be higher than expected. In some cases, this will mean that the intended effect and/or side effects will be stronger, even intolerable. At other times, it could be dangerous. Read more here www.verywellmind.com/why-shouldnt-i-drink-grapefruit-juice-with-my-meds-380358.
List of Psychotropic Medications Affected by Grapefruit
All told, there are 15 drugs commonly used to treat symptoms of bipolar disorder that are known to be affected, in differing degrees, by grapefruit:
- Anafranil (clomipramine)
- BuSpar (buspirone)
- Clozapine (clozaril)
- Elavil (amitriptyline)
- Halcion (triazolam)
- Haldol (haloperidol)
- Luvox (fluvoxamine)
- Prozac (fluoxetine)
- Seroquel (quetiapine)
- Serzone (nefazodone)
- Tegretol (carbamazepine)
- Trazodone (desyrel)
- Valium (diazepam)
- Versed (midazolam)
- Zoloft (sertraline)
CBD Oil & Drug Interactions: A Complete Guide
CBD and other compounds in hemp oil may interact with a wide range of drugs. If you are taking or plan on taking any medications and wish to begin using a CBD product of any kind, be sure to talk with your doctor first.
CBD is widely considered safe to use, well-tolerated (even in children and animals), and non-addictive (even anti-addictive). What is not widely discussed is the way that CBD oil is metabolized by the body can have a significant impact on the processing of other drugs.
https://intellicbd.com/articles/cbd-drug-interactions/
CBD and other compounds in hemp oil may interact with a wide range of drugs. If you are taking or plan on taking any medications and wish to begin using a CBD product of any kind, be sure to talk with your doctor first.
CBD is widely considered safe to use, well-tolerated (even in children and animals), and non-addictive (even anti-addictive). What is not widely discussed is the way that CBD oil is metabolized by the body can have a significant impact on the processing of other drugs.
https://intellicbd.com/articles/cbd-drug-interactions/
Herbs and Supplements to Use Only With Caution for Bipolar Disorder and Other Mental Illnesses
http://www.winchesterhospital.org/health-library/article?id=21404
http://www.winchesterhospital.org/health-library/article?id=21404
- Chromium Picolinate : Chromium treatment decreases the sensitivity of 5-HT2A receptors. (https://www.ncbi.nlm.nih.gov/pubmed/11823896.
- Ginseng (Panax Ginsing can cause mania. Avoid herbal stimulants (such as ma huang, ginseng, or kola) while taking an antipsychotic medicine.
- From https://www.naturalnews.com/DrugWatch_Seroquel.html
- The following sedating herbs may interact or increase side effects of Seroquel due to the known interaction between antipsychotics and sedatives: calamus, calendula, chamomile, California poppy, catnip, couch grass, elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap, shepherd's purse, stinging nettle, valerian, withania root, and yerba mansa.3
- American ginseng, Panax ginseng, and Siberian ginseng have antipsychotic properties and thus, may have an additive effect on the pharmacologic activity and adverse reactions of seroquel.4
- Glutamine
- Inositol (vitamin B8) induced mania - pushing up your dopamine and glutamate activity
- S-adenosylmethionine (SAMe)
- St. John's Wort
- Vanadium
- Herbs and Supplements to Use Only With Caution
Antidepressant drugs may cause manic episodes in people with bipolar disorder. For this reason, herbs and supplements with antidepressant properties might also be risky. Case reports suggest that SAMe , 16,17,18St. John's Wort , 7,8 and inositol15 can indeed trigger manic episodes.
The supplement L-glutamine , while not normally considered to have antidepressant properties, has reportedly triggered episodes of mania in two people not previously known to have bipolar disorder. 4
A ginseng product has also been associated with an episode of mania. 6
The supplement chromium is often sold in the form of chromium picolinate. Picolinate can alter levels of neurotransmitters. 5 This has led to concern among some experts that chromium picolinate might be harmful to people with bipolar disorder. 2
It has been suggested that the drug lithium works, in part, by reducing the body's level of vanadium . 1 For this reason, it might be advisable for people with bipolar disorder to avoid using supplements that contain vanadium.
Finally, numerous herbs and supplements may interact adversely with drugs used to prevent or treat bipolar disorder. For example, people who use lithium should avoid herbal diuretics.
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This introduction to the clinical science of cannabinoids will focus on helping learners to understand why cannabis effects the brain, the research into cannabinoids as a therapeutic compounds, the risks of unregulated cannabis use (with a focus on bipolar and psychotic disorders), and what we still need to learn about this complicated drug.
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Unwanted effects of psychotropic drug interactions with medicinal products and diet supplements containing plant extracts Feb 6, 2018
http://www.psychiatriapolska.pl/uploads/onlinefirst/ENGverWoron_PsychiatrPolOnlineFirstNr92.pdf
raw.pdf
Summary:
The most common effect of interactions between SSRI or SNRI antidepressants and HP were hemorrhagic complications associated with Japanese ginkgo biloba (27.45% of complications in this subgroup). Another common complication was serotonin syndrome (SS) (11.8%) occurring during the use of ginseng (one case of SS after the addition of bacopa). In the group of antipsychotic drugs, the highest number of interactions was observed in the case of haloperidol, and the highest number of complications (29.8%) was associated with ginseng (including 6 cases of ventricular arrhythmias in combination with haloperidol), milk thistle (including 7 cases of pancreatitis in combination with haloperidol or risperidone, 1 case of hepatotoxicity after adding aripiprazole) and rhodiola rosea. As for hypnotics and sedatives – interactions with ginseng were most frequently reported, mainly intensified sedative effects, cognitive disorders and disturbances in consciousness. In 132 cases, withdrawal of the plant preparation resulted in a decrease in the severity of the reported adverse reactions or a complete resolution of the described symptoms.
Conclusion
Herbal Plants (especially ginseng, rhodiola rosea, ginkgo biloba, milk thistle) are associated with a significant risk of pharmacokinetic and pharmacodynamic interactions with psychotropic drugs.
http://www.psychiatriapolska.pl/uploads/onlinefirst/ENGverWoron_PsychiatrPolOnlineFirstNr92.pdf
raw.pdf
Summary:
The most common effect of interactions between SSRI or SNRI antidepressants and HP were hemorrhagic complications associated with Japanese ginkgo biloba (27.45% of complications in this subgroup). Another common complication was serotonin syndrome (SS) (11.8%) occurring during the use of ginseng (one case of SS after the addition of bacopa). In the group of antipsychotic drugs, the highest number of interactions was observed in the case of haloperidol, and the highest number of complications (29.8%) was associated with ginseng (including 6 cases of ventricular arrhythmias in combination with haloperidol), milk thistle (including 7 cases of pancreatitis in combination with haloperidol or risperidone, 1 case of hepatotoxicity after adding aripiprazole) and rhodiola rosea. As for hypnotics and sedatives – interactions with ginseng were most frequently reported, mainly intensified sedative effects, cognitive disorders and disturbances in consciousness. In 132 cases, withdrawal of the plant preparation resulted in a decrease in the severity of the reported adverse reactions or a complete resolution of the described symptoms.
Conclusion
Herbal Plants (especially ginseng, rhodiola rosea, ginkgo biloba, milk thistle) are associated with a significant risk of pharmacokinetic and pharmacodynamic interactions with psychotropic drugs.
Supplements that affect the metabolism of drugs metabolized in the liver
The antipsychotic drug quetiapine is extensively metabolized by CYP3A4 by the liver. The major metabolic pathways are sulfoxidation to the sulfoxide metabolite and oxidation to the parent acid metabolite; both metabolites are pharmacologically inactive. In vitro studies using human liver microsomes revealed that the cytochrome P450 3A4 isoenzyme is involved in the metabolism of quetiapine to its major, but inactive, sulfoxide metabolite.
Use CAUTION with sedating herbs (e.g., lemon balm, kava kava, california poppy, catnip, St. John’s wort, skullcap, and valerian) which can increase the sedative actions of the drug.
Herbs that also use the 3A4 metabolic pathway may interact with this drug.
http://www.nutritional-solutions.net/images/phocadownload/Rx_DepleteInteractions.pdf
The antipsychotic drug quetiapine is extensively metabolized by CYP3A4 by the liver. The major metabolic pathways are sulfoxidation to the sulfoxide metabolite and oxidation to the parent acid metabolite; both metabolites are pharmacologically inactive. In vitro studies using human liver microsomes revealed that the cytochrome P450 3A4 isoenzyme is involved in the metabolism of quetiapine to its major, but inactive, sulfoxide metabolite.
Use CAUTION with sedating herbs (e.g., lemon balm, kava kava, california poppy, catnip, St. John’s wort, skullcap, and valerian) which can increase the sedative actions of the drug.
Herbs that also use the 3A4 metabolic pathway may interact with this drug.
http://www.nutritional-solutions.net/images/phocadownload/Rx_DepleteInteractions.pdf
Additional articles
Herbal Medication Interactions
https://www.pharmaceutical-journal.com/files/rps-pjonline/pdf/pj20100508_cpd.pdf
The Interactions of Herbs and Drugs
www.itmonline.org/arts/herbdrug.htm
Herb Drug Interactions
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673699064570.pdf
Concurrent use of herbs may mimic, magnify, or oppose the effect of drugs. Plausible cases of herb-drug interactions include: bleeding when warfarin is combined with ginkgo (Ginkgo biloba), garlic (Allium sativum), dong qual (Angelica sinensis), or danshen (Salvia miltiorrhiza); mild serotonin syndrome in patients who mix St John's wort (Hypericum perforatum) with serotonin-reuptake inhibitors; decreased bioavailability of digoxin, theophylline, cyclosporin, and phenprocoumon when these drugs are combined with St John's wort; induction of mania in depressed patients who mix antidepressants and Panax ginseng; exacerbation of extrapyramidal effects with neuroleptic drugs and betel nut (Areca catechu); increased risk of hypertension when tricyclic antidepressants are combined with yohimbine (Pausinystalla yohimbe); potentiation of oral and topical corticosteroids by liquorice (Glycyrrhiza glabra); decreased blood concentrations of prednisolone when taken with the Chinese herbal product xaio chai hu tang (sho-saiko-to); and decreased concentrations of phenytoin when combined with the Ayurvedic syrup shankhapushpi. Anthranoid-containing plants (including senna [Cassia senna] and cascara [Rhamnus purshiana]) and soluble fibres (including guar gum and psyllium) can decrease the absorption of drugs. Many reports of herb-drug interactions are sketchy and lack laboratory analysis of suspect preparations. Health-care practitioners should caution patients against mixing herbs and pharmaceutical drugs.
18 Herbal Supplements with Risky Drug Interactions
Herbal drug interactions that may occur when these supplements are combined with prescription medications.
Herbal interactions with prescription medications can interfere with how the drug may be broken down in the body, enhance side effects of prescription medications, or block the intended therapeutic effect of a drug.
Herb-Drug Interactions
The possibility of drug interactions, direct toxicities, and contamination with active pharmaceutical agents are among the safety concerns about dietary and herbal supplements. Although there is a widespread public perception that herbs and botanical products in dietary supplements are safe, research has demonstrated that these products carry the same dangers as other pharmacologically active compounds. Interactions may occur between prescription drugs, over-the-counter drugs, dietary supplements, and even small molecules in food—making it a daunting challenge to identify all interactions that are of clinical concern.
https://www.stonybrookmedicine.edu/sites/default/files/herbal_medicines_interactions-1.pdf
Stockley’s Herbal Medicines Interactions
A guide to the interactions of herbal medicines, dietary supplements and nutraceuticals with conventional medicines
stockleys_herbal_medicines_interactions-1.pdf
Some Herbal Supplements May Interact Badly with Prescription Meds, Study Finds
Patients taking antidepressants — as well as those taking herbal supplements to manage symptoms of depression — should be aware of potentially dangerous interactions between herbs and drugs, the authors of a new study conclude.
Critical evaluation of causality assessment of herb–drug interactions in patients - Awortwe - 2018 - British Journal of Clinical Pharmacology - Wiley Online Library
The risk of herb–drug interaction (HDI) is increasingly recognized as a public health problem often accompanied by life-threatening adverse drug events, prolonged hospitalization and loss of life [1]. With a rise in global burden of noncommunicable diseases [2–5], pain syndromes, anxiety, depression and aging [6, 7], co-usage of prescribe d medications and herbal products will persistent y be a potential health problem in both developed and developing nations. For instance, cases of acute rejection episodes have been reported in heart, renal or liver transplant patients stabilized on immunosuppressives including cyclosporine and tacrolimus due to concomitant intake of St John’swort
(SJW) known to induce drug metabolizing enzymes [8, 9]. In two case reports, patients with a history of generalized anxiety disorder and mild traumatic brain injury experienced serotonin syndrome and hypomania after addition of SJW or Ginkgo biloba to either a buspirone or fluoxetine regimen [10, 11]. Patients ’ deliberate refusal to disclose their use of herbal medicines to clinicians have led to under eporting of clinically relevant HDI cases. In addition, underestimation of the consequences of HDI due to lack of a standardized probability scoring system has contributed to wrong classification of the causality of adverse drug reactions (ADRs). Different experimental models have been u sed to understand the mechanism of such interactions.
Herbal Medication Interactions
https://www.pharmaceutical-journal.com/files/rps-pjonline/pdf/pj20100508_cpd.pdf
The Interactions of Herbs and Drugs
www.itmonline.org/arts/herbdrug.htm
Herb Drug Interactions
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673699064570.pdf
Concurrent use of herbs may mimic, magnify, or oppose the effect of drugs. Plausible cases of herb-drug interactions include: bleeding when warfarin is combined with ginkgo (Ginkgo biloba), garlic (Allium sativum), dong qual (Angelica sinensis), or danshen (Salvia miltiorrhiza); mild serotonin syndrome in patients who mix St John's wort (Hypericum perforatum) with serotonin-reuptake inhibitors; decreased bioavailability of digoxin, theophylline, cyclosporin, and phenprocoumon when these drugs are combined with St John's wort; induction of mania in depressed patients who mix antidepressants and Panax ginseng; exacerbation of extrapyramidal effects with neuroleptic drugs and betel nut (Areca catechu); increased risk of hypertension when tricyclic antidepressants are combined with yohimbine (Pausinystalla yohimbe); potentiation of oral and topical corticosteroids by liquorice (Glycyrrhiza glabra); decreased blood concentrations of prednisolone when taken with the Chinese herbal product xaio chai hu tang (sho-saiko-to); and decreased concentrations of phenytoin when combined with the Ayurvedic syrup shankhapushpi. Anthranoid-containing plants (including senna [Cassia senna] and cascara [Rhamnus purshiana]) and soluble fibres (including guar gum and psyllium) can decrease the absorption of drugs. Many reports of herb-drug interactions are sketchy and lack laboratory analysis of suspect preparations. Health-care practitioners should caution patients against mixing herbs and pharmaceutical drugs.
18 Herbal Supplements with Risky Drug Interactions
Herbal drug interactions that may occur when these supplements are combined with prescription medications.
Herbal interactions with prescription medications can interfere with how the drug may be broken down in the body, enhance side effects of prescription medications, or block the intended therapeutic effect of a drug.
Herb-Drug Interactions
The possibility of drug interactions, direct toxicities, and contamination with active pharmaceutical agents are among the safety concerns about dietary and herbal supplements. Although there is a widespread public perception that herbs and botanical products in dietary supplements are safe, research has demonstrated that these products carry the same dangers as other pharmacologically active compounds. Interactions may occur between prescription drugs, over-the-counter drugs, dietary supplements, and even small molecules in food—making it a daunting challenge to identify all interactions that are of clinical concern.
https://www.stonybrookmedicine.edu/sites/default/files/herbal_medicines_interactions-1.pdf
Stockley’s Herbal Medicines Interactions
A guide to the interactions of herbal medicines, dietary supplements and nutraceuticals with conventional medicines
stockleys_herbal_medicines_interactions-1.pdf
Some Herbal Supplements May Interact Badly with Prescription Meds, Study Finds
Patients taking antidepressants — as well as those taking herbal supplements to manage symptoms of depression — should be aware of potentially dangerous interactions between herbs and drugs, the authors of a new study conclude.
Critical evaluation of causality assessment of herb–drug interactions in patients - Awortwe - 2018 - British Journal of Clinical Pharmacology - Wiley Online Library
The risk of herb–drug interaction (HDI) is increasingly recognized as a public health problem often accompanied by life-threatening adverse drug events, prolonged hospitalization and loss of life [1]. With a rise in global burden of noncommunicable diseases [2–5], pain syndromes, anxiety, depression and aging [6, 7], co-usage of prescribe d medications and herbal products will persistent y be a potential health problem in both developed and developing nations. For instance, cases of acute rejection episodes have been reported in heart, renal or liver transplant patients stabilized on immunosuppressives including cyclosporine and tacrolimus due to concomitant intake of St John’swort
(SJW) known to induce drug metabolizing enzymes [8, 9]. In two case reports, patients with a history of generalized anxiety disorder and mild traumatic brain injury experienced serotonin syndrome and hypomania after addition of SJW or Ginkgo biloba to either a buspirone or fluoxetine regimen [10, 11]. Patients ’ deliberate refusal to disclose their use of herbal medicines to clinicians have led to under eporting of clinically relevant HDI cases. In addition, underestimation of the consequences of HDI due to lack of a standardized probability scoring system has contributed to wrong classification of the causality of adverse drug reactions (ADRs). Different experimental models have been u sed to understand the mechanism of such interactions.