One of the many indignities that often come with being diagnosed with a mental disorder is the side effects that accompany the medications used to treat that disorder. Numerous factors can influence the effect of medications on a person, including age, sex, weight, dosage, and concurrent medical conditions, other medications, herbals, dietary supplements, and vitamins. Additionally, some medications are more effective when taken on a full stomach, while others are best consumed on an empty stomach. Alcohol has a notoriously negative interaction with medication, sometimes leading to overdose, dizziness, drowsiness, nausea, arrhythmia, liver damage, impaired breathing and memory, and even death. It almost goes without saying that alcohol ought not to be consumed with medication under any circumstances, though particularly when taking sedatives or antidepressants.
What’s less understood by the general public is the effect many seemingly harmless foods can have when interacting with medications used to treat a variety of mental disorders. Grapefruit in particular seems to possess a diva complex, refusing to interact peaceably with a multitudinous variety of medications used to treat everything from depression and anxiety to heart disease, HIV, cholesterol, blood pressure, insomnia, malaria, seizures, and allergies. It’s thought that furanocoumarin, a chemical found in grapefruit, inhibits an enzyme called CYP34A from efficiently metabolizing drugs, increasing the amount of medication absorbed by the body. According to the Harvard Medical School Family Health Guide, grapefruit juices decrease the ability of the CYP34A enzyme to metabolize foods by 47 percent in the first four hours after ingestion and to a lesser degree for up to 24 hours.
A short list of psychotropic drugs that have been shown to interact negatively with grapefruit and grapefruit juice in some patients includes:
- Buspirone (Buspar), used to treat anxiety
- Sertaline (Zoloft), used to treat depression
- Fluoxetine (Prozac), used to treat depression and anxiety
Chocolate is another food that can cause an adverse reaction when interacting with antidepressants. Chocolate contains caffeine, which can cause an unhealthy spike in blood pressure when consumed with antidepressants that raise blood pressure. These medications include:
- Venlafaxine (known by the brand name Effexor), used to treat general anxiety disorder, social anxiety disorder, panic disorder, and depression
- Desvenlafaxine (known by the brand name Pristiq), used to treat depression
Negative interactions have also been found to occur in rare cases when chocolate is consumed in tandem with:
- Methylphenidate (known by the brand name Ritalin), used to treat attention deficit hyperactivity disorder (ADHD)
- Zolpidem (known by the brand name Ambien), used to treat insomnia
- Lithium (used to treat mania in people with bipolar disorder)
- Eszopiclone (known by the brand name Lunesta), used to treat insomnia
It is best to consume chocolate in moderation or not at all when taking these medications if there is a noticeable rise in blood pressure.
The use of antidepressant monoamine oxidase inhibitors (MAOs) typically coincides with dietary restrictions. Foods containing tyramine or tyrosine can trigger a potentially fatal increase in blood pressure in people prescribed MAOs. These foods include aged cheeses, chocolate, avocados, bananas, pickled foods, yogurt, and sauerkraut, as well as foods containing wine, coffee, and soy sauce. In some cases, these foods may be consumed in moderation, though they may be restricted from a person’s diet altogether depending on the degree of his or her increase in blood pressure.