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Note: The resources listed in this guide are not intended to be fully systematic or complete, nor does inclusion here imply any endorsement or recommendation by The University of Maryland or the Center for Integrative Medicine. The University of Maryland and the Center for Integrative Medicine make no warranties, express or implied, about the value or utility for any purpose of the information and resources contained herein.

Antidepressant medications - tricyclic antidepressants (TCAs)

Selected Medications:

Amitriptyline
- Elavil
- Vanatrip
Amoxapine
- Asendin
Clomipramine
- Anafranil
Desipramine
- Norpramin
Doxepin
- Sinequan Oral
- Zonalon Topical Cream
Imipramine
- Tofranil-PM
- Tofranil
Nortriptyline
- Aventyl
- Pamelor
Protriptyline
- Vivactil
Trimipramine
- Surmontil

Depletions:

Coenzyme Q10

A deficiency of the antioxidant coenzyme Q10 may be associated with long term conditions including heart disease and high blood pressure. Symptoms of deficiency include muscle weakness and pain, gingivitis, and weakened immune function.

Vitamin B2 (Riboflavin)

Symptoms of vitamin B2 deficiency may include cracks at the corners of the mouth, inflammation of the skin, growth retardation, and impaired wound healing.

Editorial Note:

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

Reviewed last on: 4/19/2010
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

Supporting Research

Bonakdar RA, Guarneri E. Coenzyme Q10. Am Fam Physician. 2005;72(6):1065-70.

Chan A, Reichmann H, Kogel A, et al. Metabolic changes in patients with mitochondrial myopathies and effects of coenzyme Q10 therapy. J Neurol. 1998;245(10):681-685.

Folkers K, Morita M, McRee J Jr. The activities of coenzyme Q10 and vitamin B6 for immune responses. Biochem Biophys Res Commun. 1993; 28(19391):88-92.

Kamikawa T, Kobayashi A, Yamashita T, et al. Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol. 1985;56(4):247-251.

Kishi T, Makino K, Okamoto T, et al. Inhibition of myocardial respiration by psychotherapeutic drugs and prevention by coenzyme Q. Biomedical and Clinical Aspects of Coenzyme Q. Vol 2. Yamamura Y, et al, eds. Elsevier/North-Holland Biomedical Press: Amsterdam; 1980.

Littarru GP, Tiano L. Bioenergetic and antioxidant properties of coenzyme Q10: recent developments. Mol Biotechnol. 2007;37(1):31-7.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:480-481.

Pepe S, Marasco SF, Haas SJ, Sheeran FL, Krum H, Rosenfeldt FL. Coenzyme Q10 in cardiovascular disease. Mitochondrion. 2007;7 Suppl:S154-67.

Pinto J, Huang YP, Pelliccione N, et al. Cardiac sensitivity to the inhibitory effects of chlorpromazine, imipramine and amitriptyline upon formation of flavins. Biochem Pharmacol. 1982;31(21):3495.

Powers HJ. Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine. Proc Nutr Soc. 1999;58(2):435-440.

Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. 2003;77(6):1352-60.

Quinzii CM, Hirano M, DiMauro S. CoQ10 deficiency diseases in adults. Mitochondrion. 2007;7 Suppl:S122-6.

Tinguely D, Jonzier M, Schopf J, et al. Determination of compliance with riboflavin in an antidepressive therapy. Arzneimittelforschung. 1985;35(2):536-538.

Thompson J. Vitamins, minerals and supplements: part two. Community Pract. 2005;78(10):366-8.

Young AJ, Johnson S, Steffens DC, Doraiswamy PM. Coenzyme Q10: a review of its promise as a neuroprotectant. CNS Spectr. 2007;12(1):62-8.

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