Miracon Science

Tricyclic antidepressants

Active substances and pharmaceuticals concerned

Name of active substance Trade name Affected micronutrients
Amitriptyline Saroten® Magnesium
Vitamin B2
Coenzyme Q10
Clomipramine Anafranil®
Melitracen Deanxit®

 

Mechanism of interaction

Mechanism of interaction
Magnesium The neuronal energy metabolism in the CNS is regulated by magnesium. It influences the serotonin availability of L-tryptophan and reduces the release of stress hormones. Magnesium is a natural NMDA receptor antagonist.
Vitamin B2 Inhibition of riboflavin kinase occurs due to structural similarities. Riboflavin cannot be converted into its active form flavin-adenine dinucleotide. Riboflavin excretion is increased.
Coenzyme Q10

Mitochondrial enzymes of the respiratory chain such as NADH-coenzyme Q10 oxidoreductase are negatively superimposed by tricyclic antidepressants. Coenzyme Q10 levels are decrease.

Consequences and possible symptoms of the interaction

Negative consequences of the interaction Possible symptoms
Vitamin B2 Decrease in vitamin B2 levels
  • Redness and flaking of the skin, seborrheic dermatitis, glossitis, corner of the mouth rhagades
  • Muscle weakness, fatigue, peripheral neuropathies
  • Keratitis, light sensitivity, vascularization of the cornea
  • Normochromic normocytic anemia, hyperhomocysteinemia
Coenzyme Q10 Decrease in coenzyme Q10 levels
  • Fatigue, weakness
  • Muscle weakness and pain
  • Disorders of cardiac bioenergetics, endothelial dysfunctions
  • Increased risk of Alzheimer's disease, tumors, Parkinson's disease
  • Increased laboratory parameters for nitrosative stress
Positive consequences of the interaction Possible symptoms
Magnesium Supporting effect
  • Effect of antidepressants is positively supported
  • Neuronal energy balance is positively influenced

Recommended Supplementation

Medical substance Recommended supplementation Dosage
Tricyclic antidepressants Magnesium 500 mg/d p.o.
Vitamin B2 10 mg/d p.o.
Coenzyme Q10 100 mg/d p.o.

Special instructions for use

Recommended supplementation
Vitamin B2 Riboflavin should be recommended in the form of a vitamin B complex.
Coenzyme Q10 A combination with riboflavin is recommended.

References

References
Gröber U. Mikronährstoffe. Metabolic Tuning – Prävention – Therapie. 3. Auflage, 2011
Gröber U. Arzneimittel und Mikronährstoffe. Medikationsorientierte Supplementierung.
3. Akt. und erw. Auflage, 2014
Moreno-Fernández AM et al. Oral treatment with amitriptyline induces coenzyme Q deficiency and oxidative stress in psychiatric patients. J Psychiatr Res. 2012 Mar;46(3):341-5. doi: 10.1016/j.jpsychires.2011.11.002. Epub 2011 Nov 26.
Pinto J et al. Inhibition of riboflavin metabolism in rat tissues by chlorpromazine, imipramine, and amitriptyline. J Clin Invest. 1981 May;67(5):1500-6.
Pochwat B et al. Antidepressant-like activity of magnesium in the chronic mild stress model in rats: alterations in the NMDA receptor subunits. Int J Neuropsychopharmacol. 2014 Mar; 17(3):393-405. doi: 10.1017/S1461145713001089. Epub 2013 Sep 26.
Stargrove Mitchell Bebel, Treasure Jonathan, McKee Dwight L.: Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies. 2008

 

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