What Vitamins Can You Not Take With Antidepressants?

There are a variety of essential vitamins and minerals you should consume on a daily basis. If you're taking antidepressants and vitamins at the same time, be aware of the ingredients in your vitamin supplements.

Certain ingredients can influence the effectiveness of your antidepressants and how they affect your health.

Antidepressants come in various forms. According to the FDA, there are seven different types of medications commonly used to treat depression. These are:

• Serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants
• Atypical antidepressants
• Monoamine oxidase inhibitors (MAOIs)
• Norepinephrine and dopamine reuptake inhibitors (NDRIs)
• Noncompetitive N-methyl-D-aspartate receptor antagonists
  

In addition to these commonly prescribed antidepressants, there are other central nervous system drugs with antidepressant effects, like antipsychotics, as well as herbs and supplements that have natural antidepressant properties.

According to a December 2012 study in the ‌Journal of Medicine and Life‌, SSRIs are primarily the recommended treatment for depression. Commonly prescribed SSRIs include sertraline (brand name Zoloft), paroxetine (Paxil), fluoxetine (Prozac) and citalopram (Celexa). According to the Mayo Clinic, all of these SSRIs work by blocking the reuptake of serotonin in the brain, which essentially makes serotonin more available.

However, SSRIs don't work for everyone, and other antidepressants work via different pathways in your body. The exact type of antidepressant you're taking will determine which foods, vitamins and supplements you should or should not ingest. If you consume something that isn't recommended, you could end up reducing the effectiveness of your medication or increasing the likelihood of side effects.

There are a variety of vitamins and minerals that are essential for good health. When people can't obtain all of the nutrients recommended, they typically look into taking supplements, per the National Institutes of Health. Sometimes, these supplements are stand-alone products or multivitamins; in other cases, they are mixed in with healthy food products, like spirulina, chlorella or herbal products.

The average vitamin or mineral should not affect your antidepressant's functionality or your health. In fact, according to the book ‌Depression in Adults With a Chronic Physical Health Problem: Treatment and Management‌, published in 2010 by the British Psychological Society, there are no specific vitamins contraindicated for consumption with antidepressants.

However, certain vitamins, supplements and medications are processed via the same enzymatic pathway (cytochrome P450) as your antidepressants. When multiple foods or supplements are processed by your body via the same exact route, they may compete with one another. In large amounts, any of these could potentially affect the way your body processes antidepressants.

According to Johns Hopkins Medicine, other medications, supplements and your diet all have the potential to affect the way your body processes your antidepressants. It's much more likely for certain foods, like grapefruit juice or herbal supplements, to affect antidepressant function.

It's best to talk to your doctor before you start taking antidepressants and vitamins, especially mixed supplements. Certain supplements may contain ingredients that are dangerous when mixed with specific medications, even if they are safe on their own.

Herbal supplements, like St. John's wort or garcinia cambogia, are much more likely to affect the functionality of your antidepressants compared to vitamins or mineral tablets. You may think that these supplements are safe because they also have antidepressant effects, but it's not that simple.

Some herbal supplements with antidepressant properties are safe to consume alongside medications. For example, ashwagandha (botanical name, ‌Withania somnifera)‌ is an herbal supplement found in anything from green smoothie mixes to root powder. According to an August 2016 study in the ‌Complementary Therapies in Medicine Journal‌, taking ashwagandha with antidepressants like SSRIs can be a safe, effective and healthy way of supporting your mental health.

However, if you were to combine St. John's wort with antidepressants like SSRIs, you could end up with disastrous results. St. John's wort can cause a buildup of serotonin in the body when taken with antidepressants. This can result in serotonin syndrome, which causes side effects like anxiety, sweating, confusion, tremors, lack of coordination and an accelerated heart rate. Serotonin syndrome can even result in death.

Ultimately, the supplements and foods you can safely ingest depend entirely on the antidepressant. While supplement and drug-induced serotonin syndrome poses a major risk for people taking SSRIs, other antidepressants can require stricter dietary changes.

Unlike people taking SSRIs who can consume most foods without issue, people taking MAOIs need to avoid foods rich in tyramine, a nonessential amino acid. You can mix other nonessential amino acids and antidepressants without any issues.

However, tyramine-rich foods like cheeses, beer and other fermented products are dangerous for people taking MAOIs. Mixing tyramine and MAOI antidepressants can result in headache, nausea, anxiety, dangerously high blood pressure and even hemorrhagic stroke.

A variety of of vitamins and nutritional supplements have been shown to help treat depression. According to an April 2016 review in the ‌Journal of Psychiatry‌, several nutrients are involved in healthy brain activity. Essential vitamins, minerals and amino acids that are involved in neurobiological function include:

• Polyunsaturated fatty acids, like eicosapentaenoic acid, an omega-3 fat
• Vitamin C
• Vitamin D
• Zinc
• Folic acid
• Tryptophan

However, several of these have had mixed results in helping support depression treatment. The ‌Journal of Psychiatry‌ study reported that omega-3 fats and vitamin D are the two essential nutrients that are most likely to help reduce depression symptoms.

Other essential vitamins and minerals may also be helpful in treating depression. A November 2013 study in the ‌Open Neurology Journal‌ found that vitamin B12 could also help reduce symptoms of depression, while a March 2015 study in the ‌Australian Journal of Herbal Medicine‌ found that several B-complex vitamins could help reduce depressive symptoms.

Be aware that antidepressants and vitamins typically work with each other — the vitamins won't replace your medication. If you're interested in taking a nutritional supplement to support your treatment for depression, talk to your doctor so you can find the one that works best for you and doesn't affect your antidepressants.