A little red meat may help your depression

If you have depression, you are not depressed because there is a deficiency of antidepressants in your body...

...however...

...you may be depressed because you have some basic nutritional deficiencies. One mineral that is involved in numerous brain and nervous system functions, and that has been extensively studied with regards to its role in the development of depression, is zinc.

Various doses of zinc were recently shown to improve immobility time in rats. Immobility in a stressful situation is a common behavior in depression. (When you are not depressed, you have better decision making and response times when it comes to managing stressful situations.)

That's exactly what fluoxetine (Prozac), paroxetine (Paxil), imipramine (Tofranil), desipramine (Norpramin), and bupropion (Wellbutrin) do!

When zinc and antidepressants were administered together, immobility time was reduced by more than either therapy produced on its own.

Practically what that says is that:
(1) if you are at risk for, or have had a history of depression, emphasizing high-zinc dietary choices and/or zinc supplementation would be a smart strategy, and
(2) if you are on an antidepressant, supplementing with zinc would be important to be sure that you get enough medication to do the job without getting so much that you set yourself up for detrimental side effects.

In fact, it seems to me that it should be an automatic recommendation of any physician, when prescribing an antidepressant, to write "zinc supplement" in the script as well...

FYI, your best sources of zinc include: red meats, liver, and oyster. And, when the originating soil is in good condtion...wheat, sweet corn, lettuce, beans, nuts, almonds, whole grains, pumpkin seeds, sunflower seeds and blackcurrant. That's a lot of different options, something for practically everyone, meat eater or not!

Cunha MP, Machado DG, Bettio LE, Capra JC, Rodrigues AL. Interaction of zinc with antidepressants in the tail suspension test. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Dec 12;32(8):1913-20. Epub 2008 Sep 11.

Being a banana brain just might be a good thing

Pyridoxine, a form of vitamin B6, is important for brain and nervous system function. It is needed for the chemical reactions that produce several neurotransmitters, including serotonin, dopamine, and norepinephrine. A recent study found that a therapeutic dose of pyridoxine administered to mice decreased their depressive-type behaviors. The response was similar to what was seen when these mice were given imipramine (Tofranil). When the two compounds were administered together, pyridoxine did NOT increase the effectiveness of imipramine.

Bottom line? Before meds, be sure your diet is balanced in the nutrients your brain needs to properly function.

The table below is from the National Institutes of Health, and it lists your best food sources of pyridoxine.

Table of Food Sources of Vitamin B6
Food Milligrams (mg) per serving % DV*
Ready-to-eat cereal, 100% fortified, ¾ c 2.00 100
Potato, Baked, flesh and skin, 1 medium 0.70 35
Banana, raw, 1 medium 0.68 34
Garbanzo beans, canned, ½ c 0.57 30
Chicken breast, meat only, cooked, ½ breast 0.52 25
Ready-to-eat cereal, 25% fortified, ¾ c 0.50 25
Oatmeal, instant, fortified, 1 packet 0.42 20
Pork loin, lean only, cooked, 3 oz 0.42 20
Roast beef, eye of round, cooked, 3 oz 0.32 15
Trout, rainbow, cooked, 3 oz 0.29 15
Sunflower seeds, kernels, dry roasted, 1 oz 0.23 10
Spinach, frozen, cooked, ½ c 0.14 8
Tomato juice, canned, 6 oz 0.20 10
Avocado, raw, sliced, ½ cup 0.20 10
Salmon, Sockeye, cooked, 3 oz 0.19 10
Tuna, canned in water, drained solids, 3 oz 0.18 10
Wheat bran, crude or unprocessed, ¼ c 0.18 10
Peanut butter, smooth, 2 Tbs. 0.15 8
Walnuts, English/Persian, 1 oz 0.15 8
Soybeans, green, boiled, drained, ½ c 0.05 2
Lima beans, frozen, cooked, drained, ½ c 0.10 6

* DV = Daily Value. DVs are reference numbers based on the Recommended Dietary Allowance (RDA). They were developed to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for vitamin B6 is 2.0 milligrams (mg). The percent DV (%DV) listed on the nutrition facts panel of food labels tells you what percentage of the DV is provided in one serving. Percent DVs are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs. Foods that provide lower percentages of the DV also contribute to a healthful diet.

Amara RO, Aburawi SM. Pyridoxine effect on the antidepressant action of imipramine in albino mice. Saudi Med J. 2008 Nov;29(11):1554-7.

Caffeine and antidepressant medications

Over the short term (one day on meds), imipramine (Tofranil)and amitriptyline (Elavil) decreased, while fluoxetine (Prozac) accelerated the overall metabolism of caffeine. Nefazodone(Serzone) also stimulated metabolism, but through a more indirect pathway. To say it another way, the body more rapidly broke down and inactivated caffeine under the influence of these medications.

Fluoxetine given chronically increased an indirect pathway of caffeine metabolism. Sertraline (Zoloft) and mirtazapine (Remeron) enhanced the rates of all caffeine oxidation pathways.

I must qualify this study was done on rats, not humans, and I can't remember the last time I saw a rat in line chumming it up with the barista. Even so, it's not unreasonable to assume the same effects could be seen in humans.

So...if you're feeling like your Prozac may have reduced the effect of your double caf skinny no foam morning treat into a half caf regular cup of joe...it may not be your imagination!

Don't let that drug influence tempt you into buying a frequent flyer card at your local coffee haunt, though. Excess caffeine is associated with insulin resistance which can aggravate weight gain. Better to focus on better sleep habits (and less late night web sudoku)than on better productivity through chemical stimulation.

Kot M, Wójcikowski J, Daniel WA. Caffeine metabolism during prolonged treatment of rats with antidepressant drugs. Pharmacol Rep. 2007 Nov-Dec;59(6):727-33.

Antidepressants and risk of bone fracture

Are broken bones the price paid for a better attitude? Some researchers may think so. In a rather large study (124,655 fracture cases and 373,962 age and gender matched controls), relationships between fractures were seen with the following psychiatric medications:

Amitriptyline (Elavil), clomipramine (Anafranil), citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft) were all associated with an increased risk of fractures. Imipramine (Tofranil) and nortriptyline (Pamelor) did not demonstrate this association. Paroxetine (Paxil) showed a slight relationship but statistically it was insignificant.

No medication is perfect, ever. However, antidepressants are used for a wide variety of medical problems, and as you know if you read my blog, many of these uses are off-label. For anyone with a family history of osteoporosis, or in a demographic group at risk for osteoporosis, it is important to (1) weight the risks vs. benefits of your prescribed medication before taking it, and(2) consider consulting with a dietitian to enhance your diet and lifestyle choices to minimize the risk of bone-debilitating side effects.

Many of the lifestyle choices you are likely to be advised to adopt to prevent osteoporosis (more exercise, less soda, wider variety of foods) also enhance brain health. And what do you know--that may reduce your depressive symptoms as well.

(If you're getting tired of hearing that exercise, healthy food, adequate sleep, and less stress might be your answer...maybe that means you should try them...tee hee!!)

Vestergaard P, Rejnmark L, Mosekilde L. Selective Serotonin Reuptake Inhibitors and Other Antidepressants and Risk of Fracture. Calcif Tissue Int. 2008 Jan 25 [Epub ahead of print]

Antidepressants and weight gain

If you're coming directly to this blog instead of linking through my website, you may be interested in a chart I have posted on that website, listing references referring to antidepressants and their potential for causing weight change (gain or loss). This particular chart ONLY covers antidepressants, but it is a very popular page and I wanted to let you all know about it.

The medications included to date are: Celexa/citalopram, Cymbalta/duloxetine, Effexor/venlafaxine, Elavil/amitryptyline, Ludiomil/maprotiline, Nardil/phenelzine, Norpramin/desipramine, Parnate/tranylcypromine, Paxil/paroxetine, Prozac/fluoxetine, Remeron/mirtazapine, Doxepin/sinequan, Tofranil/imipramine, Wellbutrin/bupropion, and Zoloft/sertraline.

The link to this chart is http://afterthediet.com/antidepressant_medications.htm