Mental Health and Behavior

Most of the time, medicines  make our lives better. They reduce aches and pains, fight infections,  and control problems such as high blood pressure or diabetes. But  medicines can also cause unwanted reactions.

One problem is interactions, which may occur between

• Two drugs, such as aspirin and blood thinners
• Drugs and food, such as statins and grapefruit
• Drugs and supplements, such as ginkgo and blood thinners
• Drugs and diseases, such as aspirin and peptic ulcers

Interactions can change the actions of one or both drugs.   The drugs might not work, or you could get side effects.

Side effects are unwanted effects caused by the drugs.  Most are  mild, such as a stomach aches or drowsiness, and go away after you stop  taking the drug.  Others can be more serious.

Drug allergies are another type of reaction.  They can be mild or  life-threatening.  Skin reactions, such as hives and rashes, are the  most common type. Anaphylaxis, a serious allergic reaction, is more rare.

When you start a new prescription or over-the-counter medication, make sure you understand how to take it correctly.  Know which other medications and foods you need to avoid. Ask your health care provider or pharmacist if you have questions. 

MedlinePlus-Dietary Supplements

MedlinePlus-Antioxidants

MedlinePlus-Vitamins

• Among  all fruit juices, grape fruit juice (GFJ) possesses high interaction  with almost all types of drugs. The juice modifies the body’s way of  metabolizing the medication, affecting the liver’s ability to work the  drug through a person’s system. Taniguchi in 2007 reported a case of  purpura (blood spots, pooling of blood underneath the skin) associated  with the ingestion of cilostazol, aspirin and grapefruit juice in 79  years old man. His purpura disappeared upon cessation of grapefruit  juice, although his medication was not altered. The most probable cause  of his purpura is an increase in the blood level of cilostazol because  of the inhibition of cilostazol metabolism by components of grapefruit  juice; Taniguch.
• Numerous  reports have documented drug interactions with GFJ that occur via  inhibition of CYP3A enzymes. Furanocoumarins present in GFJ inhibit the  intestinal CYP 3A4 and have been shown to increase the oral  bioavailability of medications that are CYP 3A4 substrates like  Felodipine, midazolam, cyclosporine and raise their concentrations above  toxic levels.
• GFJ  is generally contraindicated to patients taking psychotropics and it is  advised to inform patients about described interaction. The in vitro  data suggest that compounds present in grapefruit juice are able to  inhibit the P-gp activity modifying the disposition of drugs that are  P-gp substrates such as talinolol. The overall exposure of some drugs  can be increased by more than fivefold when taken with GFJ and increase  the risk of adverse effects.
• With  new anticonvulsants, serum iron and sodium need to be monitored.  Additionally, users are advised to avoid drinking grape fruit juice  within 1-2 hr(s) of taking these anticonvulsants. Furanocoumarines and  active bioflavonoids present in GFJ are also inhibitors of OATP and when  ingested concomitantly, can reduce the oral bioavailability of the OATP  substrate, fexofenadine. Overall, a series of flavonoids present in GFJ  are identified as esterase inhibitors, of which kaempferol and  naringenin are shown to mediate pharmacokinetic drug interaction with  most of the calcium channel antagonist and the statin groups of drugs  such as enalapril and lovastatin due to their capability of esterase  inhibition.
• Cholesterol-lowering  agent lovastatin should be taken with food to enhance gastrointestinal  absorption and bioavailability. The absorption of rosuvastatin, another  anti-hyper lipidemic agent, was significantly decreased in the fed state  compared with the fasting state, which suggests that rosuvastatin  should be administered on an empty stomach.
• Simvastatin,  Ezetimibe, pravastatin and fluvastatin may be taken without regards to  food. However, high fiber diets may lower the efficacy of these drugs.  Concomitant administration of statins with food may alter statin  pharmacokinetics or pharmacodynamics, increasing the risk of adverse  reactions such as myopathy or rhabdomyolysis or reducing their  pharmacological action. Consumption of pectin or oat bran together with  Lovastatin reduces absorption of the drug, while alcohol intake does not  appear to affect the efficacy and safety of Fluvastatin treatment.

MedlinePlus-Antidepressants

• Antidepressant  activity of monoamine oxidase inhibitors (MAOIs) was initially noted in  the 1950s. Although older monoamine oxidase inhibitors (MAOIs) are  effective in the treatment of depressive disorders, they are  under-utilized in clinical practice due to main concerns about  interaction with tyramine-containing food (matured cheese, red vine,  ripped bananas, yogurt, shrimp paste and salami) or so called cheese  reaction, since they are capable of producing hypertensive crisis in  patients taking MAOIs.
• The  first-generation MAOIs such as phenelzine and isocarboxazid were  largely nonselective inhibitors of both subtypes of MAO, MAO (A) and MAO  (B). These medications carried with them dietary restrictions. Tyramine  is an indirectly acting sympathomimetic agent, is degraded by MAO but  in the presence of MAOIs, it escapes degradation and reaches the  systemic circulation where it is taken up by the adrenergic neuron,  leading to a hypertensive crisis. However, MAOIs have been well  established as an effective intervention for people with  treatment-resistant depression, and transdermal formulations may provide  a valuable therapeutic option and eliminate the drug-food interaction.

MedlinePlus-Pain Relievers

• Analgesics  and antipyretics are used to treat mild to moderate pain and fever. For  rapid relief, acetaminophen should be taken in an empty stomach because  food may slow the body absorption of acetaminophen. Co-administration  of acetaminophen with pectin delays its absorption and onset. NSAIDs  like ibuprofen, naproxen, ketoprofen and others can cause stomach  irritation and thus they should be taken with food or milk. Avoid or  limit the use of alcohol because chronic alcohol use can increase the  risk of liver damage or stomach bleeding. The absorption of ibuprofen  and oxycodone when given in the combination tablet was affected by the  concomitant ingestion of food.
• The  Cmax and AUC0-alpha of ibuprofen were significantly increased after  single and multiple doses of Coca-Cola, thereby indicating increased  extent of absorption of ibuprofen. The daily dosage and frequency of  ibuprofen must be reduced when administered with Coca-Cola. Food intake  did not appear to affect the extent of absorption (ie, total exposure)  of oral Diclofenac potassium soft gelatin capsule at doses.

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The  list below provides information gathered from press releases and  other  public notices about certain recalls of FDA-regulated products.  Not  all recalls have press releases or are posted on this page. Certain  product recalls sometimes merit expanded coverage due to the impact they  have on public health. This section includes details of FDA's  involvement in investigating recalls, a means to search recalled  products, and information for consumers and industry representatives.  

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The National Center for Complementary and Integrative Health  (NCCIH) part of the National Institutes of Health, is the Federal  Government’s lead agency for scientific research on the diverse medical  and health care systems, practices, and products that are not generally  considered part of conventional medicine. NCCIH was formerly known as  the National Center for Complementary and Alternative Medicine. 

• ADD see Attention Deficit Hyperactivity Disorder 
• ADHD see Attention Deficit Hyperactivity Disorder 
• Adolescent Development see Teen Development 
• Agoraphobia see Phobias 
• Alzheimer's Disease 
• Amnesia see Memory 
• Anorexia Nervosa see Eating Disorders 
• Antidepressants 
• Antisocial Personality Disorder see Personality Disorders 
• Anxiety 
• Asperger Syndrome see Autism Spectrum Disorder 
• Attention Deficit Hyperactivity Disorder 
• Autism see Autism Spectrum Disorder 
• Autism Spectrum Disorder 
• Baby Blues see Postpartum Depression 
• Bereavement 
• Bi-polar Disorder see Bipolar Disorder 
• Binge Eating see Eating Disorders 
• Bipolar Disorder 
• Borderline Personality Disorder see Personality Disorders 
• Bulimia see Eating Disorders 
• Cancer--Living with Cancer 
• Child Behavior Disorders 
• Child Mental Health 
• Chronic Illness, Coping see Coping with Chronic Illness 
• Compulsive Gambling 
• Conduct Disorder see Child Behavior Disorders 
• Coping with Chronic Illness 
• Coping with Disasters 
• Cutting see Self-Harm 
• Cyclothymic Disorder see Mood Disorders 

• Delirium 
• Dementia 
• Depression 
• Depression, Teen see Teen Depression 
• Developmental Disabilities 
• Dual Diagnosis 
• Dyscalculia see Learning Disabilities 
• Dyslexia see Learning Disabilities 
• Dysthymic Disorder see Depression 
• Eating Disorders 
• Emotional Health see Mental Health 
• Gambling see Compulsive Gambling 
• Generalized Anxiety Disorder see Anxiety 
• Grief see Bereavement 
• Hair Pulling see Self-Harm 
• Hoarding see Obsessive-Compulsive Disorder 
• How to Improve Mental Health 
• Hyperactivity see Attention Deficit Hyperactivity Disorder 
• Learning Disabilities 
• Living with Cancer see Cancer--Living with Cancer 
• Manic-Depressive Illness see Bipolar Disorder 
• MCI see Mild Cognitive Impairment 
• Memory 
• Mental Disorders 
• Mental Health 
• Mental Health, Child see Child Mental Health 
• Mental Health, Older Adults see Older Adult Mental Health 
• Mental Health, Teen see Teen Mental Health 
• Mental Retardation see Developmental Disabilities 
• Mild Cognitive Impairment 
• Mood Disorders 

• Narcissism see Personality Disorders 
• Obsessive-Compulsive Disorder 
• OCDsee Obsessive-Compulsive Disorder 
• Older Adult Mental Health
• Panic Disorder 
• Pathological  Gambling see Compulsive Gambling 
• Personality Disorders 
• Pervasive Developmental Disorder see Autism Spectrum Disorder 
• Phobias 
• Pica see Eating Disorders 
• Post-Traumatic Stress Disorder 
• Postpartum Depression 
• Prader-Willi Syndrome 
• Psychiatric Disorders see Mental Disorders 
• Psychological Stress see Stress 
• Psychotic Disorders 
• PTSD see Post-Traumatic Stress Disorder 
• Reading Problems see Learning Disabilities 
• SAD see Seasonal Affective Disorder 
• Schizophrenia 
• Seasonal Affective Disorder 
• Self-Harm 
• Senility see Dementia 
• Seniors' Mental Health see Older Adult Mental Health
• SNRI see Antidepressants 
• Social Anxiety Disorder see Phobias 
• Social Phobia see Phobias 
• Specific Learning Disorder see Learning Disabilities 
• SSRIs see Antidepressants 
• Stress 
• Suicide 
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• Teen Development 
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