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Table of Contents > Depletions > Antidepressant Medications, TCAs

Antidepressant Medications

Tricyclic Antidepressants (TCAs)

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 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 healthcare provider; he or she can best assess and address your individual healthcare needs, and determine if you are at risk for nutrient depletions from these medications as well as others not listed here.

Supporting Research

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.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

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.

Munkholm H, Hansen HH, Rasmussen K. Coenzyme Q10 treatment in serious heart failure. Biofactors. 1999;9(2-4):285-289.

Nakamura R, Littarru GP, Folkers R, et al. Study of CoQ10-enzymes in gingiva from patients with periodontal disease and evidence for a deficiency of coenzyme Q10. Proc Natl Acad SciUSA. 1974;71(4):1456-1460.

Pinto J, et al. Inhibition of riboflavin metabolism in rat tissues by chlorpromazine, imipramine, and amitriptyline. J Clin Invest. 1981;67(5):1500.

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.

Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressure and insulin resistance in hypertensive patients with coronary heart disease. J Hum Hypertens. 1999;13(3):203-208.

Singh RB, Wander GS, Rastogi A, et al. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther. 1998;12(4):347-353.

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

Review Date: October 2000

Reviewed By: All depletions monographs have been reviewed by a team of experts including Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth Amboy, NJ; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc., Boston, MA; John Hinze, PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and Director of Medical Education, Preventive Medicine Research Institute, Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy, Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Leonard Wisneski, MD, FACP, George Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.