PSYCHOFARMACA AND FOOD
- Use of Lithium for Biploar Disorders and Depression
- Use of Nonselective MAO Inhibitors for Depression
Use of Lithium for Biploar Disorders and Depression
Best time to refer to the dietician:
- Diagnosis of bipolar disorder and/or depression combined with starting pharmacological treatment with lithium.
Relevant information for the dietician:
- Diagnosis: bipolar disorder or depression according to DSM-IV criteria, any comorbid conditions
- Symptoms: hypertension
- Medication: antihypertensives, diuretics, antidepressants, thyreomimetics, thyreostatics
- Other: height, (changes in) weight, blood pressure
Aims of the diet:
- prevent lithium intoxication and obesity
Characteristics of the diet:
- Preserve the amount of sodium in the diet from the moment of going on medication
- Ensure extra sodium and fluids in the event of warm weather, fever, diarrhea, overexertion and calorie restrictions
- if weight is too high, see “Overweight”
Treatment time:
- Care level 1*, see “Dietician’s working methods.”
Specific remarks:
- With prophylactic use, blood plasma concentrations of lithium are between 0.6-0.8 mmol/L mmol/L. In the elderly, concentrations range between 0.4-0.6 mmol/L.
- Lithium may cause thirst and dry mouth
- Lithium can affect thyroid function and kidney function.
References:
Afdeling Diëtetiek Parnassia Bavo Groep. Brochure Voedingsadvies bij gebruik van lithium. Den Haag: 2009
Melissen-Leeuwen JA, Pruissen-Boskaljon JC. Voeding bij lithiumgebruik: Dieetbehandelingsrichtlijn Elsevier gezondheidszorg; Maarssen: 2008
Melissen-Leeuwen JA, Pruissen-Boskaljon JC. Voedingsadviezen bij lithiummedicatie. Informatorium voor Voeding en Diëtetiek. Houten: Bohn Stafleu van Loghum: 2006
Use of Lithium for Bipolar Disorder and Depression was updated by Anke Pruissen-Boskaljon and Janny Melissen-Leeuwen, dieticians at Parnassia Bavo Groep Den Haag, also on behalf of Diëtisten Psychiatrie Nederland (DPN).
Use of Nonselective MAO Inhibitors for Depression
Best time to refer to the dietician:
- Diagnosis of depression, combined with starting pharmacological treatment with nonselective MAO inhibitor.
Relevant information for the dietician:
- Diagnosis: depression, according to the DSM-IV criteria, any comorbid conditions
- Symptoms: hypertension
- Medication: SSRIs, Levodopa, sympathicomimetic agents, pain relievers, antihypertensives, cough medicines and medication for throat pain, ENT drugs for nasal conditions
- Other: blood pressure, home situation, treatment stage (is patient able to comply with a diet well? Problems functioning, limitations in carrying out activities, participation problems, hindering or supportive personal and external factors).
Aims of the diet:
- prevent hypertensive crisis.
Characteristics of the diet:
- tyramine restricted diet
Treatment time:
- Care level 1*, see “Dietician’s working methods.”
Specific remarks:
- Nonselective MAO inhibitors are prescribed by psychiatrists. Nonselective MAO inhibitors are not registered, and if prescribed they must be accompanied by a medical practitioner’s declaration.
References:
Afdeling Diëtetiek Parnassia Bavo Groep. Voedingsadviezen bij het gebruik van een niet selectieve MAO-remmer. Afdeling Diëtetiek Parnassia Bavo Groep. Den Haag: 2009
Birkenhäger TK, Bruijn JA et al. MAO-remmers als antidepressiva. Een literatuuroverzicht betreffende indicatiegebied en werkingsmechanisme. Tijdschrift voor Psychiatrie 33(1991)7
Melissen-Leeuwen JA, Petri L, Pruissen-Boskaljon JC. Dieetbehandelingsrichtlijn bij gebruik van een niet-selectieve MAO-remmer. Elsevier gezondheidszorg. Maarssen 2010
Melissen-Leeuwen JA, Pruissen-Boskaljon JC. Voedingsadviezen bij gebruik van een MAO-remmer. Informatorium voor Voeding en Diëtetiek. Houten: Bohn Stafleu Van Loghum (reprint in progress, expected in August 2010)
Use of Nonselective MAO Inhibitors for Depression was updated by Anke Pruissen-Boskaljon and Janny Melissen-Leeuwen, dieticians at Parnassia Bavo Groep Den Haag, also on behalf of Diëtisten Psychiatrie Nederland (DPN).