Supercharge your medications with healthy habits

We know that we need to eat right, exercise regularly and get enough sleep to stay well. A healthy lifestyle can also improve the symptoms of many physical and mental disorders, such as depression or anxiety. But did you know that healthy habits can also make psychiatric medications work more effectively?

"Your brain requires that you make new chemicals, called neurotransmitters, each day, which must be made of protein (essential amino acids) in your diet," says Martie Fankhauser, M.S. Pharm., at the University of Arizona College of Pharmacy. "Many psychiatric medications, such as antidepressants and antianxiety agents, cannot work unless you eat foods that contain essential amino acids and have good glucose control."

Here are some guidelines from Fankhauser and other experts for eating for health and supercharging your meds.

Brain food
We need to eat protein plus complex carbohydrates (fruits, vegetables, nuts, and whole grains), and monounsaturated fats (good fats and essential fatty acids) every day for our brains, and also to make new hormones and repair/replace cells, muscles, and nerves. A multivitamin and mineral supplement, plus supplemental calcium (about 1 - 1.5 gram a day) and vitamin D can be added if we're not eating as well as we should.

Essential amino acids (or the subunits of protein) are important for your mood, sleep, energy, and appetite regulation. Of 20 different amino acids (the building blocks of protein), nine are called "essential" because they must come from food sources and cannot be manufactured by the body. We need one of these essential amino acids, L-tryptophan, to make serotonin, which improves our mood. L-tryptophan is found in all animal products, especially poultry and dairy. At nighttime, serotonin is converted to melatonin (or when it is dark), and this initiates the sleep-wake cycle.

All animal products provide the nine required essential amino acids that are needed for brain activity and mood. Vegetable proteins are incomplete, but when combined with more than one kind of nuts/seeds, legumes (peas or beans), or whole grains, provide all essential amino acids in one meal. Vegetarians can get adequate L-tryptophan by eating dairy products and eggs every three to four hours.

Make your meds work smarter

Celexa, Lexapro, Zoloft…
SSRI antidepressants, such as Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), Zoloft (sertraline) and Effexor (venlafaxine) will require the synthesis of serotonin to do their job. Serotonin decreases dopamine activity in the brain and makes us feel calmer and content, and sleep better. Too little serotonin, caused by inadequate L-tryptophan in the diet, results in hunger, anxiety, depression, irritability and insomnia.

If the brain cannot make enough serotonin, then over-active dopamine will cause anxiety, insomnia, shaking, increased blood pressure, irritability and anger, and increased appetite. Caffeine and nicotine can also increase dopamine activity and make these symptoms worse.

Folate: Research suggests that people with depression may have low levels of folate, which may also keep them from responding well to antidepressant treatment with selective serotonin reuptake inhibitors (SSRIs). Fruits and vegetables are the best sources of folate.

Omega-3s: According to Jerry Cott, PhD, of the US Food and Drug Administration, omega-3 fatty acids have been found to have mood stabilizing properties. Studies have shown that in countries where people eat more seafood, there is a lower prevalence of major depression. E-EPA, found in fish oil, added to standard antidepressant treatment resulted in significant decreases in depression.

Healthy food plus meds equals smiling woman

Wellbutrin/Zyban (bupropion)
Norepinephrine/Reuptake Inhibitors (NDRIs) require the synthesis of norepinephrine and dopamine to work in the brain. These drugs increase energy and concentration. Dopamine is converted to norepinephrine in the body, so foods that boost dopamine will also promote its activity. You can boost dopamine by eating kidney beans, peas, nuts, whole grains, dairy products, eggs, meats and fish. Caffeine and chocolate, in moderate amounts, also increase dopamine activity.

Lithium carbonate, valproate (Depakote®)
Studies have found that the mood stabilizing drugs lithium carbonate and valproate have an effect on nerve cell signal mechanisms that is similar to the effect omega-3 fatty acids have on these mechanisms. In a four-month study, patients who received omega-3s stayed well significantly longer and showed a decrease in depressive symptoms than patients who were receiving the omega 3s. Find out more about Omega-3 fatty acids.

Benzodiazepines
Benzodiazepines, used to treat severe anxiety conditions and insomnia, slow brain activity. When taking any of these, you must have adequate glucose in your body to make GABA, an important neurotransmitter that keeps the brain activity in balance and calm. They may cause drowsiness, difficulty with concentration and memory, poor coordination and low energy.

If you become hypoglycemic, benzodiazepines may not work and you can become more anxious, irritable, and angry, or have panic attacks. Complex carbohydrates such as fruits, vegetables, beans, and whole grains are made from simple sugars and are gradually converted to glucose in the blood over a longer period of time. Complex carbohydrates provide a steady supply of glucose in the blood and are important to maintain body and brain energy. Simple sugars are more likely to cause hyperglycemia (abnormally high blood sugar) and hypoglycemia (abnormally low sugar) and increases the risk of diabetes mellitus, a disorder of blood-sugar regulation because of the body's inability to produce or use insulin.

A healthy diet that includes these important nutrients, along with adequate exercise and sleep, can be physically and mentally healing. If you're taking psychiatric medications, you may find that they're working better. You may even find that you need less of them, or feel ready to begin the process of giving them up altogether. But, stopping a medication too fast can cause serious side effects. Work with your doctor to make a plan.

Sources
Martie Fankhauser, M.S. Pharm, Clinical Professor, Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy
The Application of Nutrition to Psychiatric Illness, Steffany J. Fredman, MA Jerrold F. Rosenbaum, MD, Presentations at the American Psychiatric Association 2004 Annual Meeting