Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Take medication with food to decrease GI upset.1
• The concentrated forms of Perphenazine should not be mixed with caffeinated drinks, tannins ( in tea )or pectinate, found in apple juice.2
• There may be an increased need for riboflavin, supplementation may be beneficial.3
• Avoid alcohol with phenothiazines like perphenazine.4
• Co-Q10 may be inhibited or depleted with phenothiazine use.5
• Vitamin E supplementation may help prevent tardive dyskinesia, a side effect associated with long term use of phenothiazines. Supplementation should not be undertaken without the knowledge/ supervision of a physician or pharmacist.6
• Phenylalanine may make tardive dyskinesia worse when taken with phenothiazines.7
• These herbs may increase the sedation caused by perphenazine: calamus, calendula, chamomile, California poppy, catnip, couch grass, elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap, shepherd's purse, stinging nettle, valerian, withania root, and yerba mansa.8
• Milk thistle may protect the liver against toxicity associated with long term phenothiazine use.9
• Ginkgo may help decrease side effects and increase effectiveness of some antipsychotic medications.10
• Avoid kava with antipsychotic medications due to increased risk of side effects.11
• Yohimbe toxicity is increased with concurrent phenothiazine use.12
References1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Tinguely D, Jonzier M, Schopf J, et al. Determination of Compliance with Riboflavin in an Antidepressive Therapy. Arzneimittelforschung, 1985, 35(2): 536-8
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
5 Folkers K. Basic chemical research on coenzyme Q10 and integrated clinical research on therapy of diseases. As cited in Lenaz G (ed.). Coenzyme Q. New York: John Wiley and Sons, 1985.
5 Kishi T, et al, "Inhibition of Myocardial Respiration by Psychotherapeutic Drugs an Prevention by Coenzyme Q" Biomedical and Clinical Aspects of Coenzyme Q, Yamamura Y, Folkers K and Ito Y, eds Elsevier/North-Holland Biomedical Press: Amsterdam, 1980, vol 2, 139-54.
5 Beal MF. Coenzyme Q10 administration and its potential for treatment of neurodegenerative diseases. Biofactors. 1999;9(2-4):261-6. Review.
6 Adler LA, et al. Vitamin E treatment of tardive dyskinesia. Am J Psychiatry 150: 1405-1407, 1993.
6 Adler LA, et al. Long term treatment effects of vitamin E for tardive dyskinesia. Biol Psychiatry 43: 868-872, 1998.
6 Elkashef AM, Wyatt RJ. Tardive dyskinesia: possible involvement of free radicals and treatment with vitamin E. Schizophr Bull. 1999;25(4):731-40. Review.
6 Dorfman-Etrog P, Hermesh H, Prilipko L, Weizman A, Munitz H. The effect of vitamin E addition to acute neuroleptic treatment on the emergence of extrapyramidal side effects in schizophrenic patients: an open label study. Eur Neuropsychopharmacol. 1999 Dec;9(6):475-7.
6 Boomershine KH, Shelton PS, Boomershine JE. Vitamin E in the treatment of tardive dyskinesia. Ann Pharmacother. 1999 Nov;33(11):1195-202. Review.
6 Sajjad SH. Vitamin E in the treatment of tardive dyskinesia: a preliminary study over 7 months at different doses. Int Clin Psychopharmacol. 1998 Jul;13(4):147-55.
7 Mosnik DM, Spring B, Rogers K, and Baruah SL. Tardive dyskinesia exacerbated after ingestion of phenylalanine by schizophrenic patients. Neuropsychopharmacology 16(2): 136-146, 1997
7 Gardos G, Cole JO, Matthews JD, Nierenberg AA, Dugan SJ. The acute effects of a loading dose of phenylalanine in unipolar depressed patients with and without tardive dyskinesia. Neuropsychopharmacology. 1992 Jun;6(4):241-7.
7 Richardson MA, Reilly MA, Read LL, Flynn CJ, Suckow RF, Maher TJ, Sziraki I. Phenylalanine kinetics are associated with tardive dyskinesia in men but not in women. Psychopharmacology (Berl). 1999 Apr;143(4):347-57.
8 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
8 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
9 Palasciano G, et al. The effect of silymarin on plasma levels of malondialdehyde in patients receiving long term treatment with psychotropic drugs. Curr Ther Res 55: 537-545, 1994.
9 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
10 Liu P, et al. Combined use of Ginkgo biloba extracts on efficacy and adverse reactions of various antipsychotics. Zhongguo Linchuang Yaolixue Zaxhi 13(4): 193-198, 1997.
11 Schelosky L, et al. Kava and dopamine antagonism. J Neurol Neurosurg Psych 58(5): 639-640, 1995.
12 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.