The 3^rd of February last week was #TimeToTalkDay, a day dedicated for everyone to start the conversation about mental health and get talking. The purpose of the day is to encourage society to talk freely about our mental health, spreading awareness far and wide on the importance of talking things through and reduce the stigma around mental health.

For many people struggling with mental health problems medications can assist in their recovery. There are four main types of medication for mental health problems:

• Anti-anxiety drugs – which can help you feel calm, or get to sleep if you have severe insomnia
• Antidepressants – Usually for moderate to severe depression
• Anti-psychotics – to reduce the symptoms of schizophrenia, psychosis and sometimes severe anxiety or bipolar disorder.
• Mood stabilisers – to help you avoid extreme mood swings. Can be prescribed for bipolar disorder.

While medications cannot cure mental illness, they can work to control many of the most troubling symptoms, often enabling people with mental health disorders to return to a near normal functioning. Reducing some of the symptoms with medication can then also enhance the effectiveness of other treatments, such as psychotherapy.

 Although the adult brain forms only 2% of the body mass, it consumes 20% of the energy consumed each day and hence, because the brain is metabolically active 24 hours a day, it requires significant amounts of complex carbohydrates, essential fatty acids, amino acids, vitamins, minerals and water to remain healthy (1).

Although the role of diet in the nation’s mental health has yet to be fully understood and embraced, this is beginning to change. It has been identified in numerous studies that good nutrition has protective qualities towards brain health (2). It can protect the brain from the effects of oxidants which have been shown to negatively impact mood and mental health. Plus feeding the brain with a healthy diet can support healthy neurotransmitter activity (2).

The strength of data has now afforded nutritional medicine a place in the mainstream psychiatric discourse, with the International Society for Nutritional Psychiatry Research recommending that “nutrition and nutraceuticals should now be considered as mainstream elements of psychiatric practice, with research, education, policy, and health promotion reflecting this new paradigm.” (13)

But additionally for people taking medication to treat or reduce the symptoms of mental illness, nutrition is very important. Deficiencies in micronutrients have been associated with a number of mental health problems. Unequal intakes of omega-3 and omega-6 fats in the diet, for example, are thought to affect a number of mental health problems, including depression, and concentration and memory problems (3).

So, although medications are a cornerstone to treating mental health problems, and there is no suggestion that they should stop being used by patients, it does appear - providing there are no contra-indications around food types and medications - that a healthy diet is important in ensuring the essential pathways associated with effective brain function are operating to optimal effect.

However, the effect that medications can have on nutritional status is little appreciated, but this can have a significant extra detrimental effect on a situation that might already be compromised by a poor diet which is common in mental illness. Below are some of the most commonly prescribed drugs in the UK used to treat mental health illness and the nutrient deficiencies which can occur.

At Vitmedics, we focus on personalised wellbeing as a whole and understand the impact medications can have upon nutritional status. Our team of dedicated healthcare professionals provide expertise as nutritionists, dieticians, pharmacists and doctors. We care just as much about your healthy mind as we do your healthy body.  We want to be a part of breaking down the stigma and help to create a supportive community where we can talk openly about mental health and feel empowered to make changes or seek help when it is needed. While highlighting the important connection of nutrition to mental health and the medications taken for it. 

Our online personalised nutrition tool, holds a database of every UK generic and branded medicine and identifies over 4000 incidences where medications alone impact upon this important element of good health. The incremental negative effects different medications, as well those created by elements of life-stage, lifestyle and diet can have an accumulative effect on micronutrient status are assessed using this award-winning platform. These can then result in hitherto unrecognised severe nutrient deficits. We always recommend dietary improvements first, but in some cases of likely nutrient deficiency a supplement is essential. If we detect this, we will guide you on the supplements which are best suited for your needs.

Try our free and simply to use vitcheck assessment here and get your results of any nutrient deficiencies within minutes. If you would like to speak with one of our specialists you can book a free one-to-one consultancy here.

If you are concerned about yourself or a loved one, here are several helplines which can offer advice:

Samaritans:

The Samaritans offer emotional support 24 hours a day, in full confidence. Call 116 123 or Website: www.samaritans.org.uk

Mind: 

Mind provides information on a range of mental health topics to support people in their own area from 9.am to 6pm Monday to Friday. Call 03001233393 or email info@mind.org.uk

Help is available and you are not alone; talk to someone you trust. Sharing a problem is often the first step to recovery.

References:

1. Mental Health Foundation, (2017). Food for thought: Mental Health and Nutrition Policy Briefing. www.mentalhealth.org.uk

2. Can antioxidant foods forstall aging? United States Department of Agriculture Food and Nutrition Research Briefs, April 1999. http:www. ars.usda.gov

3. Beyer, J., & Payne, M.E. (2016). Nutrition and Bipolar Depression. Psychiatric Clinics of North America, 39(1), 75–86.

4. Verhoeven V, Vanpuyenbroeck K, Lopez-Hartmann M, Wens J, Remmen R. Walk on the sunny side of life--epidemiology of hypovitaminosis D and mental health in elderly nursing home residents. J Nutr Health Aging. 2012 Apr;16(4):417-20. doi: 10.1007/s12603-011-0361-5. PMID: 22499468.

5. Milaneschi Y, Hoogendijk W, Lips P, Heijboer AC, Schoevers R, van Hemert AM, Beekman AT, Smit JH, Penninx BW. The association between low vitamin D and depressive disorders. Mol Psychiatry. 2014 Apr;19(4):444-51. doi: 10.1038/mp.2013.36. Epub 2013 Apr 9. PMID: 23568194.

6. Zhou SF, Xue CC, Yu XQ, Li C, Wang G. Clinically important drug interactions potentially involving mechanism-based inhibition of cytochrome P450 3A4 and the role of therapeutic drug monitoring. Ther Drug Monit. 2007 Dec;29(6):687-710. doi: 10.1097/FTD.0b013e31815c16f5. PMID:

7. Maier, L., Pruteanu, M., Kuhn, M. et al.Extensive impact of non-antibiotic drugs on human gut bacteria. Nature555, 623–628 (2018). https://doi.org/10.1038/nature25979

8. Maier, L. Typas, A. 2017, (128-135pages) Systematically investigating the impact of medication on the gut microbiome. https://www.sciencedirect.com/science/article/pii/S1369527417301984

9. Q. Le Bastard,G. A. Al-Ghalith,M. et al. 2017. Systematic review: human gut dysbiosis induced by non-antibiotic prescription medications. https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14451

10. Linday LA, Pippenger CE, Howard A, Lieberman JA. Free radical scavenging enzyme activity and related trace metals in clozapine-induced agranulocytosis: a pilot study. J Clin Psychopharmacol. 1995 Oct;15(5):353-60. doi: 10.1097/00004714-199510000-00008. PMID: 8830067.

11. Vaddadi KS, Soosai E, Vaddadi G. Low blood selenium concentrations in schizophrenic patients on clozapine. Br J Clin Pharmacol. 2003 Mar;55(3):307-9. doi: 10.1046/j.1365-2125.2003.01773.x. PMID: 12630982; PMCID: PMC1884212.

12. Al-Dujaili AH, Al-Hakeim HK, Twayej AJ, Maes M. Total and ionized calcium and magnesium are significantly lowered in drug-naïve depressed patients: Effects of antidepressants and associations with immune activation. Metabolic brain disease. 2019 Oct;34(5):1493-503.

13. Sarris J., Logan A.C., Akbaraly T.N., Paul Amminger G., Balanza-Martinez V., Freeman M.P. International Society for Nutritional Psychiatry Research consensus position statement: nutritional medicine in modern psychiatry. World Psychiatry. 2015;14(3):370–371.