Clinically relevant complications of drug-food interactions in psychopharmacology

Although often overlooked, the interaction of psychotropic medications with food or dietary health supplements can be clinically relevant, and in some cases it may be catastrophic. In this review, we highlight clinically significant drug-food interactions in psychiatry, including those related to hypertensive crises with monoamine oxidase inhibitors, absorption of medications (such as levothyroxine, ziprasidone, and lurasidone), coadministration with food, the excretion of lithium and other medications in the setting of dietary changes, and the impact of grapefruit juice, St. John’s wort, cruciferous vegetables, charbroiled meats, dietary supplements, and alcohol on drug metabolism. Routine inquiry about dietary habits and use of dietary supplements as well as enhanced anticipation and monitoring for potential drug-food interactions is an integral component of optimal psychopharmacologic practice.