Table 29.34-1
Dietary Supplements Used in Psychiatry
Name
Ingredients/
What Is It?
Uses
Adverse Effects
Interactions
Dosage
Comments
Docosahexaenoic acid
(DHA)
Omega-3
polyunsaturated
fatty acid
ADD, dyslexia, cognitive
impairment, dementia
Anticoagulant properties,
mild GI distress
Warfarin
Varies with indication Stop using prior to
surgery
Choline
Choline
Fetal brain development,
manic conditions,
cognitive disorders, tardive
dyskinesia, cancers
Restrict in patients
with primary genetic
trimethyluria, sweating,
hypotension, depression
Methotrexate, works
with B
6
, B
12
, and folic
acid in metabolism of
homocysteine
300–1,200 mg doses
>
3 g associated with
fishy body odor
Needed for structure
and function of all
cells
l
-
a
-Glyceryl-
phosphorylcholine
(
a
-GPC)
Derived from soy
lecithin
To increase growth hormone
secretion, cognitive
disorders
None known
None known
500 mg–1 g daily
Remains poorly
understood
Phosphatidylcholine
Phospholipid that
is part of cell
membranes
Manic conditions,
Alzheimer’s disease, and
cognitive disorders, tardive
dyskinesia
Diarrhea, steatorrhea in those
with malabsorption, avoid
with antiphospholipid
antibody syndrome
None known
3–9 g/day in divided
doses
Soybeans, sunflower,
and rapeseed are
major sources.
Phosphatidylserine
Phospholipid
isolated from
soya and egg
yolks
Cognitive impairment
including Alzheimer’s
disease, may reverse
memory problems
Avoid with antiphospholipid
antibody syndrome, GI side
effects
None known
For soya-derived
variety, 100 mg tid
Type derived from
bovine brain carries
hypothetical risk of
bovine spongiform
encephalopathy
Zinc
Metallic element
Immune impairment,
wound healing, cognitive
disorders, prevention of
neural tube defects
GI distress, high doses can
cause copper deficiency,
immunosuppression
Bisphosphonates,
quinolones,
tetracycline,
penicillamine, copper,
cysteine-containing
foods, caffeine, iron
Typical dose 15 mg/
day, adverse effects
>
30 mg
Claims that zinc can
prevent and treat the
common cold are
supported in some
studies but not in
others; more research
needed
Acetyl-
l
-carnitine
Acetyl ester of
l
-carnitine
Neuroprotection, Alzheimer’s
disease, Down syndrome,
strokes, antiaging,
depression in geriatric
patients
Mild GI distress, seizures,
increased agitation in some
with Alzheimer’s disease
Nucleoside analogs,
valproic acid, and
pivalic acid–containing
antibiotics
500 mg–2 g daily in
divided doses
Found in small amounts
in milk and meat
Huperzine A
Plant alkaloid
derived from
Chinese club
moss
Alzheimer’s disease, age-
related memory loss,
inflammatory disorders
Seizures, arrhythmias, asthma,
irritable bowel disease
Acetylcholinesterase
inhibitors and
cholinergic drugs
60
m
g–200
m
g/day
Huperzia serrata
has
been used in Chinese
folk medicine for the
treatment of fevers
and inflammation.
NADH (nicotinamide
adenine
dinucleotide)
Dinucleotide
located in
mitochondria
and cytosol of
cells
Parkinson’s disease,
Alzheimer’s disease,
chronic fatigue, CV disease
GI distress
None known
5 mg/day or 5 mg bid Precursor of NADH is
nicotinic acid
S
-Adenosyl-
l
-
methionine (SAMe)
Metabolite of
essential
amino acid
l
-methionine
Mood elevation, osteoarthritis Hypomania, hyperactive
muscle movement, caution
in patients with cancer
None known
200–1,600 mg daily in
divided doses
Several trials
demonstrate
some efficacy in
the treatment of
depression
1050
