Hi, I'm Dr. Tracy Marks a psychiatrist,
and I make mental health education videos.
Today I'm popping in very briefly because I wanna tell you
about medications that can be effected
by taking them with or without food.
It's not a terribly long list,
thus, this being a brief video today,
but nonetheless, it's important
because sometimes medications,
if you take them with food,
can delay the absorption of the medicine,
pushing back when it actually takes effect,
or it can increase the concentration of the medication
in your bloodstream,
increased concentration can mean increased side effects,
or it can reduce the amount of the drug that's absorbed.
Reduced absorption means that you're not getting
as much of it in your bloodstream.
And therefore you can take a medication that way and think,
gosh, this medicine doesn't work for me.
This is a failure.
Well, it may not be a failure if you took it with food.
So here's the short list of medicines
that are affected that way.
And I'll have a handout for you with these medications
that you can download
from my website at markspsychiatry.com.
If you're on my email list,
you already have this handout in your inbox.
For this video, I'm gonna say the brand name,
but the generic names are included on the handout.
First is the sleeping medicines.
Have you ever taken sleeping pills before,
and it took forever for you to feel sleepy?
It could be because you took the medicine too close
to eating your last meal.
Several of the sleepy medications
should not be taken with food because food delays the effect
of the medication by delaying absorption.
These medications include Ambien, Lunesta,
Sonata, and Trazadone.
If you take them too close to eating the food effect
can delay when you start to feel sleepy by an hour or more.
This is a big deal.
If you're taking the medicine to help you fall asleep,
you don't wanna lie in bed for an hour or two
waiting for the medicine to kick in.
So what would be considered an empty stomach?
Well, generally we consider it anywhere
between one and three hours since you last ate.
Since this is a medicine that you would take at bedtime,
I usually advise people to have dinner two to three hours
before they wanna take the medication.
In case you're someone who reads
the medication handouts or labels as we call them,
the label for Trazodone will say to take with food
because food increases the amount of Trazodone available.
So you get a little bump in the concentration,
but the label also says that food delays
the effect of the drug by one hour.
Well, Trazodone is FDA approved for depression,
and that's its intended use,
but it's rarely used for that purpose,
and mainly used to treat insomnia.
So that said the food delay becomes more important
than that bump in concentration.
So it's still best to take it on an empty stomach.
Another medication that you don't wanna take with food
is Seroquel extended release formulation.
We use Seroquel for depression,
bipolar disorder, and schizophrenia.
Seroquel immediate release version
has a lot of side effects,
including feeling very tired and sleepy, maybe even dizzy.
So they came out with the extended release version
to help smooth out some of those effects,
so that you can take it during the day and still function.
If you take it with a full meal, especially a high fat meal,
the food causes a sharp rise in how much you have
in your bloodstream, and you may get the same side effects
that you would get with the immediate release version.
So it's not horrible if you take it with food,
but you can end up having some of the same side effects
as the immediate release version,
and then it's kind of no point in taking
the extended release version.
Next are the medications that do not work as well,
if you take them with food
because food decreases the bioavailability
of the medication.
This means that less of it is available to be absorbed
in your bloodstream.
And these medications are Latuda and Geodon,
which are both antipsychotic medications
that we use for bipolar disorder and schizophrenia.
Also, this applies to the antidepressant viibryd.
If you take these medications on an empty stomach,
or just having a light meal, like a piece of toast,
you won't absorb as much of it,
and then you may not feel the effects of the drug.
It still may work well enough,
but you could require higher doses
than you would otherwise need.
Or you could conclude that the medicine
just doesn't seem to work for you.
With the medications Buspar and Invega
the amount in your bloodstream doubles with food.
Buspar is a medication that we use
to treat generalized anxiety disorder and off-label
for treatment resistant depression.
Off-label means that it's not what the drug
was FDA approved to treat.
Invega is a drug that we use to treat schizophrenia.
Because of this doubling effect you may need a lower dose,
which is fine, but then you always need
to take the medication with food so that your blood level
isn't always going up and down.
The downside of this plan is that Buspar
is usually a two to three times a day medication,
and you may not wanna have to always coordinate
your eating around taking the medication.
So in this case, it may be easier to take on
an empty stomach or wait about a couple of hours,
since you last ate to take the medication.
It's always a little trickier with medications
that you have to take more than once a day.
So the moral of the story with the Buspar and Invega
is that whatever you choose to do,
whether you take it with food or without food,
you just wanna do the same thing each and every time
consistently take with food,
or consistently take on an empty stomach.
Notice there are no antidepressants on this list
with the exception of viibryd,
which is a relatively new antidepressant,
but the common ones like Prozac, Zoloft, Lexapro,
those are not medications
that are significantly affected with food.
At least as far as the amount of it that works for you,
where it can matter with these medications
is how food affects your tolerability of the medicine.
A lot of these serotonin enhancing drugs
can cause a lot of nausea
because we actually have more serotonin receptors
in your gut than in your brain.
So anything affecting the gastrointestinal track
is common for these medications, nausea,
queasiness, diarrhea, constipation.
And so if the medication causes a lot of nausea,
sometimes taking with food can actually help
with that nausea and make you be able to get it down,
or be able to tolerate it better.
But it doesn't change the overall effectiveness
of the medication.
I hope if you're taking one of these medicines
that I did mention that where food affects the blood levels.
I hope that you're able to see a difference
in the effectiveness just by adjusting your eating schedule
around the medication.
If you're not on one of these medicines
then save the handout as a reference for the future
in case you get put on one of them.
Also pass it along to someone that you think it may benefit.
Thanks for watching.
See you next time.