Many psychiatric medications that help manage mental health conditions can have an unexpected side effect: they may reduce important vitamins and minerals in your body. This research review looked at common psychiatric drugs like antidepressants and mood stabilizers to understand which nutrients they affect most. The study found that medications can lower B vitamins, calcium, vitamin D, and other essential nutrients. The good news is that doctors and pharmacists can now watch for these deficiencies in patients taking these medications and help prevent problems before they start. This information helps healthcare providers give better care to people taking psychiatric medications long-term.
The Quick Take
- What they studied: How psychiatric medications used to treat depression, bipolar disorder, and other mental health conditions can reduce important vitamins and minerals in the body, and what doctors can do about it
- Who participated: This was a review of existing research rather than a new study with participants. Researchers looked at evidence about psychiatric medications and nutrient loss
- Key finding: Common psychiatric medications—including antidepressants, mood stabilizers, and antipsychotics—can lower levels of B vitamins, calcium, vitamin D, selenium, and other nutrients when taken long-term
- What it means for you: If you take psychiatric medications regularly, your doctor may want to check your nutrient levels. You probably don’t need to take supplements automatically, but monitoring can catch problems early and help you feel better
The Research Details
This article is a comprehensive review of scientific research on how psychiatric medications interact with nutrients in the body. Instead of conducting a new experiment, researchers gathered and analyzed all the existing studies about this topic. They looked at evidence for different psychiatric drugs—including antidepressants like SSRIs, mood stabilizers like valproic acid and carbamazepine, antipsychotics, and lithium—and documented which nutrients each medication can reduce. The researchers then suggested practical ways that doctors and pharmacists can identify patients at risk and manage these nutrient deficiencies.
This type of review is valuable because it brings together scattered information from many studies into one organized resource. Healthcare providers can use this information to understand which patients taking which medications need nutrient monitoring. The review also provides guidance on detection and treatment strategies rather than recommending that everyone taking these medications automatically take supplements.
Understanding drug-nutrient interactions is important because nutrient deficiencies can cause additional health problems on top of the conditions being treated. A person taking psychiatric medication to manage depression, for example, shouldn’t also develop a vitamin deficiency that causes fatigue or other complications. By identifying which medications cause which nutrient problems, doctors can monitor at-risk patients and prevent deficiencies before they cause harm. This helps people taking psychiatric medications have better overall health outcomes.
This is a review article that summarizes existing research rather than a new study with human participants. The strength of the findings depends on the quality of the studies reviewed. The authors note that there is actually a gap in research—there aren’t enough well-designed studies specifically about drug-nutrient interactions with psychiatric medications, and there are few clear guidelines for managing these issues. This means the evidence is somewhat limited, but the article does an important job of organizing what we do know. The information is most reliable for the most commonly prescribed medications where more research exists.
What the Results Show
The research identified several important patterns. Carbamazepine and valproic acid—two mood stabilizers—appear to reduce B vitamins, calcium, and vitamin D levels. Tricyclic antidepressants (an older class of antidepressants) can lower B vitamins, calcium, vitamin D, and coenzyme Q10. Newer antidepressants called SSRIs may also reduce calcium and vitamin D. Antipsychotic medications can lower B vitamins, calcium, and vitamin D. Lithium, used for bipolar disorder, can cause B vitamin deficiencies. Additionally, valproic acid and the antipsychotic clozapine appear to reduce selenium levels, and valproic acid may lower carnitine and zinc.
The research shows that these nutrient depletions happen because psychiatric medications can interfere with how the body absorbs, uses, or stores these nutrients. For example, some medications may affect how the digestive system absorbs vitamins, while others may increase how quickly the body uses up certain nutrients. The effects typically develop over months or years of taking the medication regularly.
Importantly, the researchers emphasize that these nutrient interactions don’t mean people should stop taking their psychiatric medications. Mental health treatment is essential, and these medications save lives. Instead, the findings suggest that patients taking these medications should be monitored for nutrient deficiencies so problems can be caught and treated early.
The review also identified that vitamin E levels may be reduced by valproic acid and carbamazepine. Selenium deficiency appears to be a particular concern with clozapine use. The research suggests that the risk of nutrient deficiency may depend on factors like how long someone has been taking the medication, the dose they’re taking, and their individual genetics and diet. Some people may be at higher risk than others.
This review fills an important gap in medical knowledge. While doctors have long known that many medications can affect nutrient levels, psychiatric medications haven’t been studied as thoroughly as some other drug classes. Previous research on other types of medications showed that drug-nutrient interactions are real and can affect health, so it makes sense that psychiatric medications would have similar effects. However, there are surprisingly few clear guidelines for managing these interactions in psychiatric patients. This review brings together scattered research and provides the first organized summary for healthcare providers.
The authors note several important limitations. First, there simply aren’t enough high-quality research studies specifically about psychiatric medications and nutrient depletion. Many of the studies reviewed were small or had design limitations. Second, most research has focused on individual medications rather than looking at people taking multiple psychiatric drugs together, which is common in real life. Third, there’s limited information about which patients are most at risk or how severe these deficiencies typically become. Finally, the review doesn’t provide clear, specific guidelines for which patients should be tested or supplemented, partly because the research base is incomplete.
The Bottom Line
Healthcare providers should consider screening for nutrient deficiencies in patients taking psychiatric medications long-term, particularly those on valproic acid, carbamazepine, or antipsychotics. However, routine supplementation for everyone taking these medications is not recommended. Instead, testing should be targeted to identify actual deficiencies, which can then be treated. Patients should discuss nutrient monitoring with their doctor or pharmacist. Eating a nutrient-rich diet with plenty of vegetables, fruits, whole grains, and protein may help reduce the risk of deficiencies. These recommendations have moderate confidence because the research base, while suggestive, is not yet comprehensive.
This information is most relevant for people taking psychiatric medications long-term (months to years), particularly mood stabilizers like valproic acid or carbamazepine, antipsychotics, or older antidepressants. People taking these medications for a few weeks probably don’t need to worry. Healthcare providers—especially pharmacists and psychiatrists—should use this information to guide patient monitoring. People with poor nutrition, limited food access, or other health conditions that affect nutrient absorption may be at higher risk. This information is less relevant for people taking psychiatric medications short-term or for those taking only SSRIs at standard doses, though monitoring may still be reasonable.
Nutrient deficiencies from psychiatric medications typically develop slowly over months to years of regular use. You probably won’t notice symptoms immediately after starting a medication. However, over time, deficiencies might cause fatigue, weakness, mood changes, or other symptoms that could be mistaken for worsening mental health. If your doctor recommends supplementation for a deficiency, you might notice improvement in energy or mood within weeks to months. The key is catching deficiencies early through monitoring rather than waiting for symptoms to develop.
Want to Apply This Research?
- Track your psychiatric medications and their doses, along with any nutrient testing results (B12, vitamin D, calcium, selenium levels). Set reminders for nutrient testing appointments recommended by your doctor, typically every 6-12 months if you’re on long-term psychiatric medication. Log any symptoms that might indicate nutrient deficiency, such as unusual fatigue, muscle weakness, or mood changes not explained by your mental health condition.
- Work with your healthcare provider to create a nutrient-monitoring plan if you take psychiatric medications long-term. If deficiencies are found, use the app to track supplement adherence and any improvements in energy or symptoms. Focus on eating nutrient-dense foods and log your diet periodically to ensure adequate intake of B vitamins, calcium, vitamin D, and other nutrients. Schedule regular check-ins with your pharmacist or doctor to discuss nutrient status.
- Set up a long-term tracking system that includes your current psychiatric medications, dosages, and start dates. Create a calendar for recommended nutrient testing based on your doctor’s advice. If supplements are prescribed, track daily adherence. Monitor and log energy levels, mood stability, and any physical symptoms that might relate to nutrient status. Review this information during appointments with your healthcare provider to adjust monitoring or treatment as needed.
This article reviews research on how psychiatric medications may affect nutrient levels in the body. It is not medical advice and should not be used to make decisions about your medications. Psychiatric medications are essential for treating serious mental health conditions, and you should never stop taking them without talking to your doctor. If you take psychiatric medications and are concerned about nutrient deficiencies, discuss nutrient monitoring and testing with your healthcare provider or pharmacist. Do not start taking supplements without professional guidance, as some supplements can interact with psychiatric medications. This information is meant to help you have informed conversations with your healthcare team, not to replace professional medical advice.