Antipsychotics (Risperidone, Quetiapine)
Common brand names: Risperdal, Seroquel, Abilify, Haldol, Zyprexa
Three nutrients listed against this medication. The most severe is marked moderate.
At a glance
None of the three is marked well documented. Each row carries its own evidence level.
At a glance
- CoQ10Moderate · Mechanism only, no human trial
- Vitamin B6 (P5P)Mild · Traditionally cited, limited evidence
- MelatoninMild · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Atypical antipsychotics impair mitochondrial electron transport and reduce CoQ10 synthesis, contributing to metabolic side effects.
Common signs, Fatigue, metabolic syndrome, muscle weakness, cognitive dulling
Lower CoQ10 has been reported in schizophrenia patients versus drug-naive, but this is an illness-confounded association; animal proteomic data suggest a drug effect. No causal human depletion trial.
CoQ10 200 to 300 mg daily with a fat-containing meal is a range in common use, not from a trial cited on this row. No causal human depletion trial exists for this pair.
Mechanism, High-dose B6 has been studied as a treatment for antipsychotic-induced akathisia, and phenothiazines interact with B6-dependent enzyme systems. A treatment effect is not a depletion: those trials gave B6 to relieve a side effect rather than measuring B6 falling on therapy. Antipsychotics have not been shown to deplete B6.
Common signs, Akathisia (restlessness), tardive dyskinesia risk, peripheral neuropathy, depression
High-dose B6 treats antipsychotic-induced akathisia (Lerner, 2002, a treatment effect); antipsychotics are not shown to deplete B6.
P5P (pyridoxal-5-phosphate, the active form) 25–50 mg daily is a range in common use, not from a trial cited on this row.
Mechanism, Proposed mechanism: dopamine receptor blockade by drugs such as olanzapine and risperidone has been suggested to suppress nocturnal melatonin secretion. Studies that measured melatonin on these drugs disagree, so a reliable depletion is not established.
Common signs, Insomnia, disrupted sleep architecture, circadian dysregulation
Antipsychotic effects on nocturnal melatonin are inconsistent across studies; supplementation may aid sleep, but a reliable depletion is not established.
Melatonin was used at 0.5–3 mg, 30 minutes before bed, starting at the low end.
For your next appointment
It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →