SSRIs (Antidepressants)
Common brand names: Zoloft, Prozac, Lexapro, Celexa
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
- MelatoninModerate · Traditionally cited, limited evidence
- Sodium / ElectrolytesModerate · Moderate evidence
- Folate (Methylfolate)Mild · 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, SSRIs alter serotonin availability. Serotonin is the precursor to melatonin. Chronic SSRI use can disrupt the serotonin→melatonin conversion cycle, affecting sleep architecture.
Common signs, Insomnia, poor sleep quality, fatigue, vivid dreams
Sharpley et al. (Psychopharmacology, 1996; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 8853216): paroxetine 30 mg reduced REM sleep and sleep efficiency versus placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received. on polysomnography in 37 healthy volunteers. That is sleep architecture, not melatonin: measured effects on melatonin are inconsistent and some SSRIs raise it. Not a reliable depletion.
Melatonin 0.5–1 mg before bed is a range in common use, not from a trial cited on this row. The cited trial compared the sleep effects of paroxetine and nefazodone and studied no melatonin. Timing is a question for the prescriber.
Mechanism, Low folate status predicts poorer SSRI response, and L-methylfolate is used as an adjunct A treatment tested on top of standard prescribed therapy rather than in place of it. to improve antidepressant outcomes. That is a relationship measured in the other direction: the trials added folate to improve response rather than measuring folate falling on treatment. SSRIs have not been shown to deplete folate.
Common signs, Antidepressant non-response, elevated homocysteine An amino acid in the blood that rises when vitamin B12, folate or B6 are low., mood instability
L-methylfolate augments SSRI response in trials (Papakostas, 2012, augmentation); SSRIs are not shown to deplete folate.
L-Methylfolate 7.5–15 mg daily (prescription doses used clinically; 400–800 mcg OTC for maintenance).
Mechanism, SSRIs can cause SIADH (syndrome of inappropriate antidiuretic hormone secretion), leading to hyponatremia. Especially in older adults.
Common signs, Confusion, fatigue, nausea, headache (in severe cases: seizures)
Kirby & Ames (Int J Geriatr Psychiatry, 2001; PMID 11376464): review documenting SSRI-associated hyponatremia (SIADH) in older adults.
Sodium levels are commonly monitored, especially in older adults or those also taking diuretics.
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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 →