Can a person taking psychiatric medications, such as antipsychotics (e.g. clozapine, olanzapine) and antidepressants, take coenzyme Q10 (CoQ10) supplements?

Coenzyme Q10 Safety with Psychiatric Medications

Coenzyme Q10 (CoQ10) is generally safe to take alongside psychiatric medications, with no significant drug interactions reported between CoQ10 and common psychiatric drugs such as antipsychotics and antidepressants. The evidence suggests CoQ10 has a favorable safety profile and may even offer potential benefits for some patients with psychiatric conditions.

Safety Profile of CoQ10

• CoQ10 has demonstrated low toxicity in both animal and human studies, with an acceptable daily intake (ADI) of 12mg/kg/day 1
• The observed safety level (OSL) for CoQ10 is 1200 mg/day based on clinical trial data 1
• CoQ10 appears to be well-tolerated at doses up to 1200 mg/day with minimal side effects 2

Potential Interactions with Psychiatric Medications

Antipsychotics

• No specific contraindications or interactions between CoQ10 and antipsychotics (including clozapine and olanzapine) are documented in the clinical guidelines
• Some evidence suggests CoQ10 levels may be reduced in patients with schizophrenia, indicating potential benefit rather than harm from supplementation 3

Antidepressants

• No documented interactions between CoQ10 and antidepressants in the clinical guidelines
• Recent research suggests CoQ10 (200 mg daily for 8 weeks) may actually have beneficial effects as an adjunctive treatment in patients with depression 4

Important Considerations

Drug Transport Mechanisms

• CoQ10 may affect the transport activity of P-glycoprotein (P-gp), an intestinal efflux transporter involved in drug-drug interactions 5
• However, this theoretical interaction has not translated to clinically significant effects with psychiatric medications

Warfarin Interaction (Non-Psychiatric)

• The most significant documented drug interaction with CoQ10 is with warfarin, where CoQ10 may affect warfarin metabolism through cytochrome p450 enzymes 6
• If a psychiatric patient is also taking warfarin, this interaction should be monitored, though a randomized controlled trial showed CoQ10 at 100 mg/day had no effect on warfarin's clinical action 6

Potential Benefits in Psychiatric Conditions

• CoQ10 may have therapeutic value in conditions with associated mitochondrial dysfunction, including some psychiatric disorders 3
• Recent research indicates CoQ10 supplementation may reduce depression symptoms and improve quality of life in patients with depression 4
• CoQ10 has shown positive effects on fatigue, cognitive impairment, and affective difficulties in several neurological and psychiatric conditions 3

Monitoring and Dosage

• Standard dosages of 100-200 mg/day appear to be optimal for potential benefits 2
• For patients taking psychiatric medications, monitoring for any unusual side effects when starting CoQ10 is prudent
• Rare side effects may include gastrointestinal symptoms such as nausea, vomiting, diarrhea, and anorexia 6

While CoQ10 appears safe with psychiatric medications, patients should always inform their healthcare providers about all supplements they are taking to ensure comprehensive medication management.