Q: I’m taking the serotonin-reuptake inhibitor sertraline (Zoloft) for depression. I feel so much better, and I assumed it was OK to keep taking my vitamins. But are there supplements I should watch out for? — Cecilia H., Ossining, New York
A: Congrats on taking charge of your depression and feeling better. Yes, there are certain supplements that interfere with selective serotonin-reuptake inhibitors (SSRIs), and with serotonin and noradrenalin reuptake inhibitors (SNRIs) too.
Serotonin is a neurotransmitter found in your gut, your blood and your nervous system. It’s considered a natural mood stabilizer. You probably weren’t getting the right balance, and the sertraline has helped you re-establish that! Since we don’t know your exact dosage or the supplements you are taking, we can’t directly answer your question. You should talk to your doctor about all the supplements and herbal preparations you may be using. When you do, here are some specifics to discuss:
— Ask your doctor about the risks of taking St. John’s wort, garcinia cambogia, L-tryptophan (or 5-HTP) and SAMe (S-adenosyl-methionine) supplements with your antidepressant. Consumer Labs says they can increase your risk of experiencing serotonin syndrome. That’s when there’s an overabundance of serotonin in your system that triggers everything from goosebumps and shivering to muscle rigidity, diarrhea and heavy sweating. (If that happens, do not ever abruptly stop taking your SSRI or SNRI!)
— Also ask about the potential benefits of these supplements: A study in the American Journal of Psychiatry found that omega-3 fish oil (specifically EPA) in combo with SSRIs caused a significant reduction in depressive symptoms. It was also true to a lesser extent for vitamin D and methylfolate, a form of folic acid.
Q: I was on a plane, and the person next to me was watching one of the latest action movies. I won’t single it out, but it was nonstop violence — and rated PG-13! How can this not negatively affect impressionable youngsters? — Jesse J., Sioux Falls, South Dakota
A: The Motion Picture industry has eroded standards so that the PG-13 rating (parents strongly cautioned, for children under 13) means next to nothing. The Harvard School of Public Health warned that a “ratings creep” (it’s a voluntary system) has allowed more violent and sexually explicit content into films that are seen by young teens. Recently, the American Academy of Pediatrics reported that gun violence in PG-13-rated films has more than tripled since 1985. And public health and mental health experts agree that nonstop violence in films (and on TV and in video games) can make kids more aggressive and damage their emotional development. So our advice to parents:
1. Do diligent research when your teen wants to see a movie. Find out how much and what type of violence a film contains, and check out Common Sense Media (commonsensemedia.org). In its Parents’ Guide, it gives ratings for categories such as positive messages, positive role models, sex, violence, language, drinking, drugs and smoking, and a review.
Here’s a partial review of the Cohen Brothers’ adaptation of the Western “True Grit,” which is rated PG-13. Common- Sense gave it an age 15+. They say: “impressive and forceful, but it’s also full of brutal (and sometimes bloody) gunfight sequences and other violent moments that aren’t appropriate for younger viewers … mature teens are likely to feel a kinship with the lead character, 14-yearold Mattie Ross…They might even learn from her adventure … lessons … dealing with loyalty, courage and determination.”
2. Ask around and find out what other parents have to say. If you’re not sure about the content, watch the movie first or watch with your youngster.
3. Talk to your kids about violence in the media. Help them evaluate what is gratuitous and reject its message. Remember, if teens want to see a movie, with all the streaming available these days, chances are they will, even if you say no. So be proactive and help them avoid the upsetting and mind-bending violence that’s out there.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.
(c) 2018 Michael Roizen, M.D. and Mehmet Oz, M.D. Distributed by King Features Syndicate, Inc.