Health - Theobroma cacao (Interactions, advice required pls?)

[humdroid]

Y has been enjoying Theobroma cacao (25 x extract) on an evening to help him sleep.

He hasn't been taking it daily, but he appreciated the relaxation it gave him, as it eased his restless legs in bed.

Just over a week ago, Y was prescribed mirtazapine, (one 15mg pill per day) and takes one in the evening. Sometimes it helps him sleep, other times it dosent.

Y knows mirtazapine has some interactions with other substances, but he didnt know of any interactions with theobroma cacao.

Mirtazapine is not an MAOI (monoamine ox inhibitor) but Y is told it interacts with other maoi medication.
Does that mean that the same holds true for theobroma cacao?

Just before Y was prescribed mirtazapine, he ordered some more supplies of theobroma cacao in. This came today, so Y will be a bit gutted if he has got a big bag of goody powder he cannot use.

Any info would be great, as Y has had a good surf already, and cannot find an answer to his question.

cheers

[Potter]

For sleep? Seriously? The patient is using methylated xanthines for sleep? Do they have some sort of massive caffeine habit like the Doktor had when they used to use a shot of espresso for a night cap? These days the Doktor can't even eat a 70% bar for dessert if they expect a decent bed time.

Anyways... There doesn't seem to be anything peer reviewed siting cacao as an MAOI, only dubious sources, though they seem to think it is mild. Pendell mentions that there are two chemicals that prevent the degradation of ananadamide which does have a single amine, so it might be one of those. Of course cacao it self IS contraindicated against MAO-I's, but if it does have an MAO-I (among the xanthines and phenethyamines) in it, that would be reasonable.

So is it dangerous, hard to tell. Since it would appear to be mild in activity (the cacao), it should be safe to try a small dose and monitor for warning signs (increased pulse). This assumes the patient has no heart issues to start with. Starting at say 3-4 milligrams and slowly titrating up over the course of days would be a reasonable series of experiments. Better yet start with some 70% and use that to get a baseline. If one gets to the point where a few bars of chocolate feels OK, then the extract can then be tried in the same manner. Of course if the patient has any heart issues, this would be VERY foolish with out the supervision of a medical professional.

Or the patient could simply ask their medical professional if the drug is contraindicated against chocolate, it would hardly be an awkward question, though when you up the ante to compensate for the extract and ask "JUST how many bars of good chocolate could I eat, I mean would 5 or 6 be bad?" they might raise some concerns over diabetes and your motivations/mental health.

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Reputation Comments on this post:

thorough answer. good advice about asking a doc

[humdroid]

Theobroma cacao is not the same as cocoa (chocolate) it is a separate plant, so Y believes.
Y dosen't think my doctor would know what the stuff is, given how ignorant GP's are in some things. Not complaining like, as the uk are lucky to have NHS.
A good reply, though.
Y hasdone some surfing, and of course, refrained from using the theo.
He also emailed the vendor of the theo cacao to ask if he could return the goods in exchange for some aromas.
Y has continued to take his depression meds.
As far as he understands, the mritazapine literature is implying the drug cannot be taken with, or 14 days after an maoi drug.
As theobroma cacao is not a drug, Y dosent want to get too worried. He wants to keep taking the pills as he is ten days into them, so they are about to become effective, in the way hoped for, by people taking new antidepressants.
Although the Theobroma cacao is not a drug, it is an extract, so this is what got Y concerned.
Y is reassuring, or trying to reassure himself, that the extract is not the same concentration as an maoi drug, as warned by mirtazapine literature, not to take the drug with.

[helikophis]

Originally Posted by humdroid

Theobroma cacao is not the same as cocoa (chocolate) it is a separate plant, so Y believes.

Y is incorrect. Theobroma cacao is the plant from which cocoa is made. The extract is in fact a drug, containing several alkaloids, including caffeine, xanthine and primarily theobromine.

See Potter's thorough historical treatment in this thread:

http://www.drugs-forum.com/forum/showthread.php?t=83601