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Medication Interactions with d-Limonene

Delta-Limonene has been well known for treating nausea, and for it's uplifting happy effect. Research has shown that this terpene increases our dopamine and serotonin levels. Conditions that have elevated dopamine and serotonin might not tolerate d-limonene, and may have a worsening of symptoms. Some of those conditions include:

What medications can interact with d-limonene?

The following are dopamine agonist, and the side effects of these medications might worsen with increased levels of d-limonene:

 

amantadine (Symmetrel,Gocovri,Osmolex ER)

apomorphine (Apokyn)

bromocriptine (Cycloset. Parlodel)

carbidopa (Lodosyn)

carbidopa / levodopa (Sinemet,Rytary, Duopa, Parcopa)

carbidopa / entacapone / levodopa (Stalevo)

entacapone (Comtan)

pergolide (Permax)

pramipexole (Mirapex)

rotigotine (Neupro)

rasagiline (Azilect)

ropinirole (Requip)

safinamide (Xadago)

selegiline (Zelapar, Eldepryl, Emsam)

tolcapone (Tasmar)

 

SSRI (selective serotonin reuptake inhibitors), or 5HT1-A agonist may also interact with d-limonene. Here are some common SSRI medications:

 

fluvoxamine (Luvox CR,)

 

fluoxetine (Sarafem, Prozac, Selfemra, Rapiflux)

 

paroxetine (Pexeva, Paxil, Brisdelle, sertraline, Zoloft)

 

There are a few other medications/substances to consider as well:

 

Serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants such as trazodone, duloxetine (Cymbalta) and venlafaxine (Effexor)

 

Bupropion (Wellbutrin, Zyban), an antidepressant and tobacco-addiction medication

Tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor)

 

Monoamine oxidase inhibitors (MAOIs), antidepressants such as isocarboxazid (Marplan) and phenelzine (Nardil)

 

Anti-migraine medications such as triptans (Axert, Amerge, Imitrex), carbamazepine (Tegretol) and valproic acid (Depakene)

 

Pain medications such as opioid pain medications including codeine (Tylenol with codeine), fentanyl (Duragesic), hydrocodone meperidine (Demerol), oxycodone (Oxycontin, Percocet, Percodan) and tramadol (Ultram).

 

Lithium (Lithobid), a mood stabilizer

 

Illicit drugs, including LSD, Ecstasy, cocaine and amphetamines

 

Herbal supplements, including St. John's wort, ginseng and nutmeg

 

Over-the-counter cough and cold medications containing dextromethorphan (Delsym, Mucinex DM, others)

 

Anti-nausea medications such as granisetron, metoclopramide (Reglan), droperidol (Inapsine) and ondansetron (Zofran)

 

Linezolid (Zyvox), an antibiotic

 

Ritonavir (Norvir), an anti-retroviral medication used to treat HIV/AIDS

 

With isolates terpenes widely available. Overdosing with a combination of the above medications with a large amount of isolated d-limonene could lead to some serious side effects.

 

Serotonin Syndrome is common with overdosing with an anti-depressant like Prozac. Seizures and a fever going over 105o can be fatal.

Prescriptions for dopamine and serotonin are commonly used for treating the following

Dopamine

Acromegaly

ADHD

Chronic Fatigue Syndrome

Depression

Diabetes, Type 2

Extrapyramidal Reaction

Fatigue

GTP-CH Deficiency

Head Injury

Hyperprolactinemia

Influenza

Influenza A

Influenza Prophylaxis

Major Depressive Disorder

Neuroleptic Malignant Syndrome

Parkinson's Disease

Parkinsonian Tremor

Parkinsonism

Periodic Limb Movement Disorder

Post-Polio Syndrome

Restless Legs Syndrome

Sexual Dysfunction, SSRI Induced

Tardive Dyskinesia

Tourette's Syndrome

 

Serotonin (SSRI)

 

Anxiety

Bulimia nervosa

Fibromyalgia

Hot flashes

Obsessive-compulsive disorder

Panic disorder

Post-Traumatic Stress Disorder

Premenstrual dysphoric disorder

 

Fun Fact

 

Tardive Diskenesia (TD) is often a permanent, horrible side effect of the prescription treatment for Parkinson's Disease. D-Limonene might be useful for treating Parkinson's Disease, but might make Tardive Diskenesia worse.

Sources

 

Lisa Wise-Faberowski, Susan Black, in Complications in Anesthesia (Second Edition), 2007

 

Schneier, F. R., Abi-Dargham, A., Martinez, D., Slifstein, M., Hwang, D. R., Liebowitz, M. R., & Laruelle, M. (2009). Dopamine transporters, D2 receptors, and dopamine release in generalized social anxiety disorder. Depression and anxiety, 26(5), 411-8.

 

Vaillancourt, D. E., Schonfeld, D., Kwak, Y., Bohnen, N. I., & Seidler, R. (2013). Dopamine overdose hypothesis: evidence and clinical implications. Movement disorders : official journal of the Movement Disorder Society, 28(14), 1920-9.

 

Yun, Jaesuk. (2014). Limonene inhibits methamphetamine-induced locomotor activity via regulation of 5-HT neuronal function and dopamine release. Phytomedicine : international journal of phytotherapy and phytopharmacology. 21. . 10.1016/j.phymed.2013.12.004.

 

http://pdring.com/parkinsons-disease-drugs-medicines-overdose-symptoms.htm

 

https://reference.medscape.com/drug/intropin-dopamine-342435

 

https://www.drugs.com/drug-class/monoamine-oxidase-inhibitors.html

 

https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

 

https://www.drugs.com/drug-class/dopaminergic-antiparkinsonism-agents.html

 

https://www.drugs.com/drug-class/ssri-antidepressants.html

 

http://drugs.nmihi.com/dopamine-blockers.htm