Ellen Campbell -Grizzle - PHARMACY TODAYVALENTINE'S DAY is upon us. Shops are fully stocked with chocolate gifts of all shapes, sizes, colour and taste. Jamaicans hold to the strong traditional link between expressions of love at this time of year and lavish gifts of chocolates and roses.
As the consumption of chocolate increases, pharmacists are very alert to the possibility of many drug and chocolate interactions. The 380 identified chemicals in chocolate increase the potential of interference with a wide range of medication. Chocolate is both food and medicine.
Chocolate indulgence is a bittersweet delight and many enthusiasts feel a lift in spirits due to the presence of caffeine and theobromine. Phenylethylamine (the love chemical) is also present. Traces of this love chemical in the brain are naturally released in the throes of love when we feel our pulse quicken and heart pound, peaking during orgasms.
Another ingredient is tryptophan, an essential amino acid that has a role in the management of depression. Chocolate is also magnesium-rich. The craving that some women have close to menstruation is linked to the fact that magnesium deficiency exacerbates pre-menstrual syndrome (PMS). In these cases, chocolates has a palliative effect.
Anandamide in chocolate will act on the cannabinoid receptors, the same site of action in the body as tetrahydrocannabinol (THC), found in marijuana. The saturated fats present increase blood cholesterol while polyphenols reduce the risk of heart disease.
Eating chocolate is pleasurable. "Chocoholics" (persons addicted to chocolate) experience a real "high" that drives their desire to binge. There have been very few cases of allergies to chocolates related to additives such as milk, soybean, almond, peanut, vanillin and lecithin.
Moderation must be the key, as many of its active chemicals in chocolate do have negative effects. For example:-
Caffeine can cause anxiety, sleep problems, heartburn, difficulty in concentrating and restlessness. Withdrawal can lead to headaches and fatigue.
The love chemical does dilate blood vessels and trigger migraine.
N-acetylethanolamine prevents the breakdown of anandamide and increases its availability to cannabinoid receptors enhancing the "feel good" feeling.
Young children may not be able to digest theobromine.
Theobromine is toxic to dogs and other animals as they are not able to digest it. An amount of 30gm of unsaturated chocolate will make a 10-pound dog quite ill.
The pharmacist's major concern at this time is how these chemicals will interfere with the safety of your medication. You need to exercise caution if you are being treated for depression, anxiety, hypertension, diabetes, nicotine addiction, migraine and obesity. Pregnant women and children tend to be more vulnerable to the effects of caffeine and must be very careful. If you are self- medicating, read labels carefully before making your choice. Remember that chocolate bases are used to mask the taste of unpalatable drugs and to mix diet shakes and sundaes.
Chocolate is a wonder of nature. Its 380 biologically-active components have many palliative effects. Many users experience physical pleasure from indulgence. There are those who recommend dark chocolates because these have less fatty acids. Remember, moderation is the key to "make your medicine your food and make your food your medicine".
If you want to know more about how chocolate interacts with medication, ask your pharmacist, you have the right to know!
Ellen Campbell Grizzle, President of the Caribbean Association of Pharmacists (CAP) and Director, Information & Research, National Council on Drug Abuse, NCDA, Kingston, Jamaica.
