Warnings & Precautions

5.1 Warnings

All medication doses should be monitored by a physician while taking Daily Essential Nutrients (DEN). Research indicates that psychoactive drugs may need to be gradually reduced or eliminated during nutrient therapy to avoid over-medication effects, with the recognition that abrupt medication discontinuation can be associated with certain symptoms (see 4.2 Drug interactions).


5.2 Precautions



5.2.1 Citrus bioflavonoids
Patients who are currently taking a citrus bioflavonoid-containing B. supplement and are currently taking or have recently taken psychoactive medications should reduce the dose of citrus bioflavonoids gradually (by no more than 10% of the original dose per day) in order to avoid psychoactive medication withdrawal effects (see 4.2 Drug interactions).



5.2.2 Clinical worsening
Patients being treated for any indication should be observed closely by families and caregivers for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of therapy, or at times of DEN or medication dose changes (either increases or decreases). Such symptoms should be reported to the patient's prescriber or health professional, as medication dose changes may be required (see 8.1 Psychiatric medication management). 
5.2.3 Iron
Although DEN contains a relatively low level of iron (less than 1 mg per capsule), children should take DEN only under adult supervision. In cases documented by US Poison Control Centers, children who have died from iron supplements have taken more than 60 mg of iron/kilogram (27.2 mg of iron/pound) of body weight.