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This is because multiple medications have been shown to deplete Vitamin B6 , including: Antidepressants including Fluoxetine (Prozac), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), Escitalopram (Lexapro), Bupropion (Wellbutrin), Mirtazapine (Remeron), Venlafaxine (Effexor), Amitriptyline (Elavil), Doxepin (Adapin), Imipramine (Tofranil), Desipramine (Norpramin), Nortriptyline (Aventyl), Protriptyline (Vivactil)

doi: 10.1080/07853890.2021.2024875 111

The FDA does not approve compounded medications the same way it approves brand-name drugs

It contains pyrethrins, sesamin, traces of essential oils, and a wide range of other chemical compounds

This helps prevent/reduce harmful cardiac remodeling or pathological changes

As additional approved options, particularly more convenient oral therapies, enter the market, FDA may have less tolerance for compounded alternatives marketed at scale