Combinations - 5-htp + Ssri

[Cuba]

I've been doing some research lately on 5-HTP and its positive effects.

-Boosts serotonin.
-Helps enhance mood.
-Helps contol appetite.
-Helps getting to sleep.

About 2 months ago, the doc put me on 40mg Paroxetine (Paxil but not CR) for depression and anxiety. Didn't notice any big changes at first, but through time, it helped out with anxiety and helped bring up my mood a bit. I also noticed the side effect of a bigger appetite that has caused me to gain 15lbs.

So 5-HTP seemed to be the perfect side kick for the Paxil to treat my anxiety and bringing up my mood.


*Both increase serotonin.
*The 5-HTP would offset the bigger appetite.
*And help me get to sleep.

All the information I could find is pretty unclear about the risks of 5-HTP alone. There is very little also about the interactions when combined with SSRIs and MAOIs.

There have been cases in the 1980's where people have gotten eosinophilia-myalgia syndrome (EMS) from L-tryptophan supplements like 5-HTP. Some investigators attributed this to contaminants in bulk tryptophan powder from a Japanese manufacturer, others are less certain.

In august 1998, researchers at the Mayo Clinic in Minnesota reported that the contaminant known as "peak X' had been found in 5-HTP.

L-Tryptophan is listeed in the USP and is Generally Regarded As Safe (GRAS) by the FDA.

NOTE: Rigid quality controll standards are no required for nutraceuticals (nutritional supplements) so substantial variability can occur both in the potence and the purity of these products.

Even more troubleing than the unclarity of this subject are the contradictions of the various studies and reports done.

So my questions for the wise is:

Has anyone attempted taking 5-HTP or any other L-tryptophan supplement with Paxil or another SSRI?

Does anyone know of some credible sources for information on this?

What exactly is "peak X"?

Any help, comments, advise would be greatly appreciated!

-Cuba

[Micklemouse]

SSRI's and tryptophan/l-5htp are listed by the BNF (British Natonal Formulary) as having a potentially hazardous interaction, heightening agitation (= anxiety, restlessness) and causing nausea in some people, tryptophan with MAOI's can cause cns excitation and confusion.

Increasing serotonin is not always such a good thing, and can very dangerous - run a search on Serotonin Syndrome for more info. Briefly though symptoms include confusion, headache, disturbed sleep, hypomania, agitation, hypertension, nausea and diarrhoea, tremor, twitching and inreased muscle contraction and relaxing (interestingly especially of the leftankle , and scarily this is one of the more advanced symptoms), increased heartrate, fever, and finally coma. Polydrug use will heighten the chances of this still rare but very real condition kicking in, - there a lot of substances, both illicit and prescribed, which boost the levels ofserotonin in the cns, antidepressants being just one class. Others include opioids (esp tramadol and pethidine), amphetamines (including adderall), acid, ecstacy, some atypical antipsychotics, dxm, the list goes on...

http://members.aol.com/atracyphd/syndrome.htm

So basically, given that you're taking a reasonably high dose of paroxetine, I wouldn't recommend supplementing it with 5-htp at this point. Speak to your doctor about he weight gain and any problems sleeping. Paroxetine can be a speedy li'l med, so given that it seems to be doing it's job with regards to the anxiety and depression it may be worth looking at reducing the dose and looking at other options, possibly including dietary supplements such as 5-htp, vit b complex, vit e, etc

Another point worth considering is that although boosting levels of serotonin can lead to an decrease in certain symptoms of depression and anxiety, it is by no means a cure. Ideally antidepressants should be used as an aid to getting some motivation back so that a person can a) carry on with their life as far as possible, and b) deal with the underlying causes of the problem.

Hope this helps a little Cuba!

[nanobrain]

Originally Posted by Cuba

So my questions for the wise is:

Has anyone attempted taking 5-HTP or any other L-tryptophan supplement with Paxil or another SSRI?

as the wise Micklemouse pointed out, and i'd like to concur: very dangerous and contraindicated combination. slight indiscrimination may lead to serotonin syndrome.

i found this out the hard way, long before SS or 5-HTP were widely known. almost ended up kicking the bucket in a very ugly fashion to the horror of my wife amongst the beautiful surrounds of the Getty Art Museum. on paxil and 5-HTP, accidentally took more of the latter.

now i may not be wise, but based on over 20 years of experience working in biomed, my advice is to try to get off the SSRI's ASAP. the long term physical and psychological consequences are just not worth it.

[Cuba]

I greatly appreciate your responsise, Micklemouse and nanobrain!!!

After doing more research on Paroxetine and its very negative consequences, I decided to stop taking the med cold turkey. As I am writing this it's been 4 days (and what a 4 days!!!) since I stopped my 40mg daily dose. Getting off paxil has been a huge challenge for me in th past, expecially while being on a dose as high as 50mg daily. Zen's thread about his daughter's experience was also a huge eye opener and motivation to get off the Paxil.

I'm going to keep this post rather breif because it's very hard for me to concentrate my thaughts while going through the withdrawal effects. When these effects lessen, I want to pick you brains more about this medicine to answer some of my questions and possibly help who are currently taking this medicine.

A few quick questions, and please excuse my ignorance:

nanobrain:
-what do you mean by "kicking the bucket"?

-Please explain how you accidentally took "more of the latter" and what this means.

Even though you claim you may not be wise (which is very humble), Keep in mind nano, that you've been working in biomed longer than I've been on this earth. So any advice you can give me will be greatly considered and emensly appreciated! Thank you as well Micklemouse for taking the time so answer my questions and help out my situation.

-Cuba

[nanobrain]

Originally Posted by Cuba

I decided to stop taking the med cold turkey. As I am writing this it's been 4 days (and what a 4 days!!!) since I stopped my 40mg daily dose.

A few quick questions, and please excuse my ignorance:

nanobrain:
-what do you mean by "kicking the bucket"?
-Please explain how you accidentally took "more of the latter" and what this means.

-Cuba

'kicked the bucket' means died. of the latter - i meant more 5-HTP, forgot i took the dose and took another 100mg. thats all it took.

now, getting of paxil cold turkey is very tough indeed, you may be experiencing all sorts of nasty effects - electric shocks, nausea, vertigo, depression, if it becomes too much, you can administer 4-5mg to stop from going postal. sorry, i meant if the 'side effects' from acute discontinuation get to be too much.

i hope you are over these by now, let us know how you are going.

[Cuba]

Thanks for the clarification nano. So the past few days seemed like all the effects were gone.

In past experiences trying to get off paxil, administering smaller doses to stop from going "ape shit" only made me depend on the smaller dose or made it psychologically easier to go back to the regular dose. So this time I decided to be a soldier and just fight through the effects. I wouldn't recommend this for anyone, but I decided it was the best thing in my own situation. I knew that I would be a complete maniac becouse of this so I forewarned my family, and friends not to take my bursts of rage personally and that they would be gone in a while.

Some effects I experienced in the past couple weeks:

-Electric shocks all through my body with simultanious light headedness. (got so bad sometimes I had to sit down for a couple minutes and stop whatever I was doing)

-Vertigo which also was so bad sometimes that I had to sit down and stop whatever I was doing.

-Going ape shit/postal/berzerk. The smallest things would throw me over the edge. Something as small as spilling a glass of milk at the table, caused me to snap and kick the chair accross the room. Road Rage was the worst, and I'm a very laid back, "chill" person by nature, but someone driving slow would make me want to throw a milk shake out the window at their car(would have if girlfriend wouldn't have stopped me). My brother is my best friend, confidant and overall favorite person and I grabbed him by the hair and almost smashed his face into a brick wall for a reason so small I can't remember right now.

-I fought the depression and anxiety side effects by staying busy and running/working out. This is something I did much more than previous times I've tried to get off paxil, and it made a tremendous difference.

So even though all these withdrawal effects were very intense, I guess it beats kicking the bucket.

I was thinking of using a short acting SSRI, such as pharmaceutical kanna, for when I start getting anxiety and depression. What could you advise me about this?

Also for all the others out there taking Paroxetine, what in your opinoin are the biggest long term physical and psychological consequenses of this drug.

Thanx for all the help again nano.

-Cuba

[Micklemouse]

Glad your still there Cuba! I did get a bit worried when I read that you were cold turkeying the Seroxat - I've nursed people through this so know how hard it is. Well done mate - you're now officially a Seroxat Survivor! It takes a lot of strength to go through a withdrawal like that. It's not recommended, but I understand your reasons for doing it. Letting your friends and family know what to expect was also a very wise move - sounds like you've got a strong support network there. Again, well done Cuba - you should be proud of yourself, and the people around you for putting up with it!

So now you're med free! What next? Give yourself a few more weeks to fully 'flush out' before thinking about anything with a SSRI effect, even herbal based. Keep on doing what your doing - keeping busy, exercising, etc - and concentrate on your diet, maybe introducing some supplements. I've found the following have helped me to keep my head above water over the last few years - Selenium; Magnesium & Zinc; Vitamin E & Omega 3, 6 & 9; Iron; Vitamin B Complex (the strongest you can find, and time release if you can get it); and last but not least Ginko Biloba. The vitamin B is the important one though, especially if you're still thinkingof trying 5HTP. Most people it seems are quite drastically deficient in the b vits, plus it helps metabolise the 5HTP and convert it into usable serotonin.

As for the anxiety and depression - when it gets acute, try to rationalise it, and let it pass. Look at what the root causes are, and work at changing your relationship to those situations. You may want to look into finding a good counsellor to help you pick your way through it all, cos believe me it's not an easy road. Well worth it in the end though! I'll try to dig up a few links in the next day or so in regards to your other questions.

Meanwhile, keep on keeping on mate - sounds like you're doing o.k.

[TruthSeeker]

Julia Ross (in her books listed below) turned me on to amino acids and it had a big impact on me. 5-HTP was good, but noticed an even better effect from L-Tyrptophan. You're giving your body what it needs to create the transmitters you need. She claims Tryptophan was used before Prozac, and that when Lily was trying to get Prozac to be used by phasicians, they wouldn't use it since the Tryptophan was already working for people. They also were trying to get doctors to reconsider since the SSRI would boost the effects of Tryptophan, which didn't go over either.

Some time after this, a company out of Japan made a bad batch of this particular amino acid, making some sick and killing others. The FDA proudly BANNED the amino!

I have taken SSRI's with the amino acids and have had positive results. The trick is to take lower doses of both and steer clear of what is called "Seratonin Syndrome" which is very very bad. The body makes seratonin out of Tryptophan, while the ssri will maintain or build up or not clear out what it has already.

[TruthSeeker]

Just want to add one more note, St. John's Wort supposedly works like an SSRI. I'd suggest looking into.

btw, i'm not a doctor