Drug info - 5-HTP for depression

[Jadegreen]

Last August I was prescribed sertraline (Zoloft) for depression. When I first started taking it, the side effects were horrible, but after about 3 days, they alleviated. However as I continued taking it, I felt less and less like myself, and I was getting snappy at people, getting angrier more easily.

About the same time I went on Zoloft, I had heard about 5-HTP, which I learned contained precursors to the production of serotonin, which is the chemical that Zoloft 'recycles'. Since I was no longer taking Zoloft as I was unhappy with the long term effects, I started taking 5-HTP. The first time I took it, I threw up. I don't know if it was coincidence or because of the drug, but it scared me from taking it for awhile. However I started feeling mentally worse every day, so I figured "it was probably just a fluke" and decided to take 5-HTP this morning.

I won't be able to tell short term effects until I take it again tomorrow.(I also took an ephedra and guarana herbal blend - of course a stimulant will make you feel good!) And the long term effects will not be known until a couple months have gone by. However I am willing to stick with it and see what happens.

So, does anyone here have experience with 5-HTP? Even in recreational situations? Any input about 5-HTP, Zoloft, or other depression treatment (drugs or not) would be appreciated.

((I'm sorry if this is in the wrong forum - I wasn't quite sure where to put it))

Reputation Comments on this post:

good thread started here

[Jadegreen]

To clarify dates, which may be confusing:

August-October - I took 100 mg of Zoloft daily
Mid-October - I stopped taking Zoloft (first going down to 50 mg)
Late-November - took 5-htp for the first time (and threw up)
Today - took 5-htp again, and have not thrown up yet! ^_^

[howlongisthenight]

SWIM is currently taking 50mg 5-HTP to combat self diagnosed depression. SWIM may not actually have it, but symptoms included:
-always being tired
-finding life dull
-having low self-esteem
-sleeping too much

SWIM has been taking it for a week and it seems to be working. SWIM hadnt had bad day since taking it, SWIM is no longer ruminating about his faults, and he seems to be more of an optimist. Of course, at this point this could all be coincidence and SWIM may just have started taking it at a good point in his mental cycle. Placebo effect could also be present as well. But SWIM will not say that it doesnt work as of yet.

Reputation Comments on this post:

interesting, please add more details if possible, and updates if anything changes

[gotxp]

Id also look into SAMe, I personally feel it works better for depression in my experience. The only problem with SAMe is it is much more expensive.

[DrMuffy]

Well if SWIY does not like prescription anti-depressants (which porzac works superbly for me) he may want to try St. John's Wort also, it is a natural Sertatonin Inhibitor, so it could help. But SWIY might want to try other prescription anti-depressants, because there are many others which do not create the same side effects of Zoloft. Haha, SWIdr suggests SWIY consult a real doctor about treatment. Hope ths helps you out with this predicament!

[Jadegreen]

I'm going to wait until after my current psych retires to go back; I don't think it would be wise to start a new script with a doctor about to retire. (He's retiring in May) So until then I'll stick with the 5-HTP which seems to be working as well if not better than the Zoloft.

(If we're talking about doing legal things, we don't have to use SWIM, right?)

[DrMuffy]

Answering that last question: This site is very strict with the "SWIM, SWIY" rule, which I do not blame them for due to legal issues. It is hard to know when to use SWIM or I in some discussions, but now that I think about it, it would be aprapo to use "I or you" in this discussion.
But back to the subject, yes that is a wise idea. Also, experimenting with different anti-depressant (prescribed by medical physicians of any kind) trials can be time consuming and vigorous, so if you think th 5-HTP is working well for you, you might just want to stick with it.

[London_Bloke]

Even though it may not be strictly necessary to use SWIM, it can be argued that the continued use of SWIM serves to keep one always vigilant against self-incrimination.

SWIY can never be dinged points for self-incrimination if SWIY never uses anything but SWIM.

It's somewhat like the old adage that if one always tells the truth, one need never keep one's lies straight. Constant use of SWIM means one less thing worry about.

[Cavy182]

SWIM was on SSRIs for about nine years for chronic depression. He used them all, Prozac, zoloft, etc. About eight months ago SWIM and mate discovered RCs, particularly phens. Read a thread that indicated use of SSRIs might mitigate the effects of seritonin reacting RCs so SWIM, perhaps unwisely, stopped taking his SSRIs in hopes of enhancing the effects of the RCs which he was becoming increasingly fond of. Stopping the SSRIs did have the desired effects of enhancing the RCs but SWIM was worried about his depression, which had been in check for many years, returning. SWIM's mate showed him a thread on 5-HTP use in mitigating the MDMA crash. SWIM couldn't exactly bring the subject up with his shrink of doing recreational drugs so he decided to experiment with 5-HTP use instead of the SSRIs. SWIM is not a doctor and does not pretend to have any answers for anyone except SWIM but replacing the SSRIs with regular 5-HTP (100 mg twice a day) use has effectively kept the depression away. Again, SWIM is not suggesting that everyone go off their SSRIs but for this cavy 5-HTP has set him free.

[howlongisthenight]

So after a while on this substance (and increasing his stack to include some nootropics) SWIM is still reporting positive results. Again, it is nothing you're going to take and be like, "hey I'm euphoric!" But over time SWIM has been much more positive then in the past, and seems less prone to worthless brooding. SWIM is making strides in many different hobbies and is doing well in school. 5-htp isn't that expensive, so SWIM reccomends to anyone who is interested to give it a trial and see how it works over a period of a month or so. Cheers!

[Fantasian]

SWIF found 5HTP massively effective for fighting the depression associated with post MDMA use. It may only be effective in this contect because of how the depression is caused (ie lack of serotonin due to MDMA).

SWIF when feeling down post use uses a high dose of Vitamin b6 (50mg) (which is used to create dopamine and serotonin) combined with a medium to high dose of 5HTP (150mg)

SWIFs mother also is using 5HTP for post traumatic stress and finds it is effective however much less effective than SWIF finds it. She finds she gets tired and sleepy during the day while using it though.

[howlongisthenight]

Wikipedia says this, ". Contrary to the recommendations of supplement providers, 5-HTP should not taken concomitant with Vitamin B6, as the combination can lead to toxic accumulation of 5-HT (seratonin) in the blood."
But SWIM trusts SWIY and is happy to see that SWIY has found a theraputic dose for SWIY.

[Nacumen]

Originally Posted by howlongisthenight

Wikipedia says this, ". Contrary to the recommendations of supplement providers, 5-HTP should not taken concomitant with Vitamin B6, as the combination can lead to toxic accumulation of 5-HT (seratonin) in the blood."
But SWIM trusts SWIY and is happy to see that SWIY has found a theraputic dose for SWIY.

I was about to quote the same thing.

Here's a little story for you all, followed by some potentially critical information.

Today SWIM was browsing his local supplement supplier for cheap 5-HTP to buy. SWIM always buys the generic version of a drug if he can, because, well, an active ingredient is an active ingredient is an active ingredient. After comparing the prices of 3 different kinds of 5-HTP (let's call them Brand X, Y, and Z), he chooses Brand Z and goes to the checkout line. While waiting, he glances at the back of the pill bottle in boredom, and suddenly notices that he forgot to check the ingredients on this particular brand's bottle. To SWIM's surprise and dismay, not only was there 50mg of 5-HTP in each pill of Brand Z, there were a slew of other active ingredients and vitamins, including Vitamin B-6.

SWIM had luckily just read the wikipedia entry on 5-HTP the night before, and this struck him as a dangerous red flag, but he was of course confused as to why two conflicting chemicals would be included in the same pill. SWIM put the questionable 5-HTP back onto the shelf and instead selected the slightly more expensive brand, Brand X which, as SWIM double-checked, contained only 5-HTP as an active ingredient. SWIM checked out and drove home, thankful that he had done the responsible thing and prevented possible issues down the road, unless of course, he was wrong, but he felt better safe than sorry.

After a return visit to wikipedia, SWIM rediscovered the section that provided him the information, then checked it's source to determine it's legitimacy, and currently SWIM has no reason to distrust it.

Reading the original source gave some interesting information that I think is worthwhile to share here.

"Alas, one company I know packages their 5-HTP in 50 mg
capsules with 10 mg of B6. They do this ostensibly so that 5-HTP
can be converted to serotonin in the brain. Duh. This insures
that any 5-HTP will get converted to serotonin in the liver
instead, and thus never make it to the brain. Vitamin B6 is the
*LAST* thing you want in an 5-HTP product.

At the very best, people who take B-vitamins with 5-HTP, or
who take 5-HTP products with B6, waste their money. All this
would be merely humorous (caveat emptor) were it not for some
other facts. At worst, ignorant people fooling with 5-HTP
actually risk their health, since serotonin in the peripheral
blood is not benign. Serotonin causes not only harmless flushing
and diarrhea, but people with serotonin secreting tumors (hindgut
carcinoids) also have problems with fibrosis of the endocardium
and valves in their right hearts, which can cause heart failure.
This fibrosis is caused by the serotonin. This effect can also
be seen with dietary intake of only modest amounts of serotonin,
and there has actually been described in the medical literature a
tribe of South Sea islanders with right heart fibrosis as a
result of eating green banana mash (matuki), which poisons them
with its serotonin content. No, I'm not making this up. The
hydroxylation of tryptophan is a rate-limiting step in the
peripheral production of serotonin, and one bypasses it at one's
peril.

How much does it take? Several hundred milligrams of 5-HTP
taken per day, if converted to serotonin, would result in a
urinary excretion of the serotonin metabolite 5-hydroxyindoleac-
etic acid (5-HIAA) of several hundred milligrams also-- an amount
well within the urinary excretion range of the average person
with a serotonin producing carcinoid. Such a dose of 5-HTP
certainly would result in a serotonin blood load comparable to
that of green-banana-diet eating people who have
serotonin-induced heart valve disease. Normally, people do not
excrete breakdown products of more than 10 mg of serotonin
metabolites per day. If you take one capsule per day of 50 mg
5-HTP with 10 mg B6, however, you would be expected to go to at
least 50 mg per day of 5-HIAA in the urine. Less metabolism in
the liver (less B6) would result in less 5-HIAA in the urine. If
you are going to take 5-HTP, therefore, you probably need 5-HIAA
urine monitoring, to figure out just how big a dose of systemic
serotonin you're actually getting (and incidentally, how much
5-HTP you're wasting)."

The author of this source may well be on the payroll of Brand-Z, but I sincerely doubt it. Anyway, I'll leave that up to you guys to decide. I'm no authority on the matter, but the logic behind the argument makes sense to me.

Always research what you take, and always double-check what's in a bottle, even if it's labeled "5-HTP", you might be getting more than you bargained for. Of course, asking your physician never hurts either.

As the author of the article said, "Caveat Empor".

Reputation Comments on this post:

	very interesting info, though a personal evaluation of the source's comments and/or experiences would be nice for contex...
	All around great post...informative

[pankreeas]

Swim seconds the notion to try Sam-e. Canada only just got wise to the many benefits of it. I believe it was banned for quite some time before that.

Here's an article that gives a good overview of Tryptophan for depression and seratonin deficiency syndrome, without getting too technical.

The Serotonin Deficiency Syndrome:
A Holiday Tale
of Tryptophan, Serotonin, Melatonin & Tinnitus

by Barry Keate

If you’re like me, you had a very enjoyable evening on Thanksgiving. After dinner and throughout the evening I was feeling very content and at ease. After a mellow evening, I slept like a baby. The next day we had leftovers for dinner and had the same great evening. I had a wonderful night’s sleep that night too. That turkey really did a number on me and was a welcome introduction to the holiday season.
Most of us know, I believe, that it’s the tryptophan in turkey that promotes the sense of well-being we associate with Thanksgiving. I began to wonder if this could have an effect on tinnitus and the anxiety and stress that often accompany it. I began to look into the effects of tryptophan. What I found out was very interesting and quite surprising. I believe there is a definite connection between tryptophan and the way many people experience tinnitus.
Tryptophan is an essential amino acid which means it is not produced by the body but rather must come strictly from the diet. There are eight essential amino acids and fourteen non-essential amino acids. The non-essential acids can be made inside the body from other components. Dietary sources of tryptophan include turkey and other meats, soy products, cottage cheese, milk, brown rice and peanuts.
In the brain, tryptophan converts to serotonin, the neuro-transmitter responsible for feelings of well-being, calmness, personal security, relaxation, confidence and concentration. Decreased serotonin levels play a key role in the development of depression. The only source for serotonin in the brain is tryptophan. It cannot be converted from any other substance. If there is not enough tryptophan in the diet, it can lead to anxiety and depression.
Depleted serotonin levels are responsible for depression and other psychological disturbances, such as anxiety, insomnia, fatigue, low concentration and low self-esteem. This is what has increasingly become known as the Serotonin Deficiency Syndrome.
Some serotonin is converted in the pineal gland to melatonin, which regulates sleep patterns. Melatonin has been shown to be helpful in getting a good night’s sleep and in some cases reducing tinnitus symptoms. A clinical study conducted at the Shea Ear Clinic in Sarasota, FL, tested 3 mg melatonin on tinnitus patients for one month. They found that those people who did not have trouble sleeping were not greatly benefited by the melatonin. However, of the people who had difficulty sleeping, 47% reported an overall improvement in their tinnitus.
My personal experience is that 3mg of melatonin will put me right to sleep, however I wake up in the middle of the night. I feel rested but I’m wide awake at 3:00 AM. I find that 3 to 6 mg of time-release melatonin will keep me asleep all night long.
There are basically two ways to rectify the Serotonin Deficiency Syndrome. One method is through the natural method of increasing tryptophan intake and the other through the use of anti-depressant medications such as Prozac. This is where the story gets very interesting.
There is a class of pharmaceutical medications called Selective Serotonin Reuptake Inhibitor (SSRI) anti-depressants. SSRI anti-depressants include Prozac, Paxil, Zoloft and others. Their method of treatment is to concentrate existing levels of serotonin in the brain so they stay in the synapse between nerves and facilitate communication. They do not create serotonin, as many people believe, but simply collect the existing serotonin so it is used more effectively. Some studies suggest that long term use of SSRI anti-depressants actually reduce serotonin levels.
SSRI anti-depressants are in wide use today and prescribed for many people with tinnitus. In some cases they help but there are a host of side effects. Some of the more serious side effects include heart palpitations and chest pain, decreased libido, suicide (this has been in the news recently as it affects teenagers), nervous system disorders and tinnitus. The Physician’s Desk reference lists tinnitus as a frequent side effect of SSRI anti-depressants. There are no side effects to supplementation with tryptophan. So here we can have a situation where an individual who is depressed because of tinnitus is prescribed a medication that is a known cause of tinnitus.
Tryptophan is easily obtainable and fairly inexpensive dietary supplement available at most health food stores or online. The L-Trytophan version is best and is best taken without protein which can hamper absorption. It is used regularly used in Canada, the Netherlands, the UK, Germany and France. There have been no reports of any serious or widespread health problems.
This was not always the case in the US.
The following had been reported in many journals and media outlets. (I found some of the information on the Life Extension Foundation website in an article titled “The FDA Ban of L-Tryptophan: Politics, Profits and Prozac” by Dean Wolfe Manders, Ph.D. Dr. Manders has extensively researched and lectured on the medical politics of tryptophan.)
In 1989, there was a spontaneous outbreak of a rare and deadly disease in New Mexico called Eosinophilia-Myalgia Syndrome, or EMS. The common cause was traced back to the fact that all the people who became sick had been using tryptophan as a dietary supplement. EMS caused the deaths of 37 people and permanent disability in another 1500. The FDA immediately issued a recall of all tryptophan on the market.
Later, researchers at MIT identified the true culprit as a contaminant in the tryptophan that came from one specific company. The Japanese manufacturer, Showa Denko, was trying to speed production by using untested, genetically engineered bacteria in the fermentation process. This produced a toxin called EBT which made its way into the final product. They also cut corners in the purification process by reducing the amount of activated charcoal used to filter the final product by 50%. Showa Denko was much more interested in beating their competitors to market than in good manufacturing practices. This company is a highly unethical pharmaceutical manufacturer which once actually blew-up part of its plant to thwart a Japanese government investigation which would have proved their culpability in contaminating a river with mercury.
The MIT researchers presented their findings to the FDA showing the tryptophan was not to blame for causing EMS. In February, 1993 a US patent was awarded to use tryptophan to treat and cure EMS, the very same deadly condition which prompted the FDA to take tryptophan off the market in the first place. Nonetheless, the FDA held firm and tryptophan is banned in over-the-counter sales in the US.
But there were loopholes to this. The FDA allowed tryptophan to be imported into the US from Ajinomoto Company in Japan. It is then distributed from the Ajinomoto USA facility in Raleigh, North Carolina through a network of compounding pharmacists across the US. It can only be purchased by individuals with a doctor’s prescription. It emerges as a new prescription medication in the serotonin marketplace. One hundred capsules of 500 mg each costs about $75.00, approximately five times more than if it were sold as a dietary supplement. It is also covered by medical insurance and adds yet another burden to our vastly overstretched medical system.
A greater irony is that tryptophan is routinely used in baby food produced and old in the US and the Department of Agriculture still sanctions the use of tryptophan used as a nutritional and bulk feed additive in the commercial hog and chicken farming industry.
One other very curious fact arises. The FDA banned tryptophan on March 22, 1990. Within four days, March 26, 1990, Newsweek featured a lead article praising the virtues of the brand new anti-depressant drug, Prozac. Its multi-color cover displayed a floating, gigantic green and white capsule of Prozac with the caption: “Prozac: a breakthrough drug for depression.”
The fact that the FDA ban of tryptophan and the Newsweek Prozac cover story occurred within four days of each other went unnoticed by both the media and the public. Yet to those who understand the effective properties of tryptophan and Prozac, the concurrence seems unbelievably coincidental. One possible explanation for this can be found in a report by the FDA Dietary Supplement Task Force on June 15, 1993. It had been working on developing FDA policy toward nutritional supplements. On page two, the report states, “The Task Force considered various issues in its deliberations; including … what steps are necessary to ensure that the existence of dietary supplements on the market does not act as a disincentive for drug development.”
With the advent of the Dietary Supplement Health and Education Act of 1994 (DSHEA) dietary supplement companies have been able to manufacture tryptophan again.
Clinical depression is a very serious condition and treatment through medication is often the right and prudent action to take. However next time a doctor wants to write a prescription for an anti-depressant, you may wish to suggest tryptophan. Or you could simply … have another piece of turkey and a glass of warm milk.

[Ximot]

With this 5-HTP fibrositis issue, does anyone know whether L-Tryptophan itself is safer?

[Fantasian]

SWIF has found it somewhat hard in the UK to find a 5HTP only product, all of them appear to come with 5HTP and B6

[Micklemouse]

AAAARRRRGGGGHHHH!!!!!!! When is this misinformation going to end!!!

1) Tryptophan from turkey. Absolute twaddle I'm afraid. The amont of tryptophan in a serving of turkey is negligible, & certainly nowhere enough to cause sleepiness, never mind cross the blood-brain barrier. What people are experiencing after such hearty meals as Thanksgiving or Christmas is a carbohydrate torpor, brought about by the fact that digesting large meals takes energy before energy is gained & fats used in the preparation or released from the bird also slow down the metabolism as a whole. In order for tryptophan to cause drowsiness it needs to be taken on an empty stomach, & without the presence of proteins. What is involved in a turkey dinner? A full stomach & loads of protein... In fact carbohydrates may play a bigger part in the increase of serotonin in the blood stream

http://chemistry.about.com/od/holida...iredturkey.htm

Thanksgiving Mystery: Does Turkey Make You Sleepy?

As for milk, certainly regular drinking may supplement the amount of serotonin in the body to an extent, but again there is not enough to cause drowsiness.

2) This whole fibrositis, 5htp & vitamin b thing - there is no hard evidence whatsoever to support this misinformation. The newsgroup posting linked to above contains no references, & only 10 year old supposition (yes, check the dates! It's over 10 (ten) years old!). If hard evidence that this was even a possibility had been found, do you really think these combination supplements would still be on the market? Come on folks! The FDA & related organistions around the world are a lot more keen to jump on supplements than they are on "traditional " meds.

I repeat, & spell out large -

M-I-S-I-N-F-O-R-M-A-T-I-O-N

Remember also, that while there is a lot of good stuff on Wikipedia, it can also be edited by anyone with an agenda, potentially completely negating it's usefulness & reliability as an information source.

SWiFantasian - Nature's Aid 5htp contains no other active ingredients. A little pricey, but good stuff!

Reputation Comments on this post:

M-I-S-I-N-F-O-R-M-A-T-I-O-N, stamped it out.

[Fantasian]

Thanks Mouse. In your oppinion would you stick to the 5-HTP stand alone forumla's too? SWIF is looking from the point of view of serotonin depletion due to various recreational substances.

[Micklemouse]

Horses for courses really. A Certain Mouse rates the Nature's Aid Hydroxytryptophan highly, for avoiding "that Tuesday feeling", & for treating depression. He can't see anything wrong with the combination brands per se though - if you need a boost in yer vitamin B's (& many people do!), then why not take them both together in one handy tablet? A Certain Mouse has used them & had good results. The Mouse's preference is to take them separately though- he doesn't need a regular boost in serotonin anymore, & has a relatively healthy diet so his supplement intake is less than it used to be anyway. However, if his alcohol intake steps up he'll step up the B complex, if his mood drops he'll step up the 5htp, & if he has a heavy weekend partying, he'll step up both (preloading with B complex, postloading with 5htp as preloading just leads to mess!).

[Nacumen]

Micklemouse, you simply state that the science presented in the wikipedia article is false, yet you fail to state why, the most crucial element of all when denouncing such a thing. At this point, I am more inclined to believe the article, because the author at least gave a logical explanation of why the combination is potentially dangerous (even if it isn't true, it at least made sense to me).

Please prove the article wrong using facts for the betterment of our collective knowledge. Otherwise, we are lost and do not know what to believe.

[Bajeda]

Originally Posted by Nacumen

Micklemouse, you simply state that the science presented in the wikipedia article is false, yet you fail to state why, the most crucial element of all when denouncing such a thing. At this point, I am more inclined to believe the article, because the author at least gave a logical explanation of why the combination is potentially dangerous (even if it isn't true, it at least made sense to me).

Please prove the article wrong using facts for the betterment of our collective knowledge. Otherwise, we are lost and do not know what to believe.

Its not that the facts are necessarily wrong, its that they aren't really supported by evidence.

I'd keep the comments in mind, but since it seems there is only a theoretical basis for the suggested actions, I wouldn't lend them much credence.

Whatever the case, I prefer 5-HTP alone and unadulterated. If people take it with vitimin B6 thats fine too. If they notice diminished effects or negative effects they can find something else or switch to 5-HTP alone and see if thats better.

The article isn't of much use if it doesn't empirically support any of its claims in a way that could be taken seriously.

[Micklemouse]

This was found on a commercial site, hence no url or link to it it is however easily found. Relevant paragraph to vitamin B in bold. Of course people are generally not monkeys or rats, however, if 'Dr' Harris's concerns had had any basis in reality rather than supposition surely we would have heard a lot more about it in the past decade?

5-HTP Safety

'
James South M.A.

Last month, a WARNING ABOUT 5-HYDROXYTRYPTOPHAN was mailed to many members of the life extension/nutritional supplementation community. This Warning alleges that little, if any, benefit is to be gained through use of 5 -Hydroxytryptophan (5-HTP), and that anyone using it is actually risking death!
What are the claims made against 5-HTP in this Warning, and what can be said about the relevance and truth of these allegations?

The Warning claims that 5-HTP should be used (if at all) only with a peripheral decarboxylase inhibitor (PDI). Yet large numbers of studies reviewed by Zmilacher et al (1) found 5-HTP more effective without PDIs than with them and with fewer and less serious side effects. Zmilachers own study of 5-HTP both with and without a PDI reported in the same article found notably more, and more serious, side effects from 5-HTP when combined with a PDI. Thus, the relevant scientific literature simply does not support the claim that 5-HTP is neither safe nor effective without a PDI.

The Warning claims that without a PDI most or all of the 5-HTP will be converted to serotonin in the bloodstream outside the brain; and since serotonin does not cross the blood-brain barrier, this would nullify any hoped-for brain benefit from 5-HTP. Yet successful studies (only some of many published) using 5-HTP without a PDI (1,2,4,6,11) clearly refute this contention. Furthermore, studies infusing tryptophan or 5-HTP directly into the bloodstream of human subjects have been performed, and these studies have not found any increase in blood serotonin caused by increased blood 5-HTP. Thus, one report states: Six healthy male subjects received ... 5-hydroxy-L-tryptophan (5-HTP) ... on two occasions in a randomized cross-over study. There were marked increases in urinary 5-HTP and 5-HT [serotonin] excretion after infusion of [5-HTP] ... . This occurred without significant changes in blood 5-HT [serotonin] levels measured in platelet-rich plasma. (23) Another report using intravenous tryptophan infusion stated: ... 5-hydroxy-Trp [5-HTP] rose rapidly and massively after Trp[tryptophan] infusions, at the 5 g dose more than ... 20-fold[!] ... and declined rapidly to about 5-fold baseline levels within 2 hours. Whole blood serotonin levels were almost unaffected by the Trp [tryptophan] infusions [in spite of the massive conversion of the tryptophan to 5-HTP in the blood]. (24) Thus, both clinical studies and blood serotonin measurements in response to dramatically increased blood 5-HTP levels fail to support the Warning claims that 5-HTP without PDI will only elevate blood serotonin and not brain serotonin levels.

The Warning circulating in the life extension/nutrition community also states that the high blood levels of serotonin (allegedly) ensuing from using 5-HTP without PDI, would cause blood platelets to clot up, triggering a heart attack, or cause a spasm of heart arteries (coronary artery vasospasm), also triggering a heart attack. Again, if this were a real-world-problem, then the many test subjects taking 5-HTP without PDIs should have suffered numerous heart attacks yet nowhere is this mentioned in the vast literature on 5-HTP! It should be noted here that platelet-aggregation and vasospasm heart attacks can be triggered in moments, even in perfectly healthy and non-occluded arteries. Thus, even a single dose of 5-HTP, not to mention weeks or months of 5-HTP use, would be sufficient to elicit a heart attack, if this were really a serious problem. As Byerley et al note in a major review article on 5-HTP use: Researchers who reported on the results of various laboratory functions (hematologic [i.e., blood], liver, kidney, etc.) found that 5 -HTP caused no significant changes ... . Oral administration of 5-HTP, with or without carbidopa [a PDI], is associated with few adverse side effects. (2) As Poeldinger et al note: In general, 5-HTP-induced adverse events worthy of note are rare within the therapeutic dosage range. (4)

Those concerned about even the theoretical possibility of 5-HTP use triggering platelet-aggregation heart attacks or coronary artery vasospasm heart attacks may minimize any such risks through a nutrient supplement program that specifically inhibits these two problems (which, of course, can and do occur in people who never take 5-HTP). According to Melvyn Werbach, M.D., 1 gm of vitamin C three times daily, 400 - 600 iu vitamin E daily, 500 -1000 mg calcium daily, 400 - 600 mg magnesium daily, 200 mcg selenium daily, and 1.5 gm EPA from fish oil daily will significantly reduce risk of platelet-aggregation and vasospasm heart attacks. (27,28)

The Warning also claims that Americans use of vitamin B-6 supplements further worsens 5-HTPs (alleged) danger, since B-6 activates the enzyme that could convert 5-HTP to serotonin in the bloodstream. Yet experiments with monkeys (18) and rats (19) fed even moderate excess amounts of B-6, increased brain serotonin production up to 60%--an impossible finding if B-6 would cause the bulk of ingested 5-HTP to be prematurely converted to serotonin outside the brain. And xxxxxxx xxxxxxx xx xxxxxxx, one of Americas premier mail-order compounding pharmacies, has been selling (by prescription) a 100 mg 5-HTP with 12.5 mg B-6 (and no PDI) since 1990 with no problems.

The Warning also offers the scary scenario that a rare type of serotonin-secreting tumor, called hind-gut carcinoid, may also be associated with fibrosis of the heart muscle and heart valves, and heart failure. However, the Warning offers no evidence (and doesnt really claim, but merely implies) that taking 5-HTP supplements at reasonable doses would actually cause these tumors, or the heart damage occasionally associated with them (one study found 19 out of 604 carcinoid patients with high blood serotonin and valvular heart damage). (20) Furthermore, studies of carcinoid heart patients have been done which find no correlation between blood levels of serotonin and the heart disease sometimes found with carcinoid syndrome. Thus one report notes: We have also studied the correlation between plasma hormone levels (e.g., 5-hydroxytryptamine {5-HT} [serotonin] and substance P) and the degree of cardiac involvement... No correlation between blood levels of 5-HT or substance P and heart involvement was found. (25) Another report states: Analysis of the data shows that unlike animal models, there is no difference in serum serotonin and urinary 5 hydroxyindole acetic acid [the chief serotonin metabolite] levels in patients with carcinoid syndrome with or without cardiac involvement (26) Nonetheless, prudence suggests that in those rare individuals suffering metastatic carcinoid disease, 5-HTP use should probably be undertaken only with a physicians recommendation and supervision.

The same paragraph mentions a tribe of South Sea islanders with right heart fibrosis as a result of eating green banana mush, which poisons them with its serotonin content. Firstly, it should be noted that 5-HTP is not serotonin, and the brains rapid absorption of 5-HTP from the blood provides an escape hatch from the bloodstream for ingested 5-HTP, before it can be converted to serotonin in the blood. If preformed serotonin were ingested and absorbed (as from the green banana mush), it would not have this same brain escape hatch to remove it from the blood. When high serotonin diets have actually been studied, (21) increases of blood serotonin have been neither consistent, nor as high as that seen in the carcinoid patients.

Lastly, the Warning asserts that taking 5-HTP is safe only if one has regular tests to determine urinary levels of 5-hydroxyindole acetic acid (5HIAA). 5HIAA is the chief breakdown metabolite of serotonin. The Warning asserts 5-HTP is safe only if urinary 5HIAA levels remain low. Yet the 1992 Italian obesity study (11) that used 900 mg 5-HTP daily (without PDI) for 12 weeks found a 50-fold increase in urinary 5HIAA compared to the placebo-control patients. It also found no blood chemistry abnormalities in the 5-HTP group and no difference in side effects between the 5-HTP and placebo patients. The study concluded by stating: ... the good tolerance to 5-HTP treatment observed suggest[s] that this substance may be safely used in the long-term treatment of obesity. The Warning claims that Some people ... could suffer from a lethal serotonin peripheral overload [from 5-HTP ingestion]. Yet in the hundreds of papers published on 5-HTP during the past 30 years, I have not been able to uncover a single reported incident of death or serious injury from oral 5-HTP use. The Warning also does not cite even a single published medical reference to any such presumed death or injury.

In summary, the anti-5-HTP allegations made by the Warning are falsified by the vast body of published scientific literature on 5-HTP. The main side effect occasionally experienced by 5-HTP users reported in the scientific literature is gastrointestinal (GI) upset gas, nausea, diarrhea, and cramping. This GI upset happens only to a minority of users, and even then, only occasionally. It usually lessens or disappears in the first few days or weeks of use. The published studies also indicate that taking 5-HTP with food (i.e., partway through a meal or snack) also minimizes the risk of GI upset. Starting with a low dose (25-50 mg) and increasing the dose slowly (every 3 - 5 days) up to a maximum of 200 - 300 mg daily will also minimize risk of GI upset. Total daily intake should be divided into 2 - 4 doses, with no more than 100 mg per dose. Those suffering from gut disorders, such as ulcers, irritable bowel disease, Crohns disease, celiac disease (sprue), etc., and those with just an extremely sensitive GI tract, should probably use 5-HTP with great caution, or not at all. The use of aloe vera juice/gel and/or ginger extracts may lessen or eliminate the occasional GI side effects of 5-HTP.

A final note of caution: 5-HTP may intensify the effects of various antidepressant drugs. Van Praag notes that 5-HTP combined with the tricyclic antidepressant clomipramine proved more effective than clomipramine alone. (22) Yet because of the potentially powerful but unpredictable synergy to increase brain serotonin when 5-HTP is combined with serotonin-potentiating drugs, those using MAO-inhibitor drugs, tricyclic antidepressants, SSRIs such as Prozac, Paxil or Zoloft, and the diet drugs Pondimin (DL-fenfluramine) or Redux (D-fenfluramine), should use 5-HTP only with medical supervision. Similarly, those wishing to reduce or eliminate their serotonin-potentiating drugs with 5-HTP, should do so only with medical supervision.

References:
1. K. Zmilacher, et al. L-5-Hydroxytryptophan Alone and in Combination with a Peripheral Decarboxylase Inhibitor in the Treatment of Depression. Neuropsychobiology. 1988; 20: 28-35.

2. W. Byerley, et al. 5-Hydroxytryptophan: A Review of Its Antidepressant Efficacy and Adverse Effects. J Clin Psychopharmacol 1987; 7: 127-37.

3. S. Risch and C. Nemeroff. Neurochemical Alterations of Serotonergic Neu ronal Systems in Depression. J Clin Psychiatry. 1992; 53: 3-7.

4. W. Poeldinger, et al. A Functional-Dimensional Approach to Depression: Serotonin Deficiency as a Target Syndrome in a Comparison of 5 -Hydroxytryptophan and Fluvoxamine. Psychopathology. 1991; 24: 53-81.

5. H. van Praag. Management of Depression with Serotonin Precursors. Biol Psychiatry. 1981; 16: 291-310.

6. S Takahashi, et al. Effect of L-5-Hydroxytryptophan on Brain Monoamine Metabolism and Evaluation of Its Clinical Effect in Depressed Patients. Psychiat Res 1975; 12: 177-87.

7. R. Kahn and H. Westenberg. L-5-Hydroxytryptophan in the Treatment of Anxiety Disorders. J Affect Disord, 1985; 8: 197-200.

8. V. Linnoila and M. Virkkunen. Aggression, Suicidality, and Serotonin. J Clin Psychiatry. 1992; 53: 46-51.

9. L. Buydens-Branchey, et al. Age of Alcoholism Onset. II. Relationship to Susceptibility to Serotonin Precursor Availability. Arch Gen Psychiatry. 1989; 46: 231-36.

10. J. Wurtman. Carbohydrate Craving, Mood Changes and Obesity. J Clin Psychiatry. 1988; 49: 37-39.

11. C. Cangiano, et al. Eating Behavior and Adherence to Dietary Prescriptions in Obese Adult Subjects Treated with 5-Hydroxytryptophan. Am J Clin Nutr 1992; 56: 863-7.

12. D. Murphy et al. Obssessive-Compulsive Disorder as a 5-HT Subsytem -Related Behavioural Disorder. Bri J Psychiatry. 1989; 155: 15-24.

13. C. Maurizi. The Therapeutic Potential for Tryptophan and Melatonin: Possible Roles in Depression, Sleep, Alzheimers Disease and Abnormal Aging. Med Hypoth. 1990; 31: 233-42.

14. G. DeBenedittis and R. Massei. 5-HT Precursors in Migraine Prophy laxis: A Double-Blind Cross-Over Study with L-5-Hydroxytryptophan versus Placebo. Clin J Pain. 1986; 3: 123-29.

15. J. Robertson and T. Monte. Natural ProzacLearning to Release Your Bodys Own Anti-Depressants. San Francisco: Harper; 1997.

16. A. Gaby. B6The Natural Healer. New Canaan: Keats: 1984.

17. H. van Praag. Studies of the Mechanism of Action of Serotonin Precursors in Depression. Psychopharmacol Bull. 1984; 20: 599-602.

18. P. Hartvig et al. Pyridoxine Effect on Synthesis Rate of Serotonin in the Monkey Brain Measured with Positron Emission Tomography. J Neural Trans. 1995; 102: 91-7.

19. K. Dakshinamurti, et al. Influence of B Vitamins on Binding Properties of Serotonin Receptors in CNS of Rats. Klin Wochenschr. 1990; 68: 142-45.

20. M. Jacobsen, et al. Cardiac Manifestations in Mid-gut Carcinoid Disease. Eur Heart J. 1995; 16: 263-68.

21. Y. Hoshino, et al. Serum Serotonin Levels of Normal Subjects in Physiological State and Stress Conditions. Jpn J Psychosom Med. 1979; 19: 283-93.

22. H. van Praag. Central Monoamine Metabolism in Depressions. I. Serotonin and Related Compounds. Compreh Psychiatry. 1980; 21: 30-43.

23. T. Li Kam Wa, et al. Blood and Urine 5-Hydroxytryptamine [Serotonin] Levels after Administration of Two 5-Hydroxytryptophan Precursors in Normal Man. Bri J Clin Pharmacol. 1995; 39:327-29.

24. G. Huether, et al. The Metabolic Fate of Infused L-Tryptophan in Men: Possible Clinical Implications of the Accumulation of Circulating Tryptophan and Tryptophan Metabolites. Psychopharmacol (Germany). 1992; 109: 442-32.

25. K. Tornebrandt, et al. Heart Involvement in Metastatic Carcinoid Disease. Clin Cardiol. 1986; 9 (1).

26. R. Arora and R. Warner. Do Indole Markers Predict Carcinoid Heart Disease? Chest. 1986; 90: 87-9.

27. M. Werbach. Nutritional Influences on Illness, 2nd ed. Atherosclerosis, 57-102. Tarzana, CA: Third Line Press; 1996.

28. P. Turlapaty and B. Altura. Magnesium Deficiency Produces Spasms of Coronary Arteries: Relationship to Etiology of Sudden Death Ischemic Heart Disease. Science. 1980; 208: 198-200.

[Nacumen]

Damn, now that's what I call a reliable source.

[dwilkes7]

I know that the principal is banned now, but this is some food for thought.

If someone is prescribed an SSRI and begins to manifest things like irritability, grandiosity, flights of ideas, etc... It is possible to have been misdiagnosed as depressive when they are really bipolar. SSRI's are notorious for flipping bipolar depression into Mania fairly quickly. Most of the time this happens when a person is bipolar2 and has not recognized the mania at all. It is almost unheard of for a bipolar2 patient to complain of the Hypomania, and just as rare for the doctor to suspect it until certain symptoms show up.

This has been a problem with SSRI drugs right from their introduction.

[darawk]

Something to keep in mind that the "serotoinin deficiency = depression" theory has little if any scientific backing. It's spin produced by pharmaceutical companies to feign explanation of SSRI's to consumers. SSRI's do _NOT_ work by increasing the concentration of serotinin in the brain(although they do do this). There are even anti-depressants that work by *enhancing* the re-uptake of serotonin, instead of inhibiting it(lookup tianeptine).

These anti-depressants are pretty much totally unexplained right now in brain research. Simply increasing the concentration of serotonin in your brain will not necessarily relieve depression or make you happier, if 5-htp or tryptophan even do that. As for the serotonin in the blood issue...that is a very real issue. 5-htp administered without a peripheral decarboxylase inhibitor WILL cause the liver to synthesize serotonin in the bloodstream from the 5-htp and serotonin IS toxic when it accumulates in the blood stream. *However* there is no evidence that ingesting 5-htp causes enough serotonin to accumulate in the blood stream to cause any significant problems. But 5-htp is far more effective at increasing serotonin concentrations in the brain if co-administered with a PDI.

EDIT: Oh, and don't trust anything written by James South. He's on the payroll of a major online supplement/drug vendor. He and James Ward. Just because his article is sourced doesn't mean it's valid or accurate. It's very easy to manipulate medical information when you're writing for peopel who aren't educated in the specific area you're talking about.