5-HTP instead of an SSRI

I have done extensive research down to the cellular level as I have been suffering from terrible anxiety for the last 18 mos.  I had much trouble getting on an SSRI and my MD wanted me to titrate up as much as I could as I was getting NO therapeutic response.  Well, Lexapro at 30 mg seemed to be making things worse.  I seem to carry the "Short arm allele" or in other words, I have a "Polymorphism" of the Serotonin transporter gene.

I have recently weaned off of the Lexapro completely and going through the withdrawal that follows which for me is the Zaps, Increased anxiety, fatigued, etc.

My question is that because 5-HTP is a direct precursor to Serotonin and crosses that blood brain barrier, might I see a clinical response (i.e. a nice reduction in my anxiety) even though I carry the short arm allele ?  It would make sense since I'm bypassing the transporter mechanism that the SSRI's need in order to be effective (i.e. I'm making more serotonin and thus making more available compared to the SSRI's where I'm not making more Serotonin but relying on the transporter to "re-use" what I already have over and over again).   It seems to make sense to me, but I just wanted to get some imput from anyone else out there that may be familiar with what I'm talking about.

Thanks in advance.....

Gary..........BSN, RN

[sumihari]

I don't think anyone here would be able to help you with this question and I don't think even your doctor could answer this. The reason is because you need a team of biologists, chemists, genetic specialist, psychiatrists and other specialists to put together their minds to give you the best answer. Perhaps you could pose this question on the doctor's forum.  

In any case, 5-HTP is a naturally occuring amino acid , which tells me it can't do you much harm and it apparently is found in turkey and cheese which most non-vegetarians would eat anyway, so why take a supplement?  But if SSRI's don't agree with you and you think a supplementation of 5-HTP will, just give it a try.

[Ambersnow]

I'm going through terrible withdrawals trying to wean off lexapro and wellbutrin. I was up to 50mg lexapro several months ago, and am currently taking 15mg lexapro (was on 300mg wellbutrin now on 37mg, almost done). This is a long, painful process that's not over yet. I have been considering taking 5-htp. From my research, taking ssri's with 5htp can be dangerous because it can elevate serotonin levels. But weaning off ssri's slowly, while introducing 5htp in small doses (50mg or less a day) may be effective. This shoud be done with dr.'s advice, but I don't have one right now, so I'll probably do this on my own. 5htp should not be taken in doses over 100mg, as there has not been any long term tests, and side effects can occur. 50 to 100mg per day seems adequate. Has anyone else tried this?

Amber, B.A.

[kalmkidd]

5-HTP (5-hydroxytryptophan or 5-hydroxy-l-tryptophan, also abbreviated as 5HTP or 5 HTP) is a natural supplement that converts in the brain into serotonin. Serotonin is an important brain chemical involved in mood, behavior, appetite, and sleep. Serotonin is also involved in impulse control. For instance, low serotonin levels may lead to addictive behavior such as gambling or other habits caused by weak will power. Serotonin is known as 5-HT, or 5-hydroxytryptamine, and is found in many places in the body particularly the brain, gastrointestinal system, and blood cells. On this web page I will discuss the proper use of 5-HTP along with mentioning 5 HTP side effects and information on the use of 5-HTP for depression, or anyxiety in your case.. therefor in my conclusion i dont think it would be a bad idea and i also DONT feel it would do any harm ''ALONE'' however because it is basically serotonin and your lexapro is increasing extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor so im not sure if it would have a ''ADVERSE'' effect to the lexapro sense your pumping more into as well as upping with the lexapro my only worry would be something very severe which is serotonin syndrome. I WOULD NOT RECOMMEND DOING THIS WITHOUT SPEAK TO ATLEAST YOUR MD.. good luck if you have any question feel free to contact me.

Shawn (Student Of Psychotherapy) DCC

[AnxiousGurl]

Ive tried it and notice a difference, not a big one but it definately helps me

[Bekah58]

I have been going to a Naturopathic physician (has the pre-med schooling that the MDs have + the Naturopathic 4 yr college work) and she has me on 250 mg of 5-HTP and other supplements for the many issues that I've been having with menopause.  I've weaned off of Prozac with NO problems after having been on it for 9 years (a very small dose of 5mg).  The only recommendation my Naturopath had was to go up on my 5-HTP by 50 mg.. hence the 250mg dose that I currently take. She had my brain chemistry tested to find out that I was low on serotonin; too high in norepinephrine (caused a lot of anxiety) and I was too high in GABA (but I was taking GABA to help me sleep).  I stopped the GABA.  She has me on L-Theanine (active ingredient in Green Tea) to counteract the too high norepinephrine... it helps tremendously with anxiety!  My naturopath is:  Dr. Renee Young located in Los Gatos, Calif. and I believe the company that provides testing of neurotransmitters is:  www.neurorelief.com  - Hope this helps!

[AliBhai]

My personal experience with 5htp is much better than any of the medication that i have taken......i would suggest you to give it a go......you ll se a difference within an hour of taking it....
but even though i am taking it..... i still dont feel normal or happy.....which means i might have problem with other neurotransmitters....so i am thnking of taking wellbutrin with 5htp....i have heard that it is safe combination if you take it 2 hrs apart......
i wish you best of luck with it.....and would definitl recommend you to take it....

[inrenton184]

A Word of Caution About
5-Hydroxytryptophan or 5-HTP

Taken from the Life Extension Foundation newsletter

The reasons for the potential risks of 5-HT were brought to our attention by Steven B Harris, M.D. He explained that: 5-Hydroxytryptophan (5-HT) is one step closer to serotonin than tryptophan. The sequence is as follows.

Tryptophan > 5-Hydroxytryptophan > SerotoninBased on the above metabolic sequence it would appear desirable to use 5-HT instead of tryptophan since 5-HT more readily converts to serotonin. Serotonin is a neurotransmitter that is often deficient in the brains of depressed people. Boosting serotonin can alleviate depression in some people and reduce carbohydrate cravings in others, thus inducing weight loss.

Here's why 5-HT will not work for most Americans, and could be lethal to some people: The blood-brain barrier does not allow significant absorption of serotonin from the blood. The brain does have a large neutral amino acid pump that freely allows tryptophan and 5-HT into the brain for conversion into serotonin. The process by which 5-H is converted into serotonin is called decarboxylation. If decarboxylation occurs before 5-HT is absorbed by the brain, than blood levels of serotonin will elevate significantly, but very little serotonin will enter the brain.

When Europeans take 5-HT, they are often prescribed the dopa decarboxylase inhibitor carbidopa that prevents 5-HT from being converted into serotonin until it reaches the brain. Americans do not take carbidopa with 5-HT and the result is possible serotonin overload in the blood, with virtually no serotonin reaching the brain. We will describe later the dangers of overloading the blood with serotonin. Americans taking 5-HT are more vulnerable to blood serotonin overload because, unlike most Europeans who are vitamin deficient, Americans who use 5-HT usually take large doses of vitamin B6 as well. Vitamin B6 rapidly converts 5-HT into serotonin before it can reach the brain. Even when combined with carbidopa, high levels of vitamin B6 will break through the carbidopa barrier and insure that 5-HT converts into serotonin in the blood before the it can reach the brain.

The multiple health benefits of vitamin B6 are too important, we believe, to recommend that people avoid taking vitamin B6 just to enable them to try using 5-HT to boost brain serotonin levels. This may be difficult anyway without also taking carbidopa, which is available in the US only as a prescription drug. At the very best, those who take vitamin B6 with 5-HT are probably wasting their money. Unfortunately, high serotonin in the blood in not benign. Anyone suffering from heart disease should avoid 5-HT because the elevation in blood serotonin could cause coronary artery spasm an/or abnormal platelet aggregation, which are risk factors for sudden death heart attack.

Here is the real frightening aspect of serotonin overload, as described by Dr. Harris: "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 of their right hearts with can cause heart failure. The 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 mush, which poisons them with its serotonin content" Dr. Harris goes on to state that people who ingest several hundred milligrams a day of 5-HT with B6 and without a decarboxylase inhibitor would expect to see urinary excretion of a serotonin metabolite in the same range as a person with a serotonin secreting tumor.

Based upon Dr. Harris' report the Foundation had its analysts conduct an extensive review of the medical literature and have come to the following preliminary conclusions:

1) For 5-HT to boost serotonin levels in the brain it is necessary to: a)Take 50 mg of carbidopa before each 5-HT dose. Carbidopa is a prescription drug. b)Limit vitamin B6 supplementation to a small dose taken at least six hours before or after 5-HT carbidopa dosing. c) Have a urinary test to measure a metabolite of serotonin called 5-hydroxy indoleacetic acid (5-HIAA) on a regular basis. As long as 5-HIAA levels are normal, than 5-HT intake would be safe.

2) Those with existing cardiovascular disease, including atrial fibrillation, coronary artery disease, congestive heart failure, cardiomyopathy, valvular disease or pulmonary hypertension may want to avoid 5-HT completely. One Foundation analyst felt that 81 mg a day of aspirin and 500 mg a day of magnesium would reduce the risk of 5-HT inducing a heart attack.

3)The effects of 5-HT by itself elevating blood serotonin levels are extremely individualistic. Some people may not experience any blood serotonin increase, while others could suffer from a lethal serotonin peripheral overload.

4) Despite the potential dangers of 5-HT, most FDA-approved drugs to treat depression and obesity appear to be more toxic.

[wala131]

Life Extension refutes all your points regarding the dangers of 5-HTP. Here is the link:
http://www.life-enhancement.com/article_template.asp?ID=46

[andrewm88]

just from personal experience i didnt like it, it made my heart race and seemed to give me more anxiety, this may have been a psychological response but it wasnt for me. everyone is different, go see a natruopath i highly recommend it :)

[Paxiled]

The so-called scientific analysis of 5-HTP does not sound so scientific to me.  Tryptophan has a hard time crossing the blood brain barrier, but 5-HTP does cross.  The reason isn't that tryptophan can't cross, obviously it does or nobody would have any serotonin in their bodies, given that it's made from tryptophan.  The problem is that most serotonin in the body isn't in the brain, it's in the blood vessels and digestive system, and the body will direct the tryptophan where it's most needed.  Second, without B6, 5-HTP can't convert to serotonin -- B6 is an essential cofactor.  Too much B6 can cause problems, however, as it can cause a neuropathy in some people, but if you have too little you can't make serotonin no matter how much tryptophan you have.  But for most people, excess B6 doesn't store in the body, it just washes out in the urine.  The body will only use as much as it needs.  Third, there is no evidence whatsoever that anyone has more or less serotonin in their brains than anyone else.  What makes ssris work isn't creating more serotonin, it's using it longer in some synapses while not using it at all in others.  5-HTP allows for more efficient production of serotonin, but it won't cause serotonin syndrome because again, the body will only make as much as it needs.  It generally causes serotonin overload only in people who are also taking an ssri or other med that increases the effects of serotonin, but even then, it's mostly theoretical, as reporting of such cases is rare.  Serotonin syndrome itself is quite rare.  I also have no idea where the information comes from that Europeans are vitamin deficient; if anything, they are less deficient than Americans because they eat more vegetables and fruits and are generally healthier.  Now, I can't guarantee I'm right here, or that the above post is wrong -- who could? -- but it sounds quite inconsistent with what we know of these things, which unfortunately is a lot less than we would like given the lack of actual real world studies double blinded and using a sufficient number of people for a sufficient amount of time.

[wala131]

Since my last comment pointing out Life Extension's refuting inrenton184's post (Dr. Harris and the risks of using 5-HTP), I have had the following happen to me:

After using up to 300mg/day 5-HTP for the last 3 weeks or so, some capsules containing B6 and some not, I started losing partial vision in my right eye. An opthamologist diagnosed hemorrhages in the retina which seemed to get somewhat better when I started taking low dose aspirin and simvostatin, but which virtually disappeared starting the morning after discontinuing 5-HTP. Could this have to do with "abnormal platelet aggregation" described in inrenton184's post? I will put this hypothesis to a doctor who I am seeing for a second opinion next week.

[sgately11]

Ha Ha. Wala131 you just killed 5-HTP for every health anxious person reading this. I am glad of your honest feedback because I had been considering it, but typically dont like to take anything new or not proved.

[Julie359]

Wala131.....after consulting my doctor and people who practice in natural medicine,i have found that the recommended dose is between 50 to 100mg per day and no more.  so im affraid to say it looks like you were overdosing.  I personally take 50mg per day in the morning and have been advised to take regular breaks throughout the month, so i take it during the week and have the weekends off.  I find that taking 5-HTP takes the edge of the general anxiety and so i feel more comfortable in my own skin.  Plus i also take a Calcium, magnesium and vitamin D3 supplement along with Omega 3 and vitamin C.  Although the supplements i have only been taking for a couple of weeks or so, the 5-HTp for far longer.  

In general....... I think some people can be extremely irresponsible in what they write on this forum, take for example  inrenton184, who goes into a scientific scare mongering of 5-HTP & how it can blinking kill you!! 5-HTP compared to the prescribed anti-depressants (in my opinion) carry FAR less side effects and dangers, however it all goes back to properly doing your research from trained professionals who work with these products on a daily basis, you need to know how much to take, how often and just listen to the advice you are being given.  These forums can be really good for getting advice but from experience (trust me on this) i now tend to not ask on here and refer my questions and concerns to the people who are trained.  

sgately11 - you are a prime example of how someone commenting can defer you from trying something that could potentially  make a big difference to how your feeling.  I would advise you not to take the above commenters words as a gospal certainty that if you took 5-HTP this would be the outcome for you.... Please be assured that every individual is different and so therefore what is one person poisen is another persons miracle.  There are millions of people who can take SSRI's successfully and live happy lives but in the same breath there are just as many who have horrendous horror stories.... saddly however you only seem to hear the stories with unsuccessful outcomes in this world, it is human nature.  so i really think that before you right it off as a no go, go your local health food centre and talk to trained staff about the product, have a chat with your GP/PC doc and someone who is a doctor of natural medicine before you make a decision.

[maguilera100]

I have developed this crazy anxiety attacks in the last week. I've never felt anxiety in such a way ever in the past and is scaring me like hell. I have been feeling like my hearth is not working properly, either beating too hard or too slow so I went to see a doctor and she said my hearth and everything was fine, I was just feeling anxiety (which never crossed my mind) and since the moment she said it I have been feeling it off and on all day everyday. She also gave me some Ativan 5mg which do absolutely nothing for me, my mind just keeps going like crazy thinking and thinking and thinking about this and that, I've even felt Im going crazy. Anyway Im not taking the Ativan, yesterday morning and this morning II had one pill of 5-HTP, I believe is the small dose pill and I feel good, the disturbing thoughts are 95% gone and I'm feeling very well. I did my research about 5-HTP and it seems to be a decent supplement. Im not planing on higher the dosage at all, I'm more looking into finding what the source of my sudden Anxiety is because I'm 23 years old and this is absolutely new to me. I should also point out that Im not taking any other medication or supplement, except  Yazmin which is a birth control pill and maybe aspirin once every two months. I have not had any bad feelings about 5-HTP but I just started
I hope this helps someone like me who is  new to anxiety. Remember to always do your research before taking any pills.

[andrewm88]

i have been taking 5-htp for a week and so far it has done NOTHING but give me MORE anxiety!

[CSCampbell]

I was wondering the same thing before I take it, if that's what it would do b/c thats the one thing I dnt want it to do.. I fear it doing that. I have random panic attacks and fear if I take this, that it will send me back into a panic attack. I have been diagnosed with anxiety disorder & have been put on several medications in the past which alot of them gave me more anxiety like you are describing. I was told to only take it before I go to bed at night, but if I wake up with a racing heart I'll be in the ER before the morning.. Now I'm scared to take it..

[cheeseface]

I'm currently taking SSNI's (specifically venlafaxine) and have been considering coming off them for a while now, however am extremely nervous about the withdrawal symptoms involved as I've experienced these before and they're horrible. I was wondering if 5HTP during the final stages of the weaning off of the SSNI's would help control some of worse withdrawals when the dosage is stopped completely.

[Paxiled]

It might make withdrawal worse, though some report it as helpful.  5-HTP is a metabolite of tryptophan, an amino acid.  Along with B6 and other co-factors, it's responsible for manufacturing serotonin in the body.  An ssni targets both certain serotonin and norepinephrine receptors.  Part of withdrawal will be serotonin receptors that the body has determined haven't been needed because of the increased activity of the targeted receptors will begin to wake up, as they will be again needed.  This is believed to be part of the withdrawal, particularly brain zaps and some other problems.  Taking 5-HTP might, and I emphasize might, increase the efficiency of serotonin production while your body is trying very hard to work normally again and this might actually prolong withdrawal.  Some people have had some success using fish oil and St. John's Wort and some other supplements to ease this process, but I'd be careful about HTP.