5-HTP for Depression

Given a boost by celebrities in recovery from depression such as Jim Carrey, 5-HTP (5-hydroxytryptophan) is once again the up-and-coming nutritional supplement for the treatment of depression.

5-HTP supplies the source of the amino acid tryptophan in a form that readily enters the brain. The human brain converts tryptophan into the key mood regulator serotonin.

What's the evidence for 5-HTP? Psychiatrists ran a research trial involving 60 people with mild to moderate depression compared 5-HTP against Luvox (fluvoxamine), an antidepressant in the same drug class as Prozac. The trial concluded that 5-HTP was slightly more effective Luvox. Moreover, while Luvox users suffered a range range of side effects usually associated with SSRIs, 5-HTP only caused mild stomach upset in a few of the people who took it.

Two decades of evidence suggest that 5-HTP is a relatively safe supplement. Nonetheless, there are people who should avoid it. The most frequently reported adverse effects from 5-HTP are heartburn, nausea, and various kinds of stomach upset. 5-HTP can cause bloating, flatulence, and stomach rumbles.

This side effect is due to the fact that the digestive tract makes its own serotonin, which may be overabundant until your body adjusts to the supplement. About 2 in 5 people who use the supplement experience these effects during the first 2 weeks of using it. To avoid adverse effects, it's a good idea to begin by taking a 50-milligram dose once or twice a day. Then slowly build up to a 100-milligram dose, but only after 3 or 4 weeks.

The medical literature does not report serious adverse effects on the central nervous system from taking even high doses of 5-HTP. In theory, however, extremely large doses of 5-HTP taken at the same time as the migraine medications naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), or zolmitriptan (Zomig), or any prescription medications for depression could cause “serotonin syndrome.”

As I note in my book Healing without Medication, this rare condition of excess serotonin may cause agitation, confusion, heightened physical reflexes, racing pulse, and excessive sweating leading to hypertension, coma, and death. Serotonin syndrome has never been observed from supplementation with 5-HTP, but as a precaution, avoid using 5-HTP if you take any prescription drugs for depression or migraine. People who have angina, uncontrolled high blood pressure, a rare form of migraine known as Prinzmetal’s angina, or who have had a heart attack should also avoid 5-HTP.

There are reports that combining 5-HTP with the Parkinson’s disease drug carbidopa can cause symptoms similar to those of the skin disease scleroderma. 5-HTP probably should not be combined with conventional antidepressants.

This does not mean you should stop your prescription antidepressant and put yourself on 5-HTP. Just the opposite: Almost all prescription medications for depression have to be tapered off gradually under your doctor's supervision. In the right circumstances, however, 5-HTP might give your brain just the boost it needs to overcome depression and return to normal function.