5-Hydroxytryptophan

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Not to be confused with serotonin (5hydro!ytryptamine, 5"#$%
5-Hydroxytryptophan
&'()* name +hide,
-amino. (5hydro!y/"indol.yl$ propanoic acid
Identifiers
*)0 number 51122

(ub*hem /33
*hem0pider .443/.

'N&& */5J6/4572

89:: ;<=..2

>e0" 5"ydro!ytryptophan
*h9?& *"9?&:/==4<

*h9>?5 *"9>?5.5<--/

)#* code N<1 )@</
Jmol.; images &mage /
0>&590
+show,
&n*h&
+show,
Properties
>olecular formula *//"/-N-6.
>olar mass --<%-. gAmol
;ensity /%343 gAm5
>elting point -24.<< B*, 5=/5=. 8, 5145=- BF
?oiling point 5-<%1 B*, =23 8, 212 BF
(verify$ (what is: A C$
9!cept where noted otherwise, data are given for materials in
their standard state (at -5 B*, /<< k(a$
&nfobo! references
5-Hydroxytryptophan (5-HTP$, also known as oxitriptan (&NN$, is a naturally occurring
amino acid and chemical precursor as well as a metabolic intermediate in the biosynthesis of the
neurotransmitters serotonin and melatonin from tryptophan%
5"#( is sold over the counter in the 'nited 8ingdom, 'nited 0tates and *anada as a dietary
supplement for use as an antidepressant, appetite suppressant, and sleep aid, and is also marketed
in many 9uropean countries for the indication of maDor depression under trade names like
Cincofarm, Levothym, Levotonine, Oxyfan, Telesol, Tript-OH, and Triptum%
+/,+-,
0everal
doubleblind placebocontrolled clinical trials have demonstrated the effectiveness of 5"#( in
the treatment of depression,
+/,
though a lack of high Euality studies has been noted%
+.,
>ore and
larger studies are needed to determine if 5"#( is truly effective in treating depression%
+3,
Contents
/ >etabolism
- (harmacology
. ;ietary sources
3 #herapeutic use
5 (ossible risks or side effects
1 0ee also
= Feferences
4 Further reading
Metabolism
5"ydro!ytryptophan is decarbo!ylated to serotonin (5hydro!ytryptamine or 5"#$ by the
enGyme aromatic5aminoacid decarbo!ylase with the help of vitamin ?1%
+5,
#his reaction
occurs both in nervous tissue and in the liver%
+1,
5"#( crosses the bloodHbrain barrier,
+=,
while 5
"# does not% 9!cess 5"#(, especially when administered with Iitamin ?1, is thought to be
metaboliGed and e!creted%
+4,+2,
Pharmacology
#he psychoactive action of 5"#( is derived from its effect on the production of serotonin in
central nervous system tissue% >ore specifically, 5"#( increases the production of serotonin%
+/<,
Fesearch shows that coadministration with carbidopa greatly increases plasma 5"#( levels%
+//,

"owever, several studies have reported that 5"#( is effective even without a peripheral
decarbo!ylase inhibitor (e%g% carbidopa$%
+/-,
6ther studies have indicated the risk of a
sclerodermalike condition resulting from the combination of 5"#( and carbidopa%
+/.,
ietary sources
#hough 5"#( is found in food only in insignificant Euantities, it is a chemical involved
intermediately in the metabolism of tryptophan, an amino acid found in milk, meat, potatoes,
pumpkin, and various greens%
+/3,
0ee also the section ;ietary sources of the article on 5
tryptophan%
5"#( ))); 0erotonin

(5(


Therapeutic use
5"#( is sold overthecounter in the 'nited 0tates, the 'nited 8ingdom, and *anada as a
dietary supplement for use as an antidepressant, appetite suppressant, and sleep aid% 5"#( in
supplement form is typically sold in 5< mg or /<< mg gelatin or vegetarian capsules% &t is usually
sourced from the seeds of Griffonia simplicifolia%
5"#( has been studied and shown to be of benefit
+clarification needed,
in the following conditions:
primary fibromyalgia syndrome,
+/5,
FriedreichJs ata!ia,
+/1,
an!iety, binge eating associated with
obesity, and insomnia%
+/=,
#here is no statistically significant difference between 5"#( and
placebo in treating chronic headaches (primary or otherwise$%
+/4,
&n -<</ a *ochrane Feview of the effect of 5"#( and tryptophan on depression was published%
#he authors included only studies of a high rigor and included both 5"#( and tryptophan in
their review because of the limited data on either% 6f /<4 studies of 5"#( and tryptophan on
depression published between /211 and -<<<, only two met the authorsJ Euality standards for
inclusion, totaling 13 study participants% #he substances were more effective than placebo in the
two studies included but the authors state that, Kthe evidence was of insufficient Euality to be
conclusive,K and note, Kbecause alternative antidepressants e!ist which have been proven to be
effective and safe, the clinical usefulness of 5"#( and tryptophan is limited at present%K
+.,
5"#( is often taken by people coming down from >;>) to relieve post>;>) dysphoria%
#he basis for doing this is that 5"#( is a necessary precursor for the brain to produce more
serotonin, and >;>) use depletes a personJs natural serotonin levels, thus taking 5"#( after a
dose of >;>) could improve serotonin production%
+citation needed,
While the practice is common,
the theory is physiologically reasonable, and anecdotal evidence is widespread,
+/2,
no
scientifically verifiable evidence can currently be found to confirm whether the practice actually
works%
Possible ris"s or side effects
?ecause 5"#( has not been thoroughly studied in a clinical setting, possible side effects and
interactions with other drugs are not well known% "owever, it is noteworthy that no published
reports of serious side effects (from noncontaminated 5"#($ e!ist, despite that 5"#( is freely
available as a nutraceutical%
+-<,+-/,+--,
#his could indicate that serious side effects are relatively rare
with 5"#(, at least in moderate doses% 6n the other hand, acute moderate gastrointestinal
effects, such as diarrhea and vomiting, are common upon administration of 5"#(, probably due
to rapid formation of serotonin in the upper intestinal tract%
+-<,+-.,+-3,
6ral 5"#( results in an increase in urinary 5"&)), a serotonin metabolite, indicating that 5
"#( is peripherally metaboliGed to serotonin, which is then metaboliGed% #his might cause a
false positive test in tests looking for carcinoid syndrome%
+-5,
8nown drug interactions:
When combined with antidepressants of the >)6& or 00F& class, 5"#( can cause acute
serotonin syndrome%
+-1,+-=,
When combined with carbidopa (as a treatment for symptoms of (arkinsonJs disease$, 5
"#( causes nausea and vomitingL however this can be alleviated via administration of
granisetron%
+-4,
)s mentioned above under pharmacology, cases of sclerodermalike
illness have been reported in patients using carbidopa and 5"#(%
+-2,
&t has been suggested that 5"#( may cause eosinophiliamyalgia syndrome (9>0$, a serious
condition which results in e!treme muscle tenderness, myalgia, and blood abnormalities%
"owever, there is evidence to show that 9>0 was caused by a contaminant in early 5"#(
supplements, before the introduction of the current :ood >anufacturing (ractices by the 'nited
0tates F;) in -<<=% >any countries now employ similar regulation%
+.<,
#ee also
>elatonin
N)cetylserotonin
0erotonin
#ryptophan
$eferences
/% M
a

b
#urner 9", ?lackwell ); (-<<5$% K5"ydro!ytryptophan plus 00F&s for
interferoninduced depression: synergistic mechanisms for normaliGing synaptic
serotoninK% Medical Hypotheses %5 (/$: /.4H33% doi:/<%/</1AD%mehy%-<<5%</%<-1%
(>&; /542./.<%
2. & 0wiss (harmaceutical 0ociety (-<<<$% Index Nominum 2000: International
Drug Directory (Boo !ith "D#$%M&% ?oca Faton: >edpharm 0cientific (ublishers%
&0?N .44=1.<=5<%
.% M
a

b
0haw 8, #urner J, ;el >ar * (-<<-$% K#ryptophan and 5hydro!ytryptophan
for depressionK% &n 0haw, 8elly )% "ochrane Data'ase of (ystematic $e)ie!s (%nline&
(/$: *;<<./24% doi:/<%/<<-A/315/454%*;<<./24% (>&; //412151%
3% & 5"ydro!ytryptophan (5"#($ *ni)ersity of Maryland Medical "enter% -<//%
)ccessed: 2 January -</-%
5% & Fahman >8, Nagatsu #, 0akurai #, "ori 0, )be >, >atsuda > (/24-$% K9ffect
of pyrido!al phosphate deficiency on aromatic 5amino acid decarbo!ylase activity with
5;6() and 55hydro!ytryptophan as substrates in ratsK% +pn, +, -harmacol, '( (5$:
4<.H//% doi:/<%/-53ADDp%.-%4<.% (>&; 124.1/2%
1% & ?ouchard, 0L ?ousEuet, *L Foberge, ): (/24/$% K*haracteristics of
dihydro!yphenylalanineA5hydro!ytryptophan decarbo!ylase activity in brain and liver of
catK% +ournal of Neurochemistry ') (.$: =4/H=% doi:/<%////AD%/3=/3/52%/24-%tb/-555%!%
(>&; 12=3--4%
=% & :omes (, 0oaresda0ilva (% (/222$% K5;6() transport properties in an
immortalised cell line of rat capillary cerebral endothelial cells, F?9 3K% Brain $es, *(+
(/H-$: /3.H/5<% doi:/<%/</1A0<<<1422.(22$</.4=1% (>&; /4335-..%
4% & ?ouchard 0, Foberge ): (/2=2$% K?iochemical properties and kinetic
parameters of dihydro!yphenylalanine5hydro!ytryptophan decarbo!ylase in brain,
liver, and adrenals of catK% "an, +, Biochem, 5) (=$: /</3H4% doi:/<%//.2Ao=2/-1%
(>&; .2114%
2% & )mamoto #, 0arai 8 (/2=1$% K6n the tryptophanserotonin metabolism in
manicdepressive disorders% *hanges in plasma 5"# and 5"&)) levels and urinary 5
"&)) e!cretion following oral loading of 55"#( in patients with depressionK%
Hiroshima +, Med, (ci, (5 (-H.$: /.5H3<% (>&; /<44.12%
/<% & K5"#(: 'ses, 0ide 9ffects, &nteractions and Warnings Web>;K% )rchived
from the original on /1 November -<<2% Fetrieved -<<2/<<5%
//% & >agnussen &, Jensen #0, Fand J", Ian Woert >" (/24/$% K(lasma
accumulation of metabolism of orally administered single dose 55hydro!ytryptophan in
manK% .cta pharmacologica et toxicologica ,+ (.$: /43H2% doi:/<%////AD%/1<<
<==.%/24/%tb<<42<%!% (>&; 1/=5/=4%
/-% & ?irdsall #* (/224$% K5"ydro!ytryptophan: a clinicallyeffective serotonin
precursorK% .lternati)e medicine re)ie! : a /ournal of clinical therapeutic ' (3$: -=/H4<%
(>&; 2=-=<44%
/.% & 0ternberg 9>, Ian Woert >", Noung 0N, et al, (/24<$% K;evelopment of a
sclerodermalike illness during therapy with 55hydro!ytryptophan and carbidopaK% N,
0ngl, +, Med, '-' (/3$: =4-H=% doi:/<%/<51AN9J>/24</<<-.<./3<.% (>&; 122==.5%
/3% & K5"ydro!ytryptophanK% 'niversity of >aryland >edical *enter% )rchived
from the original on 1 January -</<% Fetrieved -</<</-/%
/5% & *aruso &, 0arGi (uttini (, *aGGola >, )GGolini I (/22<$% K;oubleblind study of
5hydro!ytryptophan versus placebo in the treatment of primary fibromyalgia syndromeK%
1he +ournal of International Medical $esearch .* (.$: -</H2% (>&; -/2.4.5%
/1% & #rouillas (, 0erratrice :, 5aplane ;, et al, (>ay /225$% K5evorotatory form of
5hydro!ytryptophan in FriedreichJs ata!ia% Fesults of a doubleblind drugplacebo
cooperative studyK% .rchi)es of Neurology 5( (5$: 351H1<%
doi:/<%/<</Aarchneur%/225%<<53<-2<<3-</1% (>&; ==..4.2% Fetrieved -<<2<=.<%
/=% & ?irdsall #* ()ugust /224$% K5"ydro!ytryptophan: a clinicallyeffective
serotonin precursorK% .lternati)e Medicine $e)ie! : a +ournal of "linical 1herapeutic '
(3$: -=/H4<% (>&; 2=-=<44% Fetrieved -<<2<=.<%
/4% & ;e ?enedittis :, >assei F (/245$% K0erotonin precursors in chronic primary
headache% ) doubleblind crossover study with 55hydro!ytryptophan vs% placeboK%
+ournal of Neurosurgical (ciences (+ (.$: -.2H34% (>&; .2/.=5-%
19. & http:AAdancesafe%orgAdruginformationAecstasyanddepression
-<% M
a

b
#urner 9", 5oftis J>, ?lackwell );% 0erotonin a la carte: supplementation
with the serotonin precursor 5hydro!ytryptophan% (harmacol #her% -<<1
>arL/<2(.$:.-5.4% 9pub -<<5 Jul /3% Feview% (ub>ed (>&; /1<-.-/=%
-/% & ?yerley WF, Judd 55, Feimherr FW, :rosser ?&% 5"ydro!ytryptophan: a
review of its antidepressant efficiency and adverse effects% J *lin (sychopharmacol% /24=
JunL=(.$:/-=.=% Feview% (ub>ed (>&; .-24.-5%
--% & van "iele 5J% l5"ydro!ytryptophan in depression: the first substitution
therapy in psychiatryC #he treatment of 22 outpatients with JtherapyresistantJ
depressions% Neuropsychobiology% /24<L1(3$:-.<3<% (ub>ed (>&; 121=/23%
-.% & :iDsman "J, van :erven J>, de 8am >5, 0choemaker F*, (ieters >0,
Weemaes >, de FiDk F, van der (ost J, *ohen )F% (lacebocontrolled comparison of
three doseregimens of 5hydro!ytryptophan challenge test in healthy volunteers% J *lin
(sychopharmacol% -<<- )prL--(-$:/4.2% (ub>ed (>&; //2/<-13%
-3% & /: 5owe 05, Neo 8(, #eng 5, 0oon ;8, (an ), Wise 0;, (eck FW% 55
"ydro!ytryptophan augments the neuroendocrine response to a 00F&%
(sychoneuroendocrinology% -<<1 >ayL./(3$:3=.43% 9pub -<<5 ;ec -=% (ub>ed (>&;
/1.=4125%
-5% & Joy #, Walsh :, #okmakeDian 0, Ian 'um 0" (January -<<4$% K&ncrease of
urinary 5hydro!yindoleacetic acid e!cretion but not serum chromogranin ) following
overthecounter 5hydro!ytryptophan intakeK% "an, +, Gastroenterol, (( (/$: 32H5.%
(>* -152/-<% (>&; /4-<2=4/%
-1% & >a O, Ohang :, Jenney *, 8rishnamoorthy 0, #ao F% (July -<<4$%
K*haracteriGation of serotoninto!icity syndrome (to!idrome$ elicited by 5hydro!yl
tryptophan in clorgylinepretreated ratsK% 0ur + -harmacol, 5** (-H.$: /24H-<1%
doi:/<%/</1AD%eDphar%-<<4%<3%<<3% (>&; /4322/</%
-=% & &Gumi #, &wamoto N, 8itaichi N, 8ato ), &noue #, 8oyama #% (-<<1$% K9ffects
of coadministration of a selective serotonin reuptake inhibitor and monoamine o!idase
inhibitors on 5"#related behavior in ratsK% 0ur + -harmacol, 5'( (.$: -54H-13%
doi:/<%/</1AD%eDphar%-<<5%/-%<=5% (>&; /13443<2%
-4% & Jacobs :, 8amerling &, de 8am >, et al, (Nov -<<4$% K9nhanced tolerability of
the 5hydro!ytryptophane challenge test combined with granisetronK% +
-sychopharmacol, (%xford& (, (/$: 15H=-% doi:/<%//==A<-1244//<4<23-22%
(>&; /4=/2<34%
-2% & http:AAwww%truestarhealth%comANotesA/..2<<3%html
.<% & >ichelson, ;L (age, 0W, *asey, F, #rucksess, >W, 5ove, 5), >ilstien, 0,
Wilson, *, >assaEuoi, 0:, *rofford, 5J, "allett, > (/223 ;ec$% K)n eosinophilia
myalgia syndrome related disorder associated with e!posure to 55hydro!ytryptophanK%
1he +ournal of rheumatology (. (/-$: --1/H5% (>&; =1221-=%
/urther reading
den ?oer J), Westenberg ": (/22<$% K?ehavioral, neuroendocrine, and biochemical
effects of 5hydro!ytryptophan administration in panic disorderK% -sychiatry $esearch '.
(.$: -1=H=4% doi:/<%/</1A</15/=4/(2<$2<<21N% (>&; -/.2=./%
)ngst J, Woggon ?, 0choepf J (/2==$% K#he treatment of depression with 55
hydro!ytryptophan versus imipramine% Fesults of two open and one doubleblind studyK%
.rchi) f2r -sychiatrie und Ner)enranheiten ((, (-$: /=5H41% (>&; ..1<<-%
article at (sychology #oday
#urner 9", 5oftis J>, ?lackwell ); (-<<1$% K0erotonin a la carte: supplementation with
the serotonin precursor 5hydro!ytryptophanK% -harmacol, 1her, .-+ (.$: .-5H.4%
doi:/<%/</1AD%pharmthera%-<<5%<1%<<3% (>&; /1<-.-/=%
5"ydro!ytryptophan (5"#($ 0upplement &nformation at 'niversity of >aryland
>edical *enter
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Tryptamines
Asian J Psychiatr. 2013 Feb;6(1):29-34. doi: 10.1016!.a!".2012.0#.011. $"%b 2012 J%& 12.
Comparative study of efficacy of l-5-
hydroxytryptophan and fluoxetine in
patients presenting 1ith first depressive
episode9
Jan'id P( )a&i* P( +in'h P( +har,a )( -%&ia A..
Source
;epartment of (sychiatry, (ost :raduate &nstitute of >edical 0ciences, Fohtak /-3 <</,
"aryana, &ndia%
Abstract
INTRODUCTION:
Fole of l5hydro!ytryptophan (l5"#($ in depression is relatively less studied but the literature
has shown its robust role in depression% #he present randomiGed double blind study was
undertaken to assess the role of l5"#( as an antidepressant and to compare its antidepressant
efficacy with fluo!etine in first depressive episode patients of &ndian population%
METHODS:
) total of =< patients of first depressive episode, all of whom were diagnosed with &*;/<
criteria, were recruited but only 1< patients completed the study and were randomly divided into
two groups, receiving l5"#( and fluo!etine, respectively, for a period of 4weeks% )ll patients
were administered "amilton Fating 0cale for ;epression (")>;$ to assess severity of
depression at baseline, -weeks, 3weeks and 4weeks% #he efficacy of treatment was assessed by
comparing ")>; scores obtained at these e!aminations with the baseline e!aminationL final
evaluation of both efficacy and tolerance was assessed using the *linical :lobal &mpression
(*:&$ scale at the end of study%
RESULTS:
?oth treatment groups showed significant and nearly eEual reduction in ")>; scores
beginning at week two and continuing through week eight% #wentytwo patients (=.%..P$ in the
l5"#( group and -3 patients (4<P$ in the fluo!etine group showed positive response at the end
of the study%
CONCLUSION:
l5"#( has definitely got antidepressant effect in patients of depression% )ntidepressant effect
was seen within -weeks of treatment and was apparent in all degrees of depression% #he
therapeutic efficacy of l5"#( was considered as eEual to that of fluo!etine%
/e%ro $ndocrino& 0ett. 2010;31(#):663-6.
3n open-label trial of L-5-
hydroxytryptophan in sub:ects 1ith
romantic stress9
$,an%e&e $( 1ertona )( )inoretti P( -ero&di 2.
Source
;epartment of "ealth 0ciences, 0ection of (sychiatry, 'niversity of (avia, (avia, &taly%
enGo%emQlibero%it
Abstract
#his openlabel trial assessed the clinical efficacy of 55hydro!ytryptophan (5"#($, a natural
serotonin precursor, in nondepressed young subDects with high levels of romantic stress% 0ince
both neurotrophins and serotonin have been linked to human romantic attachment, we sought to
investigate the changes in serum brainderived neurotrophic factor (?;NF$ levels and platelet
serotonin content in relation to the changes in romantic stress throughout the study% ) total of /5
healthy subDects (// females and 3 males, mean age: -.%. R -%/ years$ who e!perienced a recent
romantic breakup or reported recent romantic problems took part in the study% #he participants
were treated openly for 1 weeks with 55hydro!ytryptophan (1< mg :riffonia simplicifolia
e!tract containing /-%4 mg 5"#( b%i%d%, )more!, *oropharm, Iillach, )ustria$% #he subDects
were evaluated at baseline, at . weeks and at the end of the 1week trial using an adapted version
of the 0eiffge8renkeJs (roblem 7uestionnaire% ?;NF and platelet serotonin content were
determined at baseline, at . weeks, and after the completion of the 1week trial% We observed
significant improvements in romantic stress scores from weeks < through . (pS<%<<=$ but no
further significant improvement was evident from weeks . through 1 (pS<%/2$% )t 1 weeks,
subDects had a significant increase from baseline in both ?;NF and platelet serotonin values%
6ur data suggest that direct modulation of the serotonergic system may have use for the
treatment of psychological suffering associated with unreciprocated romantic love%
0i3e +ci. 200# )ar 2#;46(19):2141-53.
#erotonergic disturbances in autistic
disorder; L-5-hydroxytryptophan
administration to autistic youngsters
increases the blood concentrations of
serotonin in patients but not in controls9
6roonenber'hs J( 7er*er* 8( +char"e +( 2ebo%tte 2( )aes ).
Source
#he 'niversity *enter of *hild and )dolescent (sychiatry, )%O%>%, 'niversity of )ntwerp,
WilriDk, ?elgium% Jan%croonenberghsQocmw%antwerpen%be
Abstract
0ome studies have suggested that disorders in the peripheral and central metabolism of serotonin
(5"#$ may play a role in the pathophysiology of autistic disorder% #his study e!amines the
whole blood concentrations of 5"# and 5hydro!yindoleacetic acid (5"&))$ in baseline
conditions and during a challenge with 556"tryptophane (5"#(L 3 mgAkg in non enteric
coated tablets$, the precursor of 5"#, in a study group of /4 male, postpubertal, *aucasian
autistic patients (age /./2 y%L &%7%T55$ and -< matched healthy volunteers% &n baseline
conditions, no significant differences in 5"# or 5"&)) levels could be found between autistic
youngsters and normal controls% 5"#( administration significantly increased the levels of 5"#
in autistic youngsters but not in normal controls% Following 5"#( challenge the 5"# levels
were significantly higher in autistic patients than in healthy volunteers% )fter challenge with 5
"#(, no significant differences were found in the concentrations of 5"&)) or the test substance
between autistic youngsters and normal controls% ;ifferences in the peripheral metabolism of 5
"# which may not be observed in baseline conditions but which became clear after loading with
5"#(, suggest that an increased synthesis of 5"# from its precursor 5"#( might be a one
factor responsible for differences in the serotonergic system between autistic postpubertal
youngsters and normal controls%
J Psycho"har,aco&. 2004 J%n;15(2):194-9.
The effect of 5-hydroxytryptophan on
cholecysto"inin-,-induced panic attac"s in
healthy volunteers9
)aron $( 9:r% ;( 7asar 7( +h&i* J.
Source
;epartment of (sychiatry, 'niversity of #artu, FaDa, 9stonia% eduard%maronQkliinikum%ee
Abstract
(revious studies suggest a modulatory role of serotonin (5"#$ in e!perimentallyinduced panic
attacks% &n the current study, we investigated the acute effects of 5"# precursor l5
hydro!ytryptophan (5"#($ on the response to panicogenic challenge with cholecystokinin
tetrapeptide (**83$ in healthy volunteers% #hirtytwo subDects were randomiGed to receive
either -<< mg of 5"#( or placebo with the **83 challenge following in 2< min in a double
blind, parallelgroup design% #he results showed a nonsignificant difference between the groups
in panic rate (/2P after 5"#( and 33P after placebo, p S <%/.$ with a trend for lower intensity
of symptoms after 5"#( (p S <%<4$% Further analysis by gender revealed that females in the 5
"#( group had a significantly lower panic rate and intensity of cognitive symptoms whereas, in
males, the effect of 5"#( was limited to lowering the intensity of somatic panic symptoms%
#hus, an increased availability of 5"# may have a genderdependent protective effect in **8
3induced panic
$%r J Pediatr. 2004 J%&;163(4):402-4. $"%b 2004 )ay 14.
L -5-Hydroxytryptophan treatment of sleep
terrors in children9
1r%ni <( Ferri 8( )iano +( 7erri&&o $.
Source
*entre for (aediatric 0leep ;isorders, ;epartment of ;evelopmental Neurology and (sychiatry,
'niversity of Fome K5a 0apienGaK, Iia dei 0abelli /<4, <</45 Fome, &taly%
oliviero%bruniQuniroma/%it
Abstract
#o test the hypothesis that the administration of 5 5hydro!ytryptophan (5 5"#($ might e!ert
beneficial effects on sleep terrors, we carried out an open pharmacological trial in a group of
children with sleep terrors compared to a group of children with the same disorder but without 5
5"#( treatment% (articipants in the trial were 35 children (.3 males and // femalesL age range
.%-/<%1 years$, referred to the 0leep *entre of the ;epartment of ;evelopmental Neurology and
(sychiatry of the 'niversity of Fome K5a 0apienGaK, affected by sleep terrors% )ll subDects
underwent: (/$ complete medical and sleep historyL (-$ complete neurological e!amination and
99: recording whilst awake and sleeping, (.$ a structured sleep diary for - months, (3$ after /
month, all subDects were e!amined again from the clinical and 99: points of view and (5$ after 1
months, a structured interview in order to evaluate the clinical outcome% )fter the first visit, 5 5
"#( was administered (- mgAkg per day$ at bedtime to ./ randomly selected patients for a single
period of -< consecutive days% )fter / month of treatment, -2A./ (2.%5P$ of patients showed a
positive response% &n the comparison group without drug therapy, after / month, the episodes
disappeared only in four children (-4%1P$ while ten children (=/%3P$ showed the persistence of
episodes with the same freEuency as before% )fter 1 months, -1A./ (4.%2P$ of children treated
with 5 5"#( were sleep terrorfree, while in five children (/1%/P$ sleep terror episodes
persisted% 6f the children in the comparison group, ten (=/%3P$ continued to show sleep terrors
at 1month followup%
CONCLUSION:
to our knowledge, this is the first study demonstrating the efficacy of a new drug treatment for
sleep terrors% #hese results confirm our initial hypothesis and represent evidence that treatment
with 5 5hydro!ytryptophan is able to modulate the arousal level in children and to induce a
longterm improvement of sleep terrors%
=eadache. 2000 J%n;40(6):4#1-6.
L-5-Hydroxytryptophan in the prophylaxis of
chronic tension-type headache; a double-
blind< randomi=ed< placebo-controlled
study9 /or the Portuguese Head #ociety9
8ibeiro 6A.
Source
;epartment of (harmacology, ?iomedical &nstitute for the Fesearch of 5ight and &mage, Faculty
of >edicine, 'niversity of *oimbra, *oimbra, (ortugal%
Abstract
) parallel, randomiGed, doubleblind trial is reported, in which =4 patients with chronic tension
type headaches were treated with 55hydro!ytryptophan (5"#($ (n S 3.$ or placebo (n S .5$
for 4 weeks, after a washout period of - weeks and with a followup period of a further - weeks%
Five patients dropped out (/ with placebo and 3 with 5"#($, / was e!cluded due to
noncompliance, and in = treatment was suspended due to adverse events (. with placebo and 3
with 5"#($, yielding a final number for evaluation of 15 patients% &n comparison with the group
treated with placebo, there was no statistically significant change in the number of days with
headache or in headache intensity in the group treated with 5"#(, .<< mg per dayL however,
there was a significant decrease in the consumption of analgesics% ;uring the - weeks after
treatment, there was a significant decrease in the number of days with headache% 0ubDective
opinion during this latter period was also favorable to 5"#(%
A, J 6&in /%tr. 1992 /o>;#6(#):563-4.
>ating behavior and adherence to dietary
prescriptions in obese adult sub:ects
treated 1ith 5-hydroxytryptophan9
6an'iano 6( 6eci F( 6ascino A( 2e& 1en )( 0a>iano A( )%scarito&i )( Anton%cci F( 8ossi-
Fane&&i F.
Source
.rd ;epartment of &nternal >edicine, 'niversity of Fome, 5a 0apienGa, &taly%
Abstract
(revious observations have shown that oral administration of 5hydro!ytryptophan (5"#($
without dietary prescriptions causes anore!ia, decreased food intake, and weight loss in obese
subDects% #o confirm these data over a longer period of observation and to verify whether
adherence to dietary restriction could be improved by 5"#(, -< obese patients were randomly
assigned to receive either 5"#( (2<< mgAd$ or a placebo% #he study was doubleblinded and
was for two consecutive 1wk periods% No diet was prescribed during the first period, a 5<3<
kJAd diet was recommended for the second% 0ignificant weight loss was observed in 5"#(
treated patients during both periods% ) reduction in carbohydrate intake and a consistent presence
of early satiety were also found% #hese findings together with the good tolerance observed
suggest that 5"#( may be safely used to treat obesity%
P);2:
135430#
?P%b)ed - inde@ed 3or )$20;/$A
Free 3%&& te@t
5-Hydroxytryptophan 45-HTP6
Overvie1
5hydro!ytryptophan (5"#($ is a chemical that the body makes from tryptophan (an essential
amino acid, which you get from food$% )fter tryptophan is converted into 5"#(, the chemical is
then changed into another chemical called serotonin (a neurotransmitter, which relays signals
between brain cells$% 5"#( dietary supplements help raise serotonin levels in the brain% 0ince
serotonin helps regulate mood and behavior, 5"#( may have a positive effect on sleep, mood,
an!iety, appetite, and pain sensation%
5"#( is not found in the foods we eat, although tryptophan is% 9ating foods with tryptophan
does not increase 5"#( levels very much, however% )s a supplement, 5"#( is made from the
seeds of an )frican plant called Griffonia simplicifolia,
&n /242, the presence of a contaminant called (eak @ was found in tryptophan supplements%
Fesearchers believed that an outbreak of eosinophilic myalgia syndrome (9>0, a potentially
fatal disorder that affects the skin, blood, muscles, and organs$ could be traced to the
contaminated tryptophan, and the '%0% Food and ;rug )dministration pulled all tryptophan
supplements off the market% 0ince then, (eak @ was also found in some 5"#( supplements, and
there have been a few reports of 9>0 associated with taking 5"#(% "owever, the level of (eak
@ in 5"#( was not high enough to cause any symptoms, unless very high doses of 5"#( were
taken% ?ecause of this concern, however, you should talk to your health care provider before
taking 5"#(, and make sure you get the supplement from a reliable manufacturer% (0ee
K(recautionsK section%$
5"#( may help treat a wide variety of conditions related to low serotonin levels, including the
following, but there is not much evidence for any of these uses:
epression
0ome small studies indicate that 5"#( may work as well as certain antidepressant drugs to treat
people with mildtomoderate depression% 5ike the class of antidepressants known as selective
serotonin reuptake inhibitors (00F&s$, which includes fluo!etine ((roGac$ and sertraline (Ooloft$,
5"#( increases the levels of serotonin in the brain% 6ne study compared the effects of 5"#( to
fluvo!amine (5uvo!$ in 1. people and found that those who were given 5"#( did Dust as well
as those who received 5uvo!% #hey also had fewer side effects than the 5uvo! group% "owever,
these studies were too small to say for sure if 5"#( works% >ore and larger studies are needed%
/ibromyalgia
#hree studies have suggested that 5"#( can improve symptoms of fibromyalgia, including pain,
an!iety, morning stiffness, and fatigue% >any people with fibromyalgia have low levels of
serotonin, and doctors often prescribe antidepressants% 0ince 5"#(, like antidepressants, raises
levels of serotonin in the brain, it may work too% "owever, it does not work for all people with
fibromyalgia, and more studies are needed to understand its effect%
Insomnia
&n one study, people who took 5"#( went to sleep Euicker and slept more deeply than those
who took placebo% #hese researchers recommend -<< 3<< mg at night to stimulate serotonin,
but it may take 1 /- weeks to be fully effective%
Migraines and Headaches
)ntidepressants are sometimes prescribed for migraine headaches% 0ome studies suggest that
high doses of 5"#( may help people with various types of headaches, including migraines%
"owever, the evidence is mi!ed, with other studies showing no effect%
Obesity
) few small studies have looked at whether 5"#( can help people lose weight% &n one study,
those who took 5"#( ate fewer calories, although they were not trying to diet, compared to
those who took placebo% Fesearchers believe 5"#( led people to feel more full (satiety$ after
eating, so they ate less%
) followup study, which compared 5"#( to placebo during a diet and nondiet period, found
that those who took 5"#( lost about -P of body weight during the nondiet period and another
.P when they dieted% #hose taking placebo did not lose any weight% "owever, doses used in
these studies were high, and many people had nausea as a side effect% &f you are seriously
overweight, see your health care provider before taking any weightloss aid% Femember that you
will need to change your eating and e!ercise habits to lose more than a few pounds%
ietary #ources
Nou canUt get 5"#( from food% #he amino acid tryptophan, which the body uses to make 5
"#(, can be found in turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and
collard greens, and seaweed%
3vailable /orms
5"#( is made from tryptophan in the body, or can be taken as a supplement% 0upplements are
made from e!tracts of the seeds of the )frican tree Griffonia simplicifolia% 5"#( can also be
found in many multivitamin and herbal preparations%
Ho1 to Ta"e It
Pediatric
5"#( should not be given to children%
3dult
"ealth care professionals generally recommend 5< mg of 5"#( taken / . times per day% 0ome
studies have used higher doses, but because 5"#( can be to!ic at high doses, you should talk to
your health care provider before raising the dose% Nour health care provider can help determine
the right dose for you%
Precautions
?ecause of the potential for side effects and interactions with medications, you should take
dietary supplements only under the supervision of your health care provider%
#ryptophan use has been associated with the development of serious conditions, such as liver
and brain to!icity, and with eosinophilic myalgia syndrome (9>0$, a potentially fatal disorder
that affects the skin, blood, muscles, and organs (see K6verviewK section$% 0uch reports
prompted the F;) to ban the sale of all tryptophan supplements in /242% )s with tryptophan,
9>0 has been reported in /< people taking 5"#(%
0ide effects of 5"#( are generally mild and may include nausea, heartburn, gas, feelings of
fullness, and rumbling sensations in some people% )t high doses, it is possible that serotonin
syndrome, a dangerous condition caused by too much serotonin in the body, could develop%
)lways talk to your health care provider before taking higherthanrecommended doses%
(eople with high blood pressure or diabetes should talk to their doctor before taking 5"#(%
&f you take antidepressants, you should not take 5"#( (see K(ossible &nteractionsK sections$%
(eople with liver disease, pregnant women, and women who are breastfeeding should not take 5
"#(%
Possible Interactions
&f you are currently being treated with any of the following medications, you should not use 5
"#( without first talking to your health care provider%
3ntidepressants (eople who are taking antidepressant medications should not take 5"#(
without their health care providerJs supervision% #hese medications could combine with 5"#( to
cause serotonin syndrome, a dangerous condition involving mental changes, hot flashes, rapidly
fluctuating blood pressure and heart rate, and possibly coma% 0ome antidepressant medications
that can interact with 5"#( include:
00F&s: *italopram (*ele!a$, escitalopram (5e!apro$, fluvo!amine (5uvo!$, paro!etine
((a!il$, fluo!etine ((roGac$, sertraline (Ooloft$
#ricyclics: )mitriptyline (9lavil$, nortryptyline ((amelor$, imipramine (#ofranil$
>onoamine o!idase inhibitors (>)6&s$: (henelGine, (Nardil$, tranylcypromine ((arnate$
NefaGodone (0erGone$
Carbidopa #aking 5"#( with carbidopa, a medication used to treat (arkinsonJs disease, may
cause a sclerodermalike illness% 0cleroderma is a condition where the skin becomes hard, thick,
and inflamed%
Tramadol 4?ltram6 #ramadol, used for pain relief and sometimes prescribed for people with
fibromyalgia, may raise serotonin levels too much if taken with 5"#(% 0erotonin syndrome has
been reported in some people taking the two together%
extromethorphan 4$obitussin M< and others6 #aking 5"#( with de!tromethorphan,
found in cough syrups, may cause serotonin levels to increase to dangerous levels, a condition
called serotonin syndrome%
Meperidine 4emerol6 #aking 5"#( with ;emerol may cause serotonin levels to increase to
dangerous levels, a condition called serotonin syndrome%
Triptans 4used to treat migraines6 5"#( can increase the risk of side effects, including
serotonin syndrome, when taken with these medications:
Naratriptan ()merge$
FiGatriptan (>a!alt$
0umatriptan (&mitre!$
Oolmitriptan (Oomig$
#upporting $esearch
)ngst J, Woggon ?, 0choepf J% #he treatment of depression with 55hydro!ytryptophan versus
imipramine% Fesults of two open and one doubleblind study% .rch -sychiatr Ner)enr%
/2==L--3:/=5H/41%
)ttele )0, @ie J#, Nuan *0% #reatment of insomnia: an alternative approach%.ltern Med $e)%
-<<<L5(.$:-32-52%
?irdsall #*% 5"ydro!ytryptophan: a clinicallyeffective serotonin precursor% .ltern Med $e),
/224L.:-=/H-4<%
?yerley WF, et al% 5"ydro!ytryptophan: a review of its antidepressant efficacy and adverse
effects% + "lin -sychopharmacol% /24=L=:/-=/.=%
*angiano *, et al% 9ffects of oral 5hydro!ytryptophan on energy intake and macronutrient
selection in noninsulin dependent diabetic patients% Int + %'es $elat Meta' Disord% /224L
--:134153%
*angiano *, *eci F, *ascino ), et al% 9ating behavior and adherence to dietary prescriptions in
obese adult subDects treated with 5hydro!ytryptophan, + "lin Nutr% /22-L51:41.41=%
*aruso &, 0arGi (uttini (, *aGGola >, et al% ;oubleblind study of 5hydro!ytryptophan versus
placebo in the treatment of primary fibromyalgia syndrome% + Int Med $es, /22<L/4:-</-<2%
*auffield J0, Forbes "J% ;ietary supplements used in the treatment of depression, an!iety, and
sleep disorders% 3ippincotts -rim "are -ract% /222L .(.$:-2<.<3%
*eci F, *angiano *, *airella >, *ascino ), et al% #he effects of oral 5hydro!ytryptophan
administration on feeding behavior in obese adult female subDects% + Neural 1ransm%
/242L=1:/<2//=%
*urcio JJ, 8im 50, Wollner ;, (ockaD ?)% #he potential of 5hydry!tryptophan for hot flash
reduction: a hypothesis% .ltern Med $e), -<<5L/<(.$:-/1-/%
;e?enedittis :, >assei F% 0erotonin precursors in chronic primary headache% ) doubleblind
crossover study with 55hydro!ytryptophan vs% placebo% + Neurosurg (ci% /245L -2:-.2-34%
9lko *J, ?urgess J5, Fobertson W6% Oolpidemassociated hallucinations and serotonin reuptake
inhibition: a possible interaction% + 1oxicol "lin 1oxicol% /224L.1(.$:/25-<.%
Freedman FF% #reatment of menopausal hot flashes with 5hydro!ytryptophan% Maturitas% -</<
)prL15(3$:.4.5%
:ardner ;>, 5ynd 5;% 0umatriptan contraindications and the serotonin syndrome% .nn
-harmacother, /224L.-(/$:...4%
&ovieno N, ;alton 9;, Fava >, >ischoulon ;% 0econdtier natural antidepressants: Feview and
critiEue% + .ffect Disord% -</< Jun -3%
Joffe F#, 0okolov 0#% *oadministration of fluo!etine and sumatriptan: the *anadian
e!perience% .cta -sychiatr (cand% /22=L25(1$:55/55-%
Joly (, 5ampert ), #homine 9, 5auret (% ;evelopment of pseudobullous morphea and sclero
dermalike illness during therapy with 55hydro!ytryptophan and carbidopa% + .m .cad
Dermatol, /22/L-5(-$:..-...%
Juhl J"% (rimary fibromyalgia syndrome and 5hydro!y5tryptophan: a 2<day open study%
.ltern Med $e)% /224L.:.1=.=5%
>ason ?J, ?lackburn 8"% (ossible serotonin syndrome associated with tramadol and sertraline
coadministration% .nn -harmacother% /22=L./(-$:/=5/==%
>eyers 0% 'se of neurotransmitter precursors for treatment of depression% .ltern Med $e)%
-<<<L5(/$:13=/%
(erry N8% Ienlafa!ineinduced serotonin syndrome with relapse following amitripyline%
-ostgrad Med +% -<<<L=1(423$:-53%
(uttini (0, *aruso &% (rimary fibromyalgia and 5hydro!y5tryptophan: a 2<day open study% +
Int Med $es% /22-L-<:/4-/42%
Fakel ;% $ael Integrati)e Medicine4 2nd ed, (hiladelphia, (): 0aundersL -<<4L3=%
Feibring 5, )gren ", "artvig (, et al% 'ptake and utiliGation of +beta//c, 5hydro!ytryptophan
(5"#($ in human brain studied by positron emission tomography% -sychiatry $esearch%
/22-L35:-/5--5%
Fibeiro *)% 55"ydro!ytryptophan in the prophyla!is of chronic tensiontype headache: a
doubleblind, randomiGed, placebocontrolled study% Headache% -<<< JunL3<(1$:35/1%
0haw 8, #urner J, ;el >ar *% )re tryptophan and 5hydro!ytryptophan effective treatments for
depressionC ) metaanalysis% .ust N 5 + -sychiatry% -<<- )ugL.1(3$:3442/%
0ternberg 9>, Ian Woert >", Noung 0N, et al% ;evelopment of a sclerodermalike illness
during therapy with 55hydro!ytryptophan and carbidopa% Ne! 0ng + Med% /24<L.<.:=4-=4=%
#oner 5*, #sambiras ?>, *atalano :, et al% *entral nervous system side effects associated with
Golpidem treatment% "lin Neuropharmacol% -<<<L-.(/$:5354%
Ian (raag ">% >anagement of depression with serotonin precursors% Biol -sychiatry%
/24/L/1:-2/./<%
Omilacher 8, et al% 55hydro!ytryptophan alone and in combination with a peripheral
decarbo!ylase inhibitor in the treatment of depression% Neuropsycho'iology% /244L-<:-4H..%
3lternative 5ames
5"#(
J ;nt )ed 8es. 1990 )ay-J%n;15(3):201-9.
ouble-blind study of 5-hydroxytryptophan
versus placebo in the treatment of primary
fibromyalgia syndrome9
6ar%so ;( +arBi P%ttini P( 6aBBo&a )( ABBo&ini 7.
Source
Fheumatology 'nit, 5% 0acco "ospital, >ilan, &taly%
Abstract
) doubleblind, placebocontrolled study of the efficacy and tolerability of 5hydro!ytryptophan
(5"#($ was conducted in 5< patients with primary fibromyalgia syndrome% )ll the clinical
parameters studied were significantly improved by treatment with 5"#( and only mild and
transient sideeffects were reported% Further controlled studies are reEuired to define properly the
value of 5"#( in patients with primary fibromyalgia syndrome%
J /e%ra& 9rans,. 1959;46(2):109-14.
The effects of oral 5-hydroxytryptophan
administration on feeding behavior in
obese adult female sub:ects9
6eci F( 6an'iano 6( 6aire&&a )( 6ascino A( 2e& 1en )( )%scarito&i )( +ibi&ia 0( 8ossi Fane&&i F.
Source
;epartment of &nternal >edicine, 'niversity of Fome 5a 0apienGa, &taly%
Abstract
Nineteen obese female subDects with body mass inde! ranging between .< and 3< were included
in a doubleblind crossover study aimed at evaluating the effects of oral 5hydro!ytryptophan
administration on feeding behavior, mood state and weight loss% 9ither 5hydro!ytryptophan (4
mgAkgAday$ or placebo was administered for five weeks during which patients were not
prescribed any dietary restrictions% Feeding behavior was investigated by means of a
Euestionnaire designed to establish the onset of anore!ia and related symptoms% Food intake was
evaluated using a threeday diet diary% ?;&, 0&, 0#)&#, and 0#)&0 were used to assess mood
state% #he administration of 5hydro!ytryptophan resulted in no changes in mood state but
promoted typical anore!iarelated symptoms, decreased food intake and weight loss during the
period of observation%
5"#( (5"ydro!ytryptophan$ is a chemical byproduct of the protein building block 5
tryptophan% &t is also produced commercially from the seeds of an )frican plant (:riffonia
simplicifolia$%
;onUt use 5"#( until more is known% 5"#( might be ?5#3/>% 0ome people who have taken
it have come down with eosinophiliamyalgia syndrome (9>0$, a serious condition involving
e!treme muscle tenderness (myalgia$ and blood abnormalities (eosinophilia$% 0ome people think
the 9>0 might be caused by an accidental ingredient (contaminant$ in some 5"#( products%
?ut there is not enough scientific evidence to know if 9>0 is caused by 5"#(, a contaminant,
or some other factor% 'ntil more is known, avoid taking 5"#(%
5"#( is used for sleep disorders, depression, an!iety, migraine and tensiontype headaches,
fibromyalgia, binge eating associated with obesity, premenstrual syndrome ((>0$, premenstrual
dysphoric disorder ((>;;$, attention deficithyperactivity disorder ();";$, and along with
prescription drugs to treat seiGure disorder and (arkinsonJs disease%
How does it work?
5"#( works in the brain and central nervous system by increasing the production of the
chemical serotonin% 0erotonin can affect sleep, appetite, temperature, se!ual behavior, and pain
sensation% 0ince 5"#( increases the synthesis of serotonin, it is used for several diseases where
serotonin is believed to play an important role including depression, insomnia, obesity, and many
other conditions%
Possibly Effective for:
2e"ression. 9here is so,e e>idence that #-=9P ,i'ht be abo%t as e33ecti>e as so,e
"rescri"tion dr%'s 3or de"ression.
Fibro,ya&'ia. 9a*in' #-=9P by ,o%th a""ears to i,"ro>e sy,"to,s o3 3ibro,ya&'ia
inc&%din' "ain se>erity( ,ornin' sti33ness( and s&ee"&essness.
Possibly Ineffective for:
9ension headaches. 9a*in' #-=9P doesnCt see, to red%ce "ain or the n%,ber o3
headaches s%33ered by "eo"&e Dith chronic tension-ty"e headaches.
Insufficient Evidence for:
A&Bhei,erEs disease. $ar&y st%dies s%''est that #-=9P doesnCt he&" sy,"to,s o3
A&Bhei,erCs disease.
An@iety. 9here is so,e e>idence s%''estin' that #-=9P ,i'ht red%ce sy,"to,s o3
an@iety disorders.
Fei'ht &oss and obesity. Pre&i,inary e>idence s%''ests that ta*in' #-=9P ,i'ht he&"
red%ce a""etite( ca&oric inta*e( and Dei'ht in obese "eo"&e.
Pre,enstr%a& syndro,e (P)+).
Pre,enstr%a& dys"horic disorder (P)22).
Attention de3icit-hy"eracti>ity disorder (A2=2).
+&ee" disorders.
<ther conditions.
)ore e>idence is needed to rate the e33ecti>eness o3 #-=9P 3or these %ses.
5"#( is PO##I7L@ ?5#3/> for use% #here is concern that it can cause a serious side effect
called eosinophilia myalgia syndrome% 0ome people think this side effect is only caused by a
contaminant in some 5"#( productsL but there is not enough scientific evidence to know if it is
caused by 5"#(, a contaminant, or some other factor% 'ntil more is known, 5"#( should be
avoided%
6ther potential side effects of 5"#( include heartburn, stomach pain, nausea, vomiting,
diarrhea, drowsiness, se!ual problems, and muscle problems%
Special Precautios ! "ari#s:
Pre#ac$ ad %reast&'eedi#: #-=9P is POSSI(L) UNS*+E in "re'nancy and breast-
3eedin'. A>oid %sin' it.
Dow s$dro,e: 9here are re"orts o3 #-=9P ca%sin' seiB%res in so,e "eo"&e Dith 2oDn
syndro,e. ;n one 'ro%" st%died( 1#G o3 "eo"&e Dith 2oDn syndro,e recei>in' &on'-ter, #-=9P
treat,ent e@"erienced seiB%res.
)edications 3or de"ression (Antide"ressant dr%'s) interacts Dith #-=9P
5"#( increases a brain chemical called serotonin% 0ome medications for depression also
increase serotonin% #aking 5"#( along with these medications for depression might
increase serotonin too much and cause serious side effects including heart problems,
shivering, and an!iety% ;o not take 5"#( if you are taking medications for depression%
0ome of these medications for depression include fluo!etine ((roGac$, paro!etine ((a!il$,
sertraline (Ooloft$, amitriptyline (9lavil$, clomipramine ()nafranil$, imipramine
(#ofranil$, and others%
)edications 3or de"ression ()A<;s) interacts Dith #-=9P
5"#( increases a chemical in the brain% #his chemical is called serotonin% 0ome
medications used for depression also increase serotonin% #aking 5"#( with these
medications used for depression might cause there to be too much serotonin% #his could
cause serious side effects including heart problems, shivering, and an!iety%
0ome of these medications used for depression include phenelGine (Nardil$,
tranylcypromine ((arnate$, and others%
Moderate Interaction Be cautious with this combination
6arbido"a (0odosyn) interacts Dith #-=9P
5"#( can affect the brain% *arbidopa (5odosyn$ can also affect the brain% #aking 5"#(
along with carbidopa can increase the risk of serious side effects including rapid speech,
an!iety, aggressiveness, and others%
2e@tro,ethor"han (8obit%ssin 2)( and others) interacts Dith #-=9P
5"#( can affect a brain chemical called serotonin% ;e!tromethorphan (Fobitussin ;>,
others$ can also affect serotonin% #aking 5"#( along with de!tromethorphan
(Fobitussin ;>, others$ might cause too much serotonin in the brain and serious side
effects including heart problems, shivering, and an!iety% ;o not take 5"#( if you are
taking de!tromethorphan (Fobitussin ;>, and others$%
)e"eridine (2e,ero&) interacts Dith #-=9P
5"#( increases a chemical in the brain called serotonin% >eperidine (;emerol$ can also
increase serotonin in the brain% #aking 5"#( along with meperidine (;emerol$ might
cause too much serotonin in the brain and serious side effects including heart problems,
shivering, and an!iety%
PentaBocine (9a&Din) interacts Dith #-=9P
5"#( increases a brain chemical called serotonin% (entaGocine (#alwin$ also increases
serotonin% #aking 5"#( along with pentaGocine (#alwin$ might increase serotonin too
much% #his could cause serious side effects including heart problems, shivering, and
an!iety% ;o not take 5"#( if you are taking pentaGocine (#alwin$%
9ra,ado& (H&tra,) interacts Dith #-=9P
#ramadol ('ltram$ can affect a chemical in the brain called serotonin% 5"#( can also
affect serotonin% #aking 5"#( along with tramadol ('ltram$ might cause too much
serotonin in the brain and side effects including confusion, shivering, stiff muscles, and
others%
9he a""ro"riate dose o3 #-=9P de"ends on se>era& 3actors s%ch as the %serEs a'e( hea&th( and
se>era& other conditions. At this ti,e there is not eno%'h scienti3ic in3or,ation to deter,ine an
a""ro"riate ran'e o3 doses 3or #-=9P. .ee" in ,ind that nat%ra& "rod%cts are not a&Days
necessari&y sa3e and dosa'es can be i,"ortant. 1e s%re to 3o&&oD re&e>ant directions on "rod%ct
&abe&s and cons%&t yo%r "har,acist or "hysician or other hea&thcare "ro3essiona& be3ore %sin'.
Ahat is 5-hydroxytryptophanB
5hydro!ytryptophan, also known as 5"#(, is a dietary supplement made from the seeds of the
)frican plant :riffonia simplicifolia%
5hydro!ytryptophan has been used in alternative medicine as an aid to relieve the symptoms of
an!iety, depression, fibromyalgia, insomnia, chronic headaches, premenstrual syndrome, binge
eating related to obesity, attention deficit disorder, and chronic headaches% 5hydro!ytryptophan
has also been used in treating certain seiGures and symptoms of (arkinsonJs disease%
Not all uses for 5hydro!ytryptophan have been approved by the F;)% 5hydro!ytryptophan
should not be used in place of medication prescribed for you by your doctor%
5hydro!ytryptophan is often sold as an herbal supplement% #here are no regulated
manufacturing standards in place for many herbal compounds and some marketed supplements
have been found to be contaminated with to!ic metals or other drugs% "erbalAhealth supplements
should be purchased from a reliable source to minimiGe the risk of contamination%
5hydro!ytryptophan may also be used for other purposes not listed in this product guide%
Ahat is the most important information I should "no1
about 5-hydroxytryptophanB
Not all uses for 5hydro!ytryptophan have been approved by the F;)% 5hydro!ytryptophan
should not be used in place of medication prescribed for you by your doctor%
5hydro!ytryptophan is often sold as an herbal supplement% #here are no regulated
manufacturing standards in place for many herbal compounds and some marketed supplements
have been found to be contaminated with to!ic metals or other drugs% "erbalAhealth supplements
should be purchased from a reliable source to minimiGe the risk of contamination%
0lideshow: 5iving with Nour >igraines: #ips for #reatment and (revention
'se 5hydro!ytryptophan as directed on the label, or as your healthcare provider has prescribed%
Ahat should I discuss 1ith my healthcare provider before
ta"ing 5-hydroxytryptophanB
;o not use this product if you are allergic to 5hydro!ytryptophan%
?efore using 5hydro!ytryptophan, talk to your doctor, pharmacist, herbalist, or other healthcare
provider about all of your medical conditions% 5hydro!ytryptophan may cause seiGures in people
with ;own syndrome%
&t is not known whether 5hydro!ytryptophan is harmful to an unborn baby% ;o not use this
product without talking to a healthcare provider if you are pregnant or plan to become pregnant
during treatment%
5hydro!ytryptophan may pass into breast milk and may harm a nursing baby% ;o not use 5
hydro!ytryptophan without telling your doctor if you are breastfeeding a baby%
;o not give any herbalAhealth supplement to a child without the advice of a doctor%
Ho1 should I ta"e 5-hydroxytryptophanB
When considering the use of herbal supplements, seek the advice of your doctor% Nou may also
consider consulting a practitioner who is trained in the use of herbalAhealth supplements%
&f you choose to take 5hydro!ytryptophan, use it as directed on the label, or as directed by your
doctor, pharmacist, or other healthcare provider% ;o not use more of 5hydro!ytryptophan than is
recommended on the label%
#ake this product with a full glass of water%
&f your condition does not improve, or if it appears to get worse, contact your doctor%
&f you need surgery, tell the surgeon ahead of time that you are using 5hydro!ytryptophan% Nou
may need to stop using the medicine for a short time%
0tore at room temperature away from moisture and heat%
Ahat happens if I miss a doseB
*all your doctor, pharmacist, herbalist, or other healthcare provider for instructions if you miss a
dose%
Ahat happens if I overdoseB
0eek emergency medical attention or call the (oison "elp line at /4<<---/---%
Ahat should I avoid 1hile ta"ing 5-hydroxytryptophanB
)void e!posure to sunlight or tanning beds% 5hydro!ytryptophan can make you sunburn more
easily% Wear protective clothing and use sunscreen (0(F /5 or higher$ when you are outdoors%
5-hydroxytryptophan side effects
:et emergency medical help if you have any of these signs of an allergic reaction: hivesL
difficulty breathingL swelling of your face, lips, tongue, or throat%
*all your healthcare provider at once if you have a serious side effect such as skin rash, bruising,
severe tingling, numbness, pain, or muscle weakness%
5ess serious side effects may include:
stomach painL
nausea, vomitingL
gas, heartburnL or
loss of appetite%
#his is not a complete list of side effects and others may occur% *all your doctor for medical
advice about side effects% Nou may report side effects to F;) at /4<<F;)/<44%
#ee also; 5hydro!ytryptophan side effects (in more detail$
Ahat other drugs 1ill affect 5-hydroxytryptophanB
;o not take 5hydro!ytryptophan without the advice of a healthcare provider if you are using
any of the following medications:
de!tromethorphan (cough medicine$L
0t% JohnJs wortL
an antidepressant such as amitriptyline (9lavil, Ianatrip, 5imbitrol$, citalopram (*ele!a$,
clomipramine ()nafranil$, do!epin (0ineEuan$, fluo!etine ((roGac$, imipramine
(#ofranil$, nortriptyline ((amelor$, paro!etine ((a!il$, sertraline (Ooloft$, traGodone
(;esyrel$, and othersL
an >)6 inhibitor such as isocarbo!aGid (>arplan$, phenelGine (Nardil$, rasagiline
()Gilect$, selegiline (9ldepryl, 9msam$, or tranylcypromine ((arnate$L
medicine to treat (arkinsonJs disease, such as carbidopaAlevodopa ()tamet, (arcopa,
0inemet$L or
prescription pain medication such as meperidine (;emerol$, pentaGocine (#alwin$, or
tramadol ('ltram, 'ltracet$%
#his list is not complete and other drugs may interact with 5hydro!ytryptophan% #ell your
doctor about all medications you use% #his includes prescription, overthecounter, vitamin, and
herbal products% ;o not start a new medication without telling your doctor%