Using 5-HTP Instead Of Antidepressant Medications

In our latest question and answer, the pharmacist discusses using 5-HTP (5-hydroxytryptophan) instead of conventional antidepressants.

Dec 20, 2017

Jlolive asked

Can you start using 5-HTP after your last dose of Effexor XR if it’s been 30 hours? I want to use 5-HTP to get off Effexor XR. Currently taking 225 mg of Effexor. That’s three 75 mg capsules. I have been on them approx 10 yrs.

Answer

While theoretically supplementation with 5-HTP may help alleviate the withdrawal symptoms of certain antidepressants such as Effexor (venlafaxine), there is a definite lack of studies that have evaluated this use. In addition, no medical guideline recommends the use of 5-HTP to aid in an effective antidepressant taper. Thus, it is impossible to give a definitive recommendation and you should speak with your doctor regarding your tapering options.


Having said all that, we will discuss some of the positive evidence for 5-HTP for the treatment of depression as well as the one study that evaluated 5-HTP use for withdrawal symptoms.

Depression

There is a large body of evidence that indicates taking 5-hydroxytryptophan (5-HTP) by mouth can improve the symptoms of depression in patients. The dosage range used in studies varied, but the most common dosage ranged from 150 mg to 800 mg. 

Some of the most positive evidence is seen from studies that directly compared 5-HTP to conventional SSRI (selective serotonin re-uptake inhibitor) antidepressant medications. In one study, a titrated dose of 400 mg of 5-HTP decreased depression symptoms in a similar manner to the antidepressant medication Prozac (fluoxetine) 40 mg daily.

Another study showed that 100 mg three times daily of 5-HTP for 6 weeks had comparable effectiveness to Luvox (fluvoxamine) 50 mg three times daily for 6 weeks.

Similar results are seen across other classes of antidepressants as well. A clinical trial showed taking 5-HTP 800 mg daily for 20 days had similar effectiveness to taking imipramine 150 mg daily.

Lastly, one study showed that adding 5-HTP 300 mg orally daily to the antidepressant clomipramine produced a greater reduction in depression symptoms than clomipramine alone.

Overall, there is a large body of evidence showing that 5-HTP may be effective for depression. More large, well designed studies are needed to confirm the anti-depressive activity of 5-HTP supplements but the preliminary evidence is strong.

Withdrawal Symptoms

There is far less data in regard to the use of 5-HTP to reduce antidepressant withdrawal symptoms and essentially no information on how to successfully use 5-HTP in these situations.

It is often recommended to taper off antidepressants (as opposed to stopping 'cold turkey') if you have been on them over 6 weeks.  Some sources recommend tapering Effexor XR if you have been taking it for as little as one week.

Generally, it is recommended to taper antidepressant medications over a period of 4 to 8 weeks. Otherwise, you may experience withdrawal symptoms such as flu-like symptoms, insomnia, irritability and sensory disturbances (e.g. headaches/migraines).

Effexor XR is associated as being an one of the  antidepressant that is most likely to cause withdrawal symptoms so an appropriate taper schedule would be prudent to follow.

If withdrawal symptoms to happen, they typically begin within 3-7 days and can last anywhere from a few days to a few weeks.

Again, an appropriate taper schedule is the most well researched and recommended way to effectively stop taking antidepressants. 5-HTP is not well studied in this regard. However, one study found that the combined use of 5-HTP (200 mg/day), tyrosine, phosphatidylcholine, and L-glutamine, may reduce withdrawal symptoms and improve mood.

As there is a lack of evidence regarding the use of 5-HTP for withdrawal symptoms, it use is not recommended to assist in discontinuing antidepressant medications.There are some sources that recommend certain 'cross-tapers' when switching between antidepressants, but there is no data regarding 5-HTP.

Please speak with your doctor regarding the best way to taper off Effexor. Once Effexor has been discontinued, 5-HTP may be an effective option to try.

General Information About 5-HTP (5-hydroxytryptophan)

5-Hydroxytryptophan (5-HTP) is a precursor to the neurotransmitter serotonin. 5-HTP is produced endogenously in the body from the amino acid L-tryptophan and is then converted to serotonin (5-hydroxytryptamine, 5-HT). Supplementing with 5-HTP has shown to increase the production of serotonin and increase overall serotonin levels. 

An increase in serotonin is one of the mainstays of antidepressant therapy with conventional medications. Classes of medications that increase serotonin levels include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (Serotonin Norepinephrine reuptake inhibitors). Theoretically, supplementing with 5-HTP will have effects similar to these medications. In addition to the use of 5-HTP for depression, it may also be beneficial for bipolar disorder and migraines.

5-HTP supplements are generally well tolerated with the most commonly reported side effects being gastrointestinal in nature.

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