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A 2002 review by the Cochrane Collaboration concluded that although the data evaluated suggests that 5-HTP is more effective than placebo in the treatment of depression, the evidence was insufficient to be conclusive due to a severe lack of high quality research.[2] More and larger studies are needed to determine if 5-HTP is truly effective in treating depression.[3]
5-HTP is sometimes taken by people coming down from MDMA to relieve post-MDMA dysphoria.[4] As 5-HTP is a necessary precursor for the brain to produce more serotonin, and MDMA use depletes a person's natural serotonin levels, it is believed that taking 5-HTP after consuming MDMA will speed up serotonin production. DanceSafe claims that the anecdotal evidence is widespread and that the theory is physiologically reasonable.[5] A research conducted by Wang et al. in 2007 suggested a recovery, when MDMA-induced depletions of 5-HT were restored in rats after administering 5-HTP.[6]
Side effects
Potential side effects of 5-HTP include heartburn, stomach pain, nausea, vomiting, diarrhea, drowsiness, sexual problems, vivid dreams or nightmares, and muscle problems.[7] Because 5-HTP has not been thoroughly studied in a clinical setting, possible side effects and interactions with other drugs are not well known.
Interactions
When combined with antidepressants of the MAOI or SSRI class, high dose 5-HTP can cause acute serotonin syndrome in rats.[8][9] In humans 5-HTP has never been clinically associated with serotonin syndrome, although 5-HTP can precipitate mania when added to a MAOI.[10] Due to the rate-limiting nature of the decarboxylase enzyme which converts 5-HTP into serotonin, the risk of serotonin syndrome with monoamine oxidase inhibitors is thought to be quite low unless both MAOIs and 5-HTP are taken in large quantities.[citation needed]
When combined with carbidopa (as a treatment for symptoms of Parkinson's disease), 5-HTP causes nausea and vomiting; however this can be alleviated via administration of granisetron.[11] As mentioned above under pharmacology, cases of scleroderma-like illness have been reported in patients using carbidopa and 5-HTP.[12]
Oral 5-HTP results in an increase in urinary 5-HIAA, a serotonin metabolite, indicating that 5-HTP is peripherally metabolized to serotonin, which is then metabolized. This might cause a false positive test in tests looking for carcinoid syndrome.[13][14] Due to the conversion of 5-HTP into serotonin by the liver, there may be a significant risk of heart valve disease from serotonin's effect on the heart.[15][16]
It has been suggested that 5-HTP may cause eosinophilia-myalgia syndrome (EMS), a serious condition which results in extreme muscle tenderness, myalgia, and blood abnormalities. However, there is evidence to show that EMS was likely caused by a contaminant in certain 5-HTP supplements.[17]
The psychoactive action of 5-HTP is derived from its increase in production of serotonin in central nervous system tissue.[23]
Research shows that co-administration with carbidopa greatly increases plasma 5-HTP levels.[24] However, several studies have reported that 5-HTP is effective even without a peripheral decarboxylase inhibitor (e.g. carbidopa).[25]
Other studies have indicated the risk of a scleroderma-like condition resulting from the combination of 5-HTP and carbidopa.[26]
Though 5-HTP is found in food only in insignificant quantities, it is a chemical involved intermediately in the metabolism of tryptophan, an amino acid found in milk, meat, potatoes, pumpkin, and various greens.[27]
The seeds of the Griffonia simplicifolia, a climbing shrub native to West Africa and Central Africa, are used as an herbal supplement for their 5-hydroxytryptophan (5-HTP) content.[28][29][30] In one 2010 trial, Griffonia simplicifolia extract appeared to increase satiety in overweight women.[31]
^Shaw K, Turner J, Del Mar C (2002). Shaw, Kelly A (ed.). "Tryptophan and 5-hydroxytryptophan for depression". Cochrane Database of Systematic Reviews (1): CD003198. doi:10.1002/14651858.CD003198. PMID11869656.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^"5-HTP". U.S. National Library of Medicine. Retrieved 7 June 2015.
^Ma Z, Zhang G, Jenney C, Krishnamoorthy S, Tao R. (July 2008). "Characterization of serotonin-toxicity syndrome (toxidrome) elicited by 5-hydroxy-l-tryptophan in clorgyline-pretreated rats". Eur J Pharmacol. 588 (2–3): 198–206. doi:10.1016/j.ejphar.2008.04.004. PMID18499101.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Izumi T, Iwamoto N, Kitaichi Y, Kato A, Inoue T, Koyama T. (2006). "Effects of co-administration of a selective serotonin reuptake inhibitor and monoamine oxidase inhibitors on 5-HT-related behavior in rats". Eur J Pharmacol. 532 (3): 258–264. doi:10.1016/j.ejphar.2005.12.075. PMID16488409.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Pardo, JV (2012). "Mania following addition of hydroxytryptophan to monoamine oxidase inhibitor". General hospital psychiatry. 34 (1): 102.e13-4. doi:10.1016/j.genhosppsych.2011.08.014. PMID21963353.
^Jacobs G, Kamerling I, de Kam M; et al. (November 2008). "Enhanced tolerability of the 5-hydroxytryptophane challenge test combined with granisetron". J Psychopharmacol. (Oxford). 24 (1): 65–72. doi:10.1177/0269881108094299. PMID18719048.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Michelson, D; Page, SW, Casey, R, Trucksess, MW, Love, LA, Milstien, S, Wilson, C, Massaquoi, SG, Crofford, LJ, Hallett, M (December 1994). "An eosinophilia-myalgia syndrome related disorder associated with exposure to L-5-hydroxytryptophan". The Journal of rheumatology. 21 (12): 2261–5. PMID7699627.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Rahman MK, Nagatsu T, Sakurai T, Hori S, Abe M, Matsuda M (1982). "Effect of pyridoxal phosphate deficiency on aromatic L-amino acid decarboxylase activity with L-DOPA and L-5-hydroxytryptophan as substrates in rats". Jpn. J. Pharmacol. 32 (5): 803–11. doi:10.1254/jjp.32.803. PMID6983619.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Bouchard, S; Bousquet, C; Roberge, AG (1981). "Characteristics of dihydroxyphenylalanine/5-hydroxytryptophan decarboxylase activity in brain and liver of cat". Journal of Neurochemistry. 37 (3): 781–7. doi:10.1111/j.1471-4159.1982.tb12555.x. PMID6974228.
^Gomes P, Soares-da-Silva P. (1999). "L-DOPA transport properties in an immortalised cell line of rat capillary cerebral endothelial cells, RBE 4". Brain Res. 829 (1–2): 143–150. doi:10.1016/S0006-8993(99)01387-6. PMID18445233.
^Bouchard S, Roberge AG (1979). "Biochemical properties and kinetic parameters of dihydroxyphenylalanine--5-hydroxytryptophan decarboxylase in brain, liver, and adrenals of cat". Can. J. Biochem. 57 (7): 1014–8. doi:10.1139/o79-126. PMID39668.
^Amamoto T, Sarai K (1976). "On the tryptophan-serotonin metabolism in manic-depressive disorders. Changes in plasma 5-HT and 5-HIAA levels and urinary 5-HIAA excretion following oral loading of L-5HTP in patients with depression". Hiroshima J. Med. Sci. 25 (2–3): 135–40. PMID1088369.
^Magnussen I, Jensen TS, Rand JH, Van Woert MH (1981). "Plasma accumulation of metabolism of orally administered single dose L-5-hydroxytryptophan in man". Acta pharmacologica et toxicologica. 49 (3): 184–9. doi:10.1111/j.1600-0773.1981.tb00890.x. PMID6175178.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Birdsall TC (1998). "5-Hydroxytryptophan: a clinically-effective serotonin precursor". Alternative Medicine Review. 3 (4): 271–80. PMID9727088.
^Sternberg EM, Van Woert MH, Young SN; et al. (1980). "Development of a scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa". N. Engl. J. Med. 303 (14): 782–7. doi:10.1056/NEJM198010023031403. PMID6997735.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^"5-Hydroxytryptophan". University of Maryland Medical Center. Archived from the original on 6 January 2010. Retrieved 21 January 2010. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^"5-Hydroxytryptophan (5-HTP)". A.D.A.M., Inc. University of Maryland Medical Center. Animated Dissection of Anatomy for Medicine, Inc. (A.D.A.M., Inc.) provided health and benefits information and technology to healthcare organizations, employers, consumers, and educational institutions
^Emanuele, E; Bertona, M; Minoretti, P; Geroldi, D (2010). "An open-label trial of L-5-hydroxytryptophan in subjects with romantic stress". Neuro endocrinology letters. 31 (5): 663–6. PMID21178946.
^"5-hydroxy-L-tryptophan", National Center for Biotechnology Information, PubChem Compound Database, September 2004CID=439280
^Rondanelli M; Opizzi A; Faliva M; Bucci M; Perna S. (March 2012). "Relationship between the absorption of 5-hydroxytryptophan from an integrated diet, by means of Griffonia simplicifolia extract, and the effect on satiety in overweight females after oral spray administration". Eat Weight Disord. 17: e22-8. doi:10.3275/8165. PMID22142813.