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In Brief: 5-HTP for Depression

   
The Medical Letter on Drugs and Therapeutics • February 20, 2012;  (Issue 1384)
A Medical Letter reader asked about the use of the nutritional supplement 5-hydroxytryptophan (5-HTP) for treatment of depression. It is sold in health food stores, pharmacies and on-line for many indications...
A Medical Letter reader asked about the use of the nutritional supplement 5-hydroxytryptophan (5-HTP) for treatment of depression. It is sold in health food stores, pharmacies and on-line for many indications including depression, mood enhancement, emotional well being, and promotion of normal sleep.

5-HTP is the intermediate metabolite in the biosynthesis of serotonin from L-tryptophan.1 Many small studies in the 1970’s and 1980’s found 5-HTP helpful in the treatment of depression, but a Cochrane Review of 108 studies in patients with depression or dysthymia using 5-HTP or L-tryptophan found that the quality of the data was insufficient to establish the efficacy or safety of these products.2

In 1989, contaminated L-tryptophan supplements were implicated as the causative agent in an outbreak of eosinophilia-myalgia syndrome (EMS), which was associated with some deaths. There is no evidence that 5-HTP could cause the syndrome.

There is no acceptable evidence that 5-HTP or L-tryptophan offers any advantage over a selective-serotonin reuptake inhibitor (SSRI) for treatment of depression. Taking 5-HTP or L-tryptophan in addition to an SSRI could cause serotonin syndrome.

There is no good reason to take 5-HTP or L-tryptophan.

1. N Iovieno et al. Second-tier natural antidepressants: review and critique. J Affect Disord 2010; 130:343.

2. K Shaw et al. Tryptophan and 5-hydroxytryptophan for depression. Cochrane Database Syst Rev 2002; (1): CD003198.

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Med Lett Drugs Ther. 2012 Feb 20;54(1384):16 | Show Full IntroductionHide Full Introduction