Why aren’t counselors and other professionals not telling us about 5-HTP to help restore serotonin issues, vs. using antidepressants? Is there something wrong or bad with 5-HTP?

I take some anxiety meds and preventative migraine meds. Would this interfere with my meds?

What are the benefits and risks of taking 5-HTP? Also, if I am taking anxiety meds, am I able to take this or not?

Thank you for your attention in this matter.

Tammy, Black River Falls, WI


Dear Tammy,

Your question about 5-HTP is a good one. And it’s got some interesting history. During the 70s and 80s, the amino acid tryptophan was often used as an antidepressant and sleep-enhancer. The reason was that tryptophan is converted in the body to serotonin, and also to melatonin. Deficiencies of serotonin in the brain have been linked to a number of disparate conditions, including: depression (especially the agitated, anxious, irritable type),1-6 anxiety,7 suicide,8 alcoholism,9 violent behavior,8 PMS,10obesity,10,11 compulsive gambling,12 insomnia,13 carbohydrate craving,10 SAD (seasonal affective disorder),10 and migraine headaches.14 

LEM1502synthesis274.gifSerotonin nerve circuits promote feelings of well-being, calmness, personal security, relaxation, confidence and concentration.15 Serotonin circuits also help counterbalance the tendency of two other major neurotransmitters in the brain — dopamine and noradrenaline — to encourage overarousal, fear, anger, tension, aggression, violence, obsessive-compulsive actions, overeating, anxiety and sleep disturbances.15

Many people found that 500 to 3,000 mg of supplementary tryptophan daily provided practical relief from depression, PMS, insomnia and obsessive-compulsive disorders. In 1989, the FDA removed tryptophan from the American health food market due to a mysterious outbreak of a rare but serious ailment — eosinophilia myalgia syndrome(EMS). This EMS “epidemic” was later traced to a single batch of contaminated tryptophan from a Japanese producer. Although tryptophan has been proven to be safe (and has always been available in baby food formulas, intravenous feeding solutions, and veterinary products) the FDA only recently allowed tryptophan back onto the market as a dietary supplement.

Curiously, within months of the FDA’s order banning tryptophan from the marketplace, Prozac was introduced, followed by a flurry of similar “selective serotonin reuptake inhibitor” (SSRIs) pharmaceuticals (Paxil, Zoloft). Although these drugs did not contain any serotonin or precursors, they blocked the uptake of serotonin into the nerve endings, thereby increasing the amount of serotonin available to act on serotonin receptors in the neural cleft.

Fortunately, there was a safe, natural and effective alternative to tryptophan. This substance is L-5-Hydroxytryptophan (5-HTP), and was found to be even more effective than L-tryptophan. 5-HTP easily crosses the blood-brain barrier,1 and is not incorporated into proteins, as is tryptophan; nor is 5-HTP used to make vitamin B3, as is tryptophan. Thus, in comparison to tryptophan, 5-HTP is virtually a “guided missile” that is directly targeted to increasing brain serotonin levels. Not surprisingly, studies have shown better results using only 200 to 300 mg of 5-HTP per day as an antidepressant compared to other studies using 2,000 to 3,000 mg or more of tryptophan per day.16

A placebo-controlled, double-blind study in 1992 found excellent results treating obesity using doses of 5-HTP as high as 900 mg daily, with minimal side effects (the greatest side effect being diarrhea or upset stomach)!11 In one study, the antidepressant effects of 5-HTP was compared with the SSRI fluvoxamine (Luvox®). The 5-HTP patients showed slightly better treatment response than the fluvoxamine group, yet had significantly fewer and less severe side effects. The researchers note: “Regarding tolerance and safety, however, oxitriptan [5-HTP] proved superior to fluvoxamine as was apparent from a marked difference in severity of untoward side effects between the two compounds. The study presented here … strongly confirm[s] the efficacy of 5-HTP as an antidepressant.”4

The many successful published studies using 5-HTP show that 5-HTP, by naturally elevating brain serotonin, can alleviate the serotonin-deficiency syndrome without any help from SSRI drugs. The success of SSRI drugs is crucially dependent upon the brain producing adequate serotonin (from either tryptophan or 5-HTP), and that brain serotonin production is the controlling or rate-limiting variable underlying the apparent success of SSRIs. It appears that the more logical and economically sound choice to alleviate conditions that result from the serotonin deficiency syndrome is 5-HTP, the immediate precursor of the deficient substance.

Thus, with regard to your questions regarding combining 5-HTP with your anti-depressants and / or anxiety meds: If your medications are in the SSRI class, you may be able to reduce your dosage or eliminate the drugs altogether with supplemental 5-HTP. Of course, do this in conjunction with your physician’s guidance.

Ward Dean, MD


  1. Zmilacher K, Battegay R, Gastpar M. L-5-hydroxytryptophan alone and in combination with a peripheral decarboxylase inhibitor in the treatment of depression. Neuropsychobiology. 1988;20:28 – 35.
  2. Byerley WF, Judd LL, Reimherr FW, Grosser BI. 5-Hydroxytryptophan: A review of its antidepressant efficacy and adverse effects. J Clin Psychopharmacol.1987;7:127 – 37.
  3. Risch SC, Nemeroff CB. Neurochemical alterations of serotonergic neuronal systems in depression. J Clin Psychiatry. 1992;53:3 – 7.
  4. Pöldinger W1, Calanchini B, Schwarz W. A functional-dimensional approach to depression: serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology. 1991;24:53 – 81.
  5. van Praag HM. Management of depression with serotonin precursors. Biol Psychiatry. 1981;16:291 – 310.
  6. Takahashi S, Kondo H, Kato N. Effect of L-5-hydroxytryptophan on brain monoamine metabolism and evaluation of its clinical effect in depressed patients. Psychiat Res. 1975;12:177 – 87.
  7. Kahn RS, Westenberg HG. L-5-hydroxytryptophan in the treatment of anxiety disorders. J Affect Disord. 1985; 8:197 – 200.
  8. Linnoila VM, Virkkunen M. Aggression, suicidality, and serotonin. J Clin Psychiatry. 1992; 53:46 – 51.
  9. Buydens-Branchey L1, Branchey MH, Noumair D, Lieber CS. Age of Alcoholism Onset. II. Relationship to susceptibility to serotonin precursor availability. Arch Gen Psychiatry. 1989;46:231 – 6
  10. Wurtman J. Carbohydrate craving, mood changes and obesity. J Clin Psychiatry.1988;49: 37 – 9.
  11. Cangiano C1, Ceci F, Cascino A, Del Ben M, Laviano A, Muscaritoli M, Antonucci F, Rossi-Fanelli F. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr. 1992;56:863 – 7.
  12. Murphy DL, Zohar J, Benkelfat C, Pato MT, Pigott TA, Insel TR. Obssessive-compulsive disorder as a 5-ht subsystem-related behavioral disorder. Brit J Psychiatry. 1989;155:15 – 24.
  13. Maurizi CP. The therapeutic potential for tryptophan and melatonin: possible roles in depression, sleep, Alzheimer’s disease and abnormal aging. Med Hypoth. 1990;31:233 – 42.
  14. DeBenedittis G, Massei R. 5-HT Precursors in migraine prophylaxis: a double-blind cross-over study with L-5-hydroxytryptophan versus placebo. Clin J Pain.1986;3:123 – 9.
  15. Robertson J, T. Monte T. Natural Prozac-Learning to Release Your Body’s Own Anti-Depressants. San Francisco: Harper; 1997.
  16. Hvan Praag HM. Studies of the mechanism of action of serotonin precursors in depression. Psychopharmacol Bull. 1984;20:599 – 602.