re-uptake devices in the brain may actu- ally reduce the amount of serotonin being produced. This finding surprised a lot of doctors. To get around the problem, they began changing dosages and prescribing additional anti-depressants, beta-blockers or naltrexone. But none of these changes really helped patients achieve the results they had when first taking SSRIs. Integrative physicians, however,
quickly realized that 5-HTP would assist SSRIs by helping increase the amount of serotonin in the brain. Traditional doctors still stay away from this practice because they fear it will create a condition known as serotonin syndrome. This syndrome, which is marked by hypertension, profuse sweating, diarrhea and possible psychosis, can occur if too much 5-HTP is taken. However, in small doses, it can safely produce positive results for depressed patients. Many integrative physicians prescribe 5-HTP to patients regularly, and in the 20- some years since SSRIs have been out, most have never had a patient experience a life-threatening reaction to the combina- tion of an SSRI and low doses of 5-HTP.
Incorporating 5-HTP into Depression Treatment
There are a number of ways to find
out whether or not your serotonin is low. One way is if you notice your SSRI isn't working as well as it used to. Another is to take inventory of your mood and actions. If you're low on serotonin, you'll notice some of the following things:
• A hypercritical attitude—particularly as it relates to your feelings about your self • Feeling overwhelmed • A need for control • Indecisiveness • Obsessive compulsive feelings (this occurs with very low serotonin) • Craving carbohydrates like bread, rice and sugar
The way to determine whether or not
a patient might benefit from 5-HTP in conjunction with his or her antidepressant is by taking a thorough history. Question- naires are also helpful. Usually this is enough data to determine the need for 5-HTP. Then one can take a small dose of 5-HTP and increase it slowly.
Sometimes, a urine test is useful. Se- rotonin is made in the brain, but it is ex- creted in the urine. So by monitoring a patient's urine levels, a doctor can deter- mine a patient's serotonin level. If a depressed patient's urine has low
levels of serotonin, that's an indication that his or her brain doesn't have the serotonin levels necessary for an SSRI to properly rearrange the concentrations of the neu- rotransmitter. Then one can use 5-HTP to increase the patient's serotonin levels. This will help the SSRI work better, and it may reduce the patient's dose of the SSRI. This, in turn, tends to reduce any side effects the patient experiences from taking the anti- depressant. Always start patients out on the lowest dose of 5-HTP possible— 50-100mg a day.
Elizabeth Vaughan, MD
Over time, increase the dosage. Most people require between 200mg and 500mg a day. The maximum dosage rec- ommended is 800mg daily, divided up into 200mg four times a day. If a patient is on an SSRI, they will usually use 100- 400mg daily. If a person seems particu- larly sensitive to 5-HTP and is experienc- ing an increase in side effects similar to those felt with the SSRI, reduce the dosage.
SSRI SIDE EFFECTS Side effects of SSRIs can include:
• Nausea • Dry mouth • Headache • Diarrhea • Nervousness, agitation or restlessness • Reduced sexual desire or difficulty reaching orgasm • Inability to maintain an erection (erectile dysfunction) • Rash
• Increased sweating • Weight gain • Drowsiness • Insomnia
Natural Triad Magazine
DECEMBER 2012
9
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