More threads by David Baxter PhD

David Baxter PhD

Late Founder
Treating Depression with Natural Supplements: SAM-e and 5-HTP
by Merely Me
Monday, June 22, 2009

In my last post, I began our discussion of treating depression with natural supplements with many warnings. I am going to stress some of those warnings again. When you buy vitamins, herbs, and supplements, just because they are "natural" does not mean they won't have any side effects or interactions with other medications and supplements. Natural remedies are also not regulated by the FDA. There could be unknown fillers or the brand of supplement you buy may not have enough of the active ingredient to be effective.

Know the risks you are taking by using natural supplements. Please do your research and also always tell your doctor everything you are taking including herbal or vitamin products.

I have talked about SAM-e at length in a previous post but I am going to add on a few additional bits of information to round out that discussion. And then I am going to tell you my findings about 5-HTP. In subsequent posts I will talk about other supplements.

About SAM-e: You can find my past article about this substance here. SAM-e is a dietary supplement (pronounced "sammy"), used to treat depression, arthritis, and some liver disorders. I have been taking it for well over a year now and I feel that it has been very effective in decreasing my episodes of depression.

Here are some additional things you should know about SAM-e:

  • I do not know if SAM-e would be effective for all types of depression. I believe it is mostly effective for those suffering from an on-going mild to moderate type of depression.
  • Buy SAM-e from a reputable company. I purchase mine from Whole Foods and use their brand. Make sure the tablets are enteric-coated and store them in a cool dry place.
  • Take the minimum dosage and see how it works for you and then increase the dosage as needed. I began by taking 200 mg and now I take 400 mg. This is an effective dose for me but studies show that most people need 800-1600 mg for it to make a difference in treating their depression.
  • The main side effect I had personally experienced was stomach upset. Take SAM-e on an empty stomach. The literature states that other side effects may include greater anxiety, sleeplessness, and or feeling dizzy. Here is a web site which lists some of the possible side effects of taking SAM-e.
  • Don't stop taking your anti-depressant in order to take SAM-e without a thorough discussion with your doctor. Do not take SAM-e in addition to your anti-depressant. You need to ask your doctor about possible drug interactions. Here is a list of the possible interactions with SAM-e.
  • Some of the literature warns that you should not take SAM-e if you have Bipolar Disorder (it could kick you into mania) or Parkinson's disease.
  • There is some confusion out there about whether or not SAM-e will decrease or increase homocysteine levels in your body. Why be concerned about this? Homocysteine is a derivative of the amino acid methionine and may contribute to atherosclerosis (hardening of the arteries) by producing irritation and inflammation in the inner lining of arteries. So the worry is whether or not SAM-e could contribute to heart problems.
There are some clinical trials going on at this time to see if SAM-e does raise homocysteine levels.

In this Question and Answer session guidance is given about how to decrease the chances of rising homocysteine levels:

"SAMe will lower homocysteine levels provided that your body has enough methylating cofactors such as vitamin B12, B6 and folic acid. Without these cofactors, SAMe will eventually breakdown into homocysteine. That why it is imperative to take vitamin B12, B6 and folic acid when taking SAMe."
So if you are taking SAM-e also be sure to take a combination of B vitamins and folic acid to help prevent any health risks due to a build up of homocysteine.

About 5-HTP:
Know that I have no firsthand experience of taking this supplement. If you have taken this or are presently taking 5-HTP let us know about your experience.

5-Hydroxytryptophan (5-HTP) is a chemical created from tryptophan and is the intermediate step towards the production of the brain chemical serotonin. And as you probably already know, serotonin is very important for the regulation of mood. Some reports say that 5-HTP relieves the symptoms of depression and may also be used as a weight loss supplement as well as a treatment for migraines. This supplement is manufactured from the seeds of the African plant Griffonia simplicifolia.

In researching this supplement I must tell my readers that I am seeing far more warnings and precautions than I am of any scientific proof that 5-HTP is effective for the treatment of depression.

The Journal of Psychiatry and Neuroscience does report that, "In studies where 5-HTP was found to be better than placebo, it was given at doses of 200 mg per day or more with a peripheral decarboxylase inhibitor."

Cathy Wong, who writes about alternative treatments for depression tells us about the flaws of the studies which have investigated the use of 5-HTP for the treatment of depression:

"For example, in a six week clinical trial, 63 people were given either 5-HTP (100 mg three times a day) or an antidepressant (fluvoxamine, 50 mg three times a day). The 5-HTP was found to be as effective as the antidepressant, with fewer side effects. However, a 2002 systematic review of studies published between 1966 to 2000 found that only one out of 108 studies met the quality standards."
It is clear that more reliable research is needed to show that this particular supplement has any merit in the treatment of depression.

What are the possible side effects of taking 5-HTP?
I must say that the side effects seem to be considerable considering this is supposed to be a natural supplement.

On this mental health site the authors warn that side effects can include:

"agitation, drowsiness, flushing, headache, mild stomach upset, and tachycardia (fast heart rate). There is a small risk of developing liver toxicity when using 5-HTP."
Dr. Ray Sahelian cautions that: "Common side effects with high dosage of 5-HTP include nausea, stomach upset, loose stools or constipation, and headache. Regular use of 5HTP could lead to reduce sex drive or libido." This doctor also warns that the use of 5-HTP can induce nightmares in some people. He recommends that you only take the minimum dosage and take frequent breaks from it.

It seems that this is not a supplement anyone recommends taking long term.

What is the recommended dosage for taking 5-HTP?
Nancy Schimelpfening, a writer for a health site, warns us that:

"Dosages of 5-hydroxy L-tryptophan (5-HTP) greater than 100 milligrams per day should be taken only under the guidance of a physician. 5-HTP use at doses greater than 100 mg per day should be taken with the prescription drug carbadopa to prevent excessive levels of serotonin production in the peripheral blood circulation. 5-HTP can increase the effect of tranquilizing drugs and can impair the ability to drive an automobile."
This Depression Guide suggests that you take one tablet in the evening on an empty stomach.

What about drug interactions?
There seem to be many for this particular supplement. Nancy Schimelpfening, who writes about depression treatments warns us that you cannot take 5-HTP if you are currently taking any of the following medications:

"Anti-depressant drugs; Monoamine oxidase inhibitors; Selective Serotonin Reuptake Inhibitors; Tricyclic medications; Weight Loss medications; Anti-parkinson medications; Barbiturates and other tranquilizing drugs; Antihistamines and cold medications; Alcoholic beverages; Intravenous drugs; Cancer chemotherapy or antibiotic medications"
Of course it is wise to check with your doctor about any supplement you use to see if there are any possible drug interactions.

What do other people have to say about 5-HTP?
Our Teri Robert has written about this supplement with regard to using it for the treatment of migraines. You can read her report here.

It seems she is wary about people using this supplement for migraines or any other purpise.

You can also find patient reports of their experience using 5-HTP here It is worth noting that some people describe that 5-HTP did help them to decrease the symptoms of depression.

Research does take a bit of time but it is well worth it. You really do need to know the facts about what you are putting into your body whether it is a prescription drug or a natural supplement. I do have my particular biases but I do hope to present you with a credible and balanced view of the treatments out there. If you have any experience with taking these supplements or have studies you can cite about their efficacy, it would be much appreciated. Knowledge is power. You have the ultimate power to make that choice to decide what is best for you.
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