5-HTP:

The Natural Alternative to Prozac®

by John Morgenthaler & Lane Lenard, PhD
$3.95 - softcover, 40 pages (Out of Stock)

Who Needs Prozac? Printer Friendly version

In first half of 1997, three of the top 10 prescription drugs sold in the United States were Prozac® (#2) and its chemical cousins, Zoloft® (#5) and Paxil® (#8). In just 6 months, these three drugs combined brought in more than $1.6 billion to their respective pharmaceutical companies. This figure represents only what pharmacies, HMOs, and hospitals paid for the drugs. When you add in the markup of these organizations, it means that we, the public (along with our insurance companies), probably laid out upwards of $3 billion for them.1, 2 Prozac brings in so much money to its manufacturer, Eli Lilly and Co., that they have endowed the largest private charitable foundation in the United States-- the Lilly Endowment -- with assets valued at nearly $13 billion. Why are these drugs so popular?

Prozac burst upon the scene in the late 1980s as a major advance in the treatment of clinical depression. In the decade since, researchers, physicians, and patients have discovered that many other common conditions -- sometimes debilitating, but always difficult to treat -- seem to respond to treatment with Prozac or one of its relatives. Scientific evidence suggests that these drugs may be effective for treating:

Depression
Anxiety disorders, up to and including panic
Obesity
Insomnia
Premenstrual syndrome (PMS)
Migraine
Obsessive-compulsive disorder (OCD)
Aggressive or violent tendencies
Fibromyalgia
Alcoholism

There is even reason to believe that these drugs may offer important benefits for some people who are not suffering from any recognized clinical condition, but who simply want to improve their personality. This was the controversial subject of the best-selling book by psychiatrist Peter D. Kramer, MD, called Listening to Prozac, in which he suggested that Prozac can help make some "normal" people more confident, popular, mentally nimble, and emotionally resilient.3 In apparent confirmation of Kramer's contention that this type of drug can alter personality, a recent study found that people taking Zoloft experienced reduced hostility and a general decline in negative affect, even if they were not depressed.4

For all their benefits, though, these drugs have some important drawbacks, not the least of which is a disturbing loss of sexual desire and/or nausea and vomiting in as much as 30 to 40% of users. These and other unpleasant side effects, not to mention their high cost, have led many people to search for alternatives.*

*(For and in-depth discussion of the adverse effects of Prozac and related drugs, see the book Talking Back to Prozac by Peter R. Breggin, MD, and Ginger Ross Breggin. -- St. Martin's Paperbacks.)

The 5-HTP Option

In this booklet, we are going to tell you about a remarkable natural alternative to Prozac and similar drugs. It is an amino acid named 5-hydroxytryptophan, or 5-HTP, for short. A growing base of scientific evidence, collected from studies conducted both in animals and people, suggests that 5-HTP does everything the drugs do, but with far fewer adverse effects.

One reason 5-HTP and Prozac-like drugs have such similar effects is that they each act on the same chemical in the brain -- a neurotransmitter called serotonin (also known as 5-hydroxytryptamine, or 5-HT). (Neurotransmitters are vital chemicals that enable nerve cells to communicate with one another.) A reduction in brain levels of serotonin is now widely believed to be an important factor in the development of all the conditions mentioned above.

The general effect of both 5-HTP and Prozac-like drugs is to increase the availability of serotonin at specific sites in the brain, known as "serotonin receptors." (Receptors are ultra-microscopic points on nerve cell surfaces where serotonin molecules attach -- like a key in a lock -- and, in so doing, trigger further activity in that nerve cell.) Increasing the availability of serotonin at these receptors -- by a variety of means -- has generally been associated with alleviation of these disorders.

Here is a key point, which we will elaborate shortly: although 5-HTP and Prozac-like drugs both tend to increase the availability of serotonin molecules at serotonin receptors, they each work in very different ways.

The drugs act by interfering with a natural process -- the reuptake or recycling of released serotonin molecules. The net effect of this action is to make more serotonin molecules available to stimulate serotonin receptors. Because they inhibit serotonin reuptake, these drugs are classed as selective serotonin reuptake inhibitors, or SSRIs.
5-HTP raises serotonin levels by enhancing a natural process -- the synthesis of new serotonin molecules. This difference in mechanism of action may be the primary reason why 5-HTP, at reasonable doses, produces far fewer and less severe unpleasant side effects, including loss of libido.

In the remainder of this booklet, we will review evidence that 5-HTP can be helpful for:

Relieving depression
Alleviating anxiety, panic, and obsessive-compulsive disorder (OCD)
Reducing the pain and frequency of migraine attacks
Alleviating the pain and discomfort of fibromyalgia
Improving sleep
Suppressing appetite and losing weight

In the Beginning, There Was Tryptophan

If the name "5-hydroxytryptophan" rings a bell, you're probably remembering another amino acid with a similar name -- tryptophan (also known as L-tryptophan). Tryptophan is an essential amino acid. This means that your body requires it to function but cannot manufacture it itself. Therefore, it must come from dietary sources that are rich in tryptophan, including animal proteins (turkey and milk are especially good sources) and tryptophan supplements.

For many years, tryptophan was one of the best-known and widely used nutritional supplements. Many people found it to be particularly effective for relieving depression and anxiety and for enhancing sleep. Then, in 1989, the FDA abruptly pulled all tryptophan supplements off the market after a number of people became very ill or died from a disease called eosinophilia-myalgia syndrome (EMS). The one thing these people seemed to have in common was that they were all taking tryptophan supplements.

The suddenness of the mysterious EMS outbreak puzzled many researchers. Tryptophan had been in use for many years with hardly any serious problems, let alone multiple deaths. The fact that all the cases occurred within a discreet period of time suggested two things: first, that tryptophan per se was probably not to blame; and second, that some tryptophan may have been involved, perhaps due to contamination, mislabeling, or adulteration.

It wasn't long before the mystery was solved. Beginning as early as 1990, numerous independent investigators began reporting the results of studies pointing strongly in the direction of a contaminant in the tryptophan produced by a single manufacturer, a Japanese company named Showa Denko.8-9 In an attempt to increase their yield (and hence, their profits), Showa Denko had altered the time-honored fermentation recipe for making tryptophan by introducing a new, untested strain of genetically altered bacteria. It turned out that virtually all the individuals who had become ill had been using the Showa Denko product.

Nearly a decade later, despite incontrovertible evidence that uncontaminated tryptophan produced by conventional fermentation methods does not cause EMS, the FDA's tryptophan prohibition remains in force in the United States, and the agency shows no sign that they are interested in lifting it.* The FDA supports their ban by citing a few studies purporting to show that high doses of tryptophan can cause changes in animals that resemble some of the symptoms of EMS. They also speculate that some rare individuals, who may be particularly sensitive to tryptophan supplements, may be susceptible to developing EMS.9

* (Despite the US restriction, tryptophan supplements remain widely available in other countries, where they havenot been associated with a single case of EMS since the Showa Denko incident.)

For a brief, but excellent, discussion of the tryptophan fiasco, see the article "The FDA Ban of L-Tryptophan: Politics, Profits, and Prozac," by Dean Wolfe Manders, PhD, which appeared in Social Policy Magazine, Winter 1995, vol. 26. The article is available in its entirety at the Cognitive Enhancement Research Institute's (CERI) website: www.ceri.com. CERI is an excellent resource for high quality technical, political, and social information related to "smart" drugs and nutrients.

The FDA's tryptophan ban has had one unforeseen benefit, however. It has forced tryptophan users to look elsewhere for a means of enhancing their serotonergic function. Although many turned to SSRIs, others have been giving 5-HTP a closer look. 5-HTP had been studied by scientists for many years, but it was not in widespread use by ordinary people, largely because tryptophan was more readily available, its effects were better-documented, and it was less costly to produce.

With tryptophan embargoed in the US, production of 5-HTP has finally become financially viable. This has been a fortuitous development, because 5-HTP now actually appears to be even more effective than its precursor in many important ways, especially for relief of depression. At the same time, according to the results of a rare head-to-head study, 5-HTP was found to be equally effective to an SSRI drug (fluvoxamine) for relieving depression, while causing fewer unpleasant side effects.10 (See Chapter 4.)

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