Is this stress- and depression-relieving natural supplement a miracle drug or dangerous science?

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When Sarah*, 33, felt frazzled by her demanding job as a publicist, she didn’t want to turn to prescription medication for her anxiety. After pouring over the book Depression-free for Life by Gabriel Cousens, MD (a holistic medicine pioneer with a huge following, including Woody Harrelson), Sarah started taking a natural supplement that sounded ideal for her: 5-Hydroxytryptophan, or 5-HTP. It comes from the seeds of an African plant called griffonia simplicifolia and is touted for relieving depression, anxiety, and sleep issues.

5-HTP converts into serotonin, the neurotransmitter that makes you feel positive, confident, and not obsessively cranky about stupid things like why your co-worker keeps leaving dirty lunch dishes in the communal sink. Without the right level of serotonin in your brain, sleepless nights can become the norm, and irritability, depression, and anxiety attacks start to creep in. You can’t simply take serotonin pills, because your brain can’t absorb it that way. However, 5-HTP can get into the brain, where it’s synthesized into happy juice.

When you eat foods with tryptophan (animal protein from beef, chicken, turkey, fish, or dairy products), it converts to 5-HTP, which is then converted to serotonin. Taking a 5-HTP supplement is not only vegan, but also circumvents the tryptophan-to-5-HTP conversion process, going right to the step that gets into the brain.

Daily dosage of 5-HTP, available over the counter, ranges from 50 to 250 mg. Sarah took 100 mg of 5-HTP per night for about three months, and during that time she says she felt calmer and more focused in her daily life and it helped her sleep through the night. In today’s world of 24-hour work demands, it’s results like these that have people scrambling to take the supplement, something that psychotherapist and nutritional therapist Julia Ross, author of The Mood Cure, is all for. “If we just talk about depression and anxiety, we have a great tool for eliminating those problems, but people who are irritable and edgy, perfectionistic, even obsessive, all of these are very clear cut, well-researched serotonin deficiencies,” she explains. (There’s an intriguing quiz on Ross’ site where you can identify if you have the symptoms of serotonin deficiency.)

5-HTP has been studied quite a bit, and while some studies have shown promise, many doctors find the results fall flat. One meta-analysis published in the Journal of Neuropsychiatric Disease and Treatment claims: “This nutrient has a large and strong following who advocate exaggerated and inaccurate claims relating to its effectiveness in the treatment of depression and a number of other serotonin-related diseases. These assertions are not supported by the science.”

Some psychiatrists and neurologists dismiss 5-HTP as ineffective at best and dangerous at worst because messing around with your brain chemicals is not something to take lightly. “If you tinker with the system [via serotonin], it has an indirect effect on other neurotransmitters,” explains  Prakash Masand, MD, former consulting professor of psychiatry and behavioral sciences at Duke University and president of Global Medical Education, an online medical education site.  He also points out that blaming low serotonin for depression and anxiety is too simplistic and flat-out wrong: “If it was as easy as boosting serotonin, all my patients would be better in 48 hours.” Julia Samton, MD, a psychiatrist and neurologist, agrees, explaining that an improper balance of neurotransmitters can even make depression worse.

Frank Lipman, MD, author of The New Health Rules and go-to health guru for many well-heeled New Yorkers, does find 5-HTP effective for depression and sleep issues, but warns that you need to be careful with dosage, so it’s best to consult a doctor before going all in. Reactions with other medication, including some antidepressants and migraine medicine, can be severe, and pumping too much serotonin in the brain can cause “serotonin syndrome,” a serious condition that can cause seizures, diarrhea, and may even kill you, says Masand.

As for Sarah, she says that she felt that the effects lessened over time and has since stopped taking 5-HTP. She’s still looking for the right solution for her anxiety and racing mind, somewhere between prescription drugs and natural therapy.

​Sources:

  1. Depression-free for Life: A Physicians All-Natural, 5-Step Plan
  2. The Mood Cure
  3. NYU Langone Medical Center
  4. Journal of Neuropsychiatric Disease and Treatment
  5. Prakash Masand, MD
  6. Julia Samton, MD
  7. Frank Lipman, MD
  8. Mayo Clinic
  9. New England Journal of Medicine