Serotonin a la carte: Supplementation with the serotonin precursor 5-hydroxytryptophan

Erick H. Turner, Jennifer M. Loftis, Aaron D. Blackwell

Research output: Contribution to journalReview articlepeer-review

199 Scopus citations

Abstract

This paper reviews the preclinical and clinical evidence regarding the use of the dietary supplement 5-hydroxytryptophan (5-HTP) for the treatment of depression. In the absence of supplementation with exogenous 5-HTP, the amount of endogenous 5-HTP available for serotonin synthesis depends on the availability of tryptophan and on the activity of various enzymes, especially tryptophan hydroxylase, indoleamine 2,3-dioxygenase, and tryptophan 2,3-dioxygenase (TDO). Factors affecting each of these are reviewed. The amount of 5-HTP reaching the central nervous system (CNS) is affected by the extent to which 5-HTP is converted to serotonin in the periphery. This conversion is controlled by the enzyme amino acid decarboxylase, which, in the periphery, can be blocked by peripheral decarboxylase inhibitors (PDIs) such as carbidopa. Preclinical and clinical evidence for the efficacy of 5-HTP for depression is reviewed, with emphasis on double-blind, placebo-controlled (DB-PC) trials. Safety issues with 5-HTP are also reviewed, with emphasis on eosinophilia myalgia syndrome (EMS) and serotonin syndrome.

Original languageEnglish (US)
Pages (from-to)325-338
Number of pages14
JournalPharmacology and Therapeutics
Volume109
Issue number3
DOIs
StatePublished - Mar 2006

Keywords

  • 5-HTP
  • Antidepressants
  • Depression
  • Selective serotonin re-uptake inhibitor
  • Serotonin
  • Tryptophan

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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