69 replies to this topic

[invalidusername]

'Hat has summed up the options here, and on the contrary, a lot of people choose to support the withdrawal with another SSRI. We aware of a certain group elsewhere that are right against this, and we respect this, but we are of the opinion of not causing any more suffering than need be. If it gets to this point, then we do suggest considering one of the above options. Think of it as natural childbirth if you will!! A drug-free birth is great.. sure it is, but boy can I imagine it smarts a bit!

 

Just in case you weren't aware;

 

Escitalopram = Lexapro

Celexa = Citalopram

Zoloft = Sertraline

 

You can also have a look at my most recent thread as I have gone from Cymbalta, to Citalopram and then to Escitalopram. I am VERY sensitive to drugs, so consider my journey a relatively nasty one. I was pushed and pulled all over the place and have gone thru hell - I use that term lightly, but it is fitting here. But things are slowly improving.

 

https://www.cymbalta...after-last-dose

 

Keep us updated, Sir. Anything else you would like to ask, please do so - we are all here for you both.

[gail]

Hello,

Does your wife still have the hyper sexual behavior? It should have lessened with time.

Zoloft is a good choice, few side effects. Lexapro and prozac also. You'd be surprised by the number of people who returned to another antidepressant. Many need it for !ife. The point is not to be med free, but to live free. You do what needs to be done.

Come back anytime, we're always here for you.

[invalidusername]

"The point is not to be med free, but to live free."

 

Great words, m'dear

[HRTBroken]

The hyper sexuality still hasn't resolved. She confessed to masturbating 3-5 times a day, in breaks from work, morning and night etc etc. Its been 4 months since that started. I am no longer with her but I am keeping a close eye, hopefully one day all these symptoms will resolve and the woman I love might come back. I don't know. 

 

Reading the medical literature, its understood that very low serotonin causes hypersexuality. So I think her serotonins levels are so low that she can't feel any emotions and is stuck in a state of hyper sexuality. Sex drive is inhibited by serotonin in the amygdala, where as in the prefrontal cortex serotonin stimulates emotions. So it has the opposite effect. So theoretically if she is severely serotonin deficient it leaves her trapped in a ice fold emotionless state with uncontrollable sexual urges.  

 

Because she can't feel anything she doesn't see why she needs to restart treatment with an SSRI. 

[fishinghat]

5htp and L-tryptophan both raise serotonin. That may help if you can get her to try it. They can't be taken with an ssri or snri but as long as she is off of them she would be OK. Just start at a low dose and work your way up. There is details on both supplements in Summary of Cymbalta Withdrawal Information in the medical support section as well as other things that can be done to raise serotonin.

[HRTBroken]

Ok thanks Fishing Hat. So technically 5HTP is contraindicated in depressed patients because to make the increased amounts of serotonin you deplete the ability to make Dopamine and consequently norepinephrine. 

 

Have you read anything on combining 5HTP and Tyrosine? Thats the precursor to L-Dopa, my biochemistry is not detailed enough to know if there is sufficient Tyrosine, will increased serotonin production still reduce the production of dopamine and norepinephrine. 

[HRTBroken]

I see, you need to use L-Tryptophan at the same time so you don't deplete aromatic L-amino acid decarboxylase and put dopamine out of balance. I thought that was suggesting two separate treatments, not the two together. I follow now

[fishinghat]

Using them together is Ok but you have to watch the risk of serotonin syndrome that is why you need to start slow and work your way up to a minimum effective dose.

[HRTBroken]

Ok so a minimum effective dose I presume would mean better sleep, and reduced hyper sexuality and slowly increased mood. Is there is a safe dose that can be maintained or do you take it for a short period until you feel better?

 

Any studies you would recommend me looking at? She has had serotonin syndrome once before, from getting overdosed on the wrong SSRI from the pharmacist. 

[fishinghat]

FYI
 
More to follow


http://www.ncbi.nlm....les/PMC3415362/


5-HTP alone contraindicated for long-term use

The most significant side effects and adverse reactions may occur with long-term use (many months or longer). Administration of 5-HTP alone depletes catecholamines (dopamine, norepinephrine, and epinephrine).12,15 When dopamine depletion is great enough, 5-HTP will no longer function.15 If other centrally acting monoamine-related disease processes involving catecholamines are present, administration of 5-HTP alone may deplete dopamine, norepinephrine and epinephrine thereby exacerbating these conditions.15

 

12. Hinz M, Stein A, Uncini T. APRESS: apical regulatory super system, serotonin, and dopamine interaction. Neuropsychiatr Dis Treat. 2011;7:457–463. [PMC free article] [PubMed]
15. Hinz M, Stein A, Uncini T. Relative nutritional deficiencies associated with centrally acting monoamines. Int J Gen Med. 2012;5:413–430. [PMC free article] [PubMed]

[fishinghat]

If more info is needed please let me know.

5HTP

http://www.umm.edu/h...tryptophan-5htp
Overview
5-hydroxytryptophan (5-HTP) is a chemical that the body makes from tryptophan (an essential amino acid that you get from food). After tryptophan is converted into 5-HTP, the chemical is changed into another chemical called serotonin (a neurotransmitter that relays signals between brain cells). 5-HTP dietary supplements help raise serotonin levels in the brain.

 

A 2002 review concluded that although the data evaluated suggests that 5-HTP is more effective than placebo in the treatment of depression, the evidence was insufficient to be conclusive due to a severe lack of high quality research. More and larger studies are needed to determine if 5-HTP is truly effective in treating depression. Wiki

 

Safety
5-HTP is POSSIBLY SAFE when taking by mouth appropriately. 5-HTP has been used safely in doses up to 400 mg daily for up to one year. However, some people who have taken it have developed a condition called eosinophilia-myalgia syndrome (EMS), a serious condition involving extreme muscle tenderness (myalgia) and blood abnormalities (eosinophilia). Some people think EMS might be caused by an accidental ingredient or contaminant in some 5-HTP products. However, there is not enough scientific evidence to know if EMS is caused by 5-HTP, a contaminant, or some other factor. Until more is known, 5-HTP should be used cautiously.

Other potential side effects of 5-HTP include heartburn, stomach pain, nausea, vomiting, diarrhea, drowsiness, sexual problems, and muscle problems.

5-HTP is POSSIBLY UNSAFE when taken by mouth in large doses. Doses from 6-10 grams daily have been linked to severe stomach problems and muscle spasms.

 

Special precautions & warnings:
Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking 5-HTP if you are pregnant or breast feeding. Stay on the safe side and avoid use.

Surgery: 5-HTP can affect a brain chemical called serotonin. Some drugs administered during surgery can also affect serotonin. Taking 5-HTP before surgery might cause too much serotonin in the brain and can result in serious side effects including heart problems, shivering, and anxiety. Tell patients to stop taking 5-HTP at least 2 weeks before surgery.

Are there interactions with medications?
Major - Do not take this following combination.
Medications for depression (Antidepressant drugs)
5-HTP increases a brain chemical called serotonin. Some medications for depression also increase serotonin. Taking 5-HTP along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take 5-HTP if you are taking medications for depression.

Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.

 

Medications for depression (MAOIs)
5-HTP increases a chemical in the brain. This chemical is called serotonin. Some medications used for depression also increase serotonin. Taking 5-HTP with these medications used for depression might cause there to be too much serotonin. This could cause serious side effects including heart problems, shivering, and anxiety.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
Moderate - Be cautious with this combination.

 

Carbidopa (Lodosyn)
5-HTP can affect the brain. Carbidopa (Lodosyn) can also affect the brain. Taking 5-HTP along with carbidopa can increase the risk of serious side effects including rapid speech, anxiety, aggressiveness, and others.

 

Dextromethorphan (Robitussin DM, and others)
5-HTP can affect a brain chemical called serotonin. Dextromethorphan (Robitussin DM, others) can also affect serotonin. Taking 5-HTP along with dextromethorphan (Robitussin DM, others) might cause too much serotonin in the brain and can result in serious side effects including heart problems, shivering, and anxiety. Do not take 5-HTP if you are taking dextromethorphan (Robitussin DM, and others).

 

Meperidine (Demerol)
5-HTP increases a chemical in the brain called serotonin. Meperidine (Demerol) can also increase serotonin in the brain. Taking 5-HTP along with meperidine (Demerol) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety.

 

Pentazocine (Talwin)
5-HTP increases a brain chemical called serotonin. Pentazocine (Talwin) also increases serotonin. Taking 5-HTP along with pentazocine (Talwin) might increase serotonin too much. This might cause serious side effects including heart problems, shivering, and anxiety. Do not take 5-HTP if you are taking pentazocine (Talwin).

 

Sedative medications (CNS depressants)
5-HTP might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking 5-HTP along with sedative medications might cause too much sleepiness.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

 

Tramadol (Ultram)
5-HTP increases a brain chemical called serotonin. Tramadol (Ultram) can also increase serotonin. Taking 5-HTP along with tramadol (Ultram) might cause too much serotonin in the brain and might result in side effects including confusion, shivering, stiff muscles, and others.

 

Herbs and supplements with sedative properties
5-HTP can cause sleepiness or drowsiness. Using it along with other herbs and supplements that have the same effect might cause too much sleepiness. Some of these herbs and supplements include calamus, California poppy, catnip, hops, Jamaican dogwood, kava, St. John's wort, skullcap, valerian, yerba mansa, and others.

 

Herbs and supplements with serotonergic properties
5-HTP increases a brain chemical called serotonin. Taking 5-HTP along with other herbs and supplements that increase serotonin might lead to too much serotonin and cause side effects including heart problems, shivering and anxiety. Other herbs and supplements that increase serotonin levels include Hawaiian baby woodrose, L-tryptophan, S-adenosylmethionine (SAMe), and St. John's wort.

 

A total of 74 drugs (242 brand and generic names) are known to interact with 5-hydroxytryptophan.
55 major drug interactions
19 moderate drug interactions
For the complete list and to see what the interaction is go to:
http://www.drugs.com...3&generic_only=

Member comments

No brain zaps in 5 days

I decided to stop taking it completely b/c I really didn't think it was doing much of anything for me/I wasn't withdrawling and started taking 25 to 50 mg 5-HTP about a week ago. The 5-HTP doesn't really seem to be helping me. I am feeling more depressed...
The brain zaps are horrid, but 5-HTP really does ease them dramatically. I'm taking 100mg in the morning, and 50mg before bed. It really does help you sleep, and lifts your mood.

 

Tria - My head seems clearer and I just seem to feel more normal (knock on wood - don't want to jinx myself!) I can't say this is all due to the 5-HTP as she started me on a few other supplements as well but I only start one new supplement at a time, give it a couple weeks then start another, and my mood did improve after starting the 5-HTP.

 

AKAnole - I took 150mg of 5HTP every day for a few months. I stopped in December thinking I no longer needed it then over the holidays the depression came back suddenly.

 

brz - i am still not sure how best to take 5htp, it seems to work on a delayed "as needed" basis. does that make sense? it takes about a day to kick in but as soon as i get my anxiety under control it doesn't seem to be a problem to just stop. - which is not what i was expecting when i started last october. since many people take it on a regular basis, that is what i do. i take one 100mg time release pill every morning. just wanted to pass along my experience. however, while i have had good results from the 5htp for anxiety, i can't speak to its effectiveness as a sleep aid.

Penguin1982 - There was a post I read that even though the half life is only 12 hrs, it can stay in your liver and fat stores for months. Didn't realize that when I started supplementing with 200mg 5htp and 750mg GABA at night only to find myself peeing every ten min and shivering beyond control. After seeing that post I realized I was getting waaaay too much serotonin and creating serotonin syndrome for myself . I've since stopped both and seem to be coming back around .

 

AKAnole - 5 HTP to supplement the lack of serotonin that I was experiencing. It helped but didn't curb the anxiety I would experience at times. L-Tryptophan which I think works better for me mood wise but I can't take it at night or else it disrupts my sleep

 

FN - 5HTP worked/works great for me as well ... I did stop using it daily, and have been using it just once in a while, and was doing just fine ... however, I'm now actually considering going back on it daily, as I've been working a really stressful temp job, and I'm starting to feel a bit "unsteady" ...
There is a rebound effect from 5-htp if it is stopped cold turkey. Next time try phasing it out over a 2 week period and you will do a lot better

 

http://www.cymbaltaw...5-htp/?hl=helps
5thp information and discussion.

https://examine.com/supplements/5-htp/
Detailed summary of scientific studies on 5HTP including anxiety and depression.

https://www.ncbi.nlm...les/PMC3415362/
Lack of effectiveness and dangers of its use.

5-HTP is not found in the foods we eat, although tryptophan is. Eating foods with tryptophan does not increase 5-HTP levels very much, however. As a supplement, 5-HTP is made from the seeds of an African plant called Griffonia simplicifolia.
Source: http://www.umm.edu/a...m#ixzz2Q0VyOr4w

1. 5-HTP is changed into serotonin
2. Our body uses tryptophan to make 5-HTP
3. Vitamin B6, vitamin C, folic acid and magnesium are necessary for the metabolization of tryptophan. In addition, tyrosine and phenylalanine compete with tryptophan for absorption.
4. Several dietary, lifestyle, and health factors reduce the conversion of tryptophan to serotonin, including cigarette smoking, high sugar intake, alcohol abuse, excessive consumption of protein, hypoglycemia and diabetes.
5. Depression, anxiety, irritability, impatience, impulsiveness, inability to concentrate, weight gain or unexplained weight loss, slow growth in children, overeating and/or carbohydrate cravings, poor dream recall, and insomnia can all be signs that a person may need more tryptophan.
6. The following foods contain tryptophan: red meat, dairy products, nuts, seeds, legumes, soybeans and soy products, tuna, shellfish, chicken and turkey.

5-HTP can be a wonder drug for anxiety and depression but MUST be used correctly.
1st – Start out slow. Build slow
50 mg once per day for 3 days
50 mg twice a day for 3 days
50 mg three times per day for 3 days then
50-50-75 for 3 days
50-75-75 for 3 days
75-75-75 dor 3 dats and then
100-75-75
100-100-75
100- 3 times a day (maximum dose).
As you ramp up watch for stomach upset (stop at that point)
If at anytime your symptoms are minimal do not go up any more.
2nd – Absolutely do not take with a ssri/snri as it may cause serotonin syndrome (easily recognized by a fever over 102F).
3rd – Check list of incompatible drugs. Drugs.com
4th – After you have been emotionally stable for a couple weeks you need to slowly, slowly decrease the 5-HTP as your system may not need as much now that it has had a chance to catch up. Many people start out using 150 mg/day and feel fine and then taper down to 75 mg for the long haul. This is important as with long term usage 5-HTP can deplete some necessary nutrients in the body.
5th – 5-HTP can be gotten for our body by consuming foods rich in tryptophan along with a small supplement of Vitamin B6, vitamin C, folic acid and magnesium. Foods high in tryptophan include red meat, dairy products, nuts, seeds, legumes, soybeans and soy products, tuna, shellfish, chicken and turkey.
6th - Depression, anxiety, irritability, impatience, impulsiveness, inability to concentrate, weight gain or unexplained weight loss, slow growth in children, overeating and/or carbohydrate cravings, poor dream recall, and insomnia can all be signs that a person may need more tryptophan.
7th - Several dietary, lifestyle, and health factors reduce the conversion of tryptophan to serotonin, including cigarette smoking, high sugar intake, alcohol abuse, excessive consumption of protein, hypoglycemia and diabetes.

[HRTBroken]

Thank you Fishing Hat, very useful. I have ordered some of each to get her started.

 

Has anyone encountered impulse control difficulties with Cymbalta withdrawal? If someone uses a dopamine agonist, (used for treatment of parkinson's), the patient gets impulse control difficulties because there is more dopamine in places overriding seretonin and norepinephrine. Theoretically, when you stop Cymbalta, serotonin and norepinephrine levels drop to an unhealthy level, therefore leaving dopamine as a dominant neurotransmitter. 

 

So just wondering if impulse control becomes a difficulty for people during the withdrawal process. Anyone encountered this?

[invalidusername]

That would be a difficult one to diagnose I think, as I have symptoms that resemble such an anomaly, but this is understood to be a direct result of overproduction of adrenaline, originating from high levels of norepinephrine.

 

The problem coming off an SNRI is that once the withdrawal has begun, and especially once the patient is going alone after stopping altogether, this is where subjectivity comes in. No one brain will start to puts the pieces back together in the same way. Both serotonin and norepinephrine can go higher and lower as the levels become adjusted. Dopa levels can also play a large factor in both as well, not forgetting that levels can differ simultaneously in different areas of the brain, thus causing different emotional/physical symptoms as a direct influence on the transporting and inhibiting properties of norepinephirine.

 

As you know, measuring the levels of any of these - as they are in the brain - will not happen, so we can only go by our symptoms, but at least with the withdrawal, we are on the "same side" as our brain in that we are trying to restore an equilibrium, rather than trying to unbalance it. If we knew how to unscramble an egg in neurological terms, things would be so much easier!

 

Will be interested in Hat's input on this too.

[invalidusername]

If you aren't already familiar with it, take a look at Lövheim's 3-dimensional model of emotion. I have used this in my research from time to time. Still a theory, but held in high regard all the same;

 

https://upload.wikim..._of_emotion.jpg

[fishinghat]

"impulse control difficulties"

I assume you are referring to emotional impulse control. Many experienced a strong desire for alcohol, certain foods and even a few for gambling. Of course physical impulse control, exists too. Seizures, restless leg, cramps, muscle spasms, etc.

Something else to consider is this is NOT simply a dopamine to serotonin to norepinephrine to adrenaline issue. There are over 100 chemicals (transporters, enzymes, minerals, vitamins, etc) associated with these chemical reactions. There are so many variables involved that saying raising serotonin will lower dopamine. Diet, other metabolic conditions, genetics and other factors all play a part and predictions are very difficult.

[invalidusername]

"There are over 100 chemicals (transporters, enzymes, minerals, vitamins, etc) associated with these chemical reactions"

 

I guess I asked for that one!

 

But yes, point being that saying "deficiency of x = symptoms of y" is always going to be guesswork when it comes to the noggin.

[HRTBroken]

Agreed on all counts. There is no simple explanation - just theorising based on what we observe when manipulating other neurotransmitters. There is much research to do!

[HRTBroken]

Sorry i have so many question... i guess my life has really been turned upside by this Cymbalta withdrawal thing. She was admitted into a psych ward for making a suicide plan and note. Yet several hours later was fine. The depression that comes in vicious waves. She is back in my care.

 

Has anyone found the the 5HTP and L-Tryptophan to help with the emotional confusion? Or just a general aid for the insomnia and mood?

[fishinghat]

Both tend to help with the emotional swings. Those who suffer constant cycles of anxiety have options other than antidepressants for their anxiety but those who have waves of depression have less prescription medications that are effective other than ssri/snri. Both of those supplements tend to stabilize serotonin which should help. Remember they can both cause serotonin syndrome so I would start with a very low dose of one and gradually work up until I see no further benefit. Then evaluate if the other one is needed and if so start on it in very low dosage. I would also consider telling her doctor about these supplements as well.

[HRTBroken]

I have been reading the pathophysiology of SSRI withdrawal, and have to generalise the same applies to Cymbalta in terms of the serotonin functions.

 

So according to animal studies on acute cessation of SSRI's - serotonin production increases rapidly. Its actually down regulated during therapy due to the receptor blockade, so over time you produce less serotonin. So when you stop the receptor blockade you start producing much more more serotonin. This means that you get depleted, resulting in waves of depression, and secondly the increased serotonin, which doesn't have enough receptors to bind to, steals dopamine receptors, acting as an antagonist on the dopaminergic pathways, causing emotional numbness, loss of feelings of love etc. The other effect of increased serotonin production can be cannibalisation of catecholamine production resulting in less dopamine being produced.

 

So my question has anyone tried L-Tyrosine alongside L-Tryptophan and/or 5HTP. L-Tyrosine is the precursor to catecholamines, so dopamine, norepinephrine etc. - thus logically if you increase dopamine precursors it might help to balance things out. 

 

My wife has mostly started to balance out, stopped having waves of depression etc. The 5HTP seemed to help a lot with this. However the most traumatising remaining feature is her feelings for me have completely vanished. She looks at me still and says I know I loved you, but right now I feel nothing. Nothing at all. This technically mean dopamine blockade, i am just hoping its not permanent. 

[fishinghat]

It should not be permanent.

"So according to animal studies on acute cessation of SSRI's - serotonin production increases rapidly. Its actually down regulated during therapy due to the receptor blockade, so over time you produce less serotonin."

It has been well established that during use of an ssri/snri serotonin levels initially elevate and after a few weeks then decline below the baseline values. As far as after cessation it is not clear exactly what occurs. Ssri/snri are thought to do some but little blockade of the receptors, impede the serotonin transporter (thought to be the primary action), decrease monoamine oxidase activity and effects the further production of serotonin. I have studied numerous articles on the effects of serotonin on the human body before, during and after use of a ssri/snri and the results are quite varied. Even reproductive hormones, thyroid hormones and other hpa factors effect the reaction. For example during withdrawal the thyroid levels can go toward the hypothyroidic levels in some but not all patients, The reproductive hormones have been shown to frequently, but not always, decrease markedly. Over production of serotonin after withdrawal seems to be fairly common and also non-existent depending on the research you read. Factors such as daylight exposure, diet, liver and kidney damage and many other variables have been shown to effect this event.

Now having said that, normally people who have significant withdrawal symptoms suffer from anxiety and lack of serotonin evidenced by the beneficial effects of taking a serotonin producing supplement. Tryptophan and 5-htp do cross the blood brain barrier and therefore typically raise serotonin levels in the brain. L-tyrosine and phenylalanine compete with tryptophan for absorption. Tryptophan is converted to serotonin by the body so if too much L-tyrisine is present n the blood stream then serotonin levels may decrease further. To further complicate things because dopamine is related to serotonin production it is very difficult to effect both at the same time especially considering the other variables that are present.
 

Tryptophan and 5-htp have provided much benefit to members but are rarely taken at the same time due to serotonin syndrome. Those members who took L-tyrisine and either L-tryptophan or 5-HTP at the same time had inconsistent results probably due to the competitive nature of these components. It is possible to have your amino acid levels checked in a blood sample but these have been found to be to variable due to recent diet activity altering them.
 

"The other effect of increased serotonin production can be cannibalisation of catecholamine production resulting in less dopamine being produced."

While serotonin has no influence on dopamine receptors it does effect the 5-htp1a and 5-htp1C serotonin receptors which are responsible for dopamine production. As an agonist it reduces dopamine production.
"and secondly the increased serotonin, which doesn't have enough receptors to bind to,"
Research has shown that the various 5-htp serotonin receptors do not have a perfect stereochemical structure to properly bind to the newly used ssri/snri so with time (app 4 to 8 weeks) they adapt their shape to properly fit the ssri/snri and the antidepressant activity kicks in. Unluckily it has also been shown that these synapses take up to 2 years to fully return to normal after cessation of the antidepressant. While sufficient levels of serotonin receptors are available their normal function is slow to return.
 

"She looks at me still and says I know I loved you, but right now I feel nothing. Nothing at all. This technically mean dopamine blockade, i am just hoping its not permanent."
 

A lack of dopamine production is quite probable. Remember that dopamine is linked to norepinephrine and to adrenaline production. So raising dopamine levels can effect the production of the other two markedly depending on other biological activities going on at the same time.
 

I would strongly suggest a one step at a time approach. For example, start with a low dose of tryptophan and work upward until you achieve the best benefit. Then add the L-tyrosine and work the dosage up slowly until you see if it is beneficial. Starting two products at the same time presents a problem. If it is effective OR causes side effects it will be unclear which one is the culprit. Also, if she is experiencing depression and emotional numbness more than anxiety I would probably start with the L-tyrosine as it is a precursor to dopamine production. Just a thought.

[HRTBroken]

Thanks Fishing Hat, you really have done your research. Turns out you were right, in terms of one step at a time. We introduced Tyrosine, and her temper and aggression went through the roof, telling family members she hated them, completely destabilised her for a few days, stopped it, and back to normal.

[fishinghat]

Tyrosine is a tricky one. Its blood levels are effected by many, and I mean many, other things in our diet including other amino acids and vitamins. I am glad she is alright and praying that things get better and better for her and you.

[HRTBroken]

When I say normal, i mean how she has been, on a slow path to recovery, not well, but starting to stabilise in general. We are going to try some Oxytocin nasal spray for a month. Some SSRIs have been shown to significantly Oxytocin and it may be linked to the loss of feelings associated with me, and her family actually.

[invalidusername]

How did I miss this? A very interesting discussion - and fantastic read there Hat.

 

Whilst tryptophan is capable of crossing the blood-brain barrier and converting to serotonin (via 5-HTP), it too has to complete with other amino's to get there. It is my understanding that it acts as a reserve that can be taken up by the brain when it is called for. However, in some people, the brains ability to make this call for extra production is not working correctly (as in the case of withdrawal) and find that it is not effective as it does not raise the levels. This is where 5-HTP would be used as it more forcefully raises the level by immediately crossing the blood-brain barrier and producing the serotonin regardless of whether the brain is calling for it.

[invalidusername]

Regarding the balance, this is a very tricky one. Like Hat said, you raise one, and others go out of balance. It is not something to be take lightly as you have seen in your above post. Serotonin overproduction will reduce dopa, and then this will eventually need to be balanced out with tyrosene - but this may put the levels of norepinephrene/adrenaline out of line, and it becomes a bit of a mess. This could in turn affect the cats, and so the situation goes. This is why any such supplement should only be used at times where there is a clear depletion of one amino acid (or perhaps two), that would benefit from short-term treatment. Long-term is likely to have adverse effects if taken on a regular basis and will result in a similar situation to that of an SSRI withdrawal.

[fishinghat]

Accurate comment IUN. There is research to show that tryptophan can pass through the blood brain barrier and if enough is taken then it can build up serotonin to the level to cause serotonin syndrome. BUT we can eat enough meat with tryptophan in it to sink a small ship and yet the body will absorb only what it thinks it needs. No risk of serotonin syndrome from left over Thanksgiving dinner. lol

[invalidusername]

LOL - yes Turkey is full of the stuff!!

 

I have found the best way to illustrate the serotonin supplement is by using the metaphor of flour in a cake; the supplement being the flour, and the brain being the cake mixture.

 

Tryptophan is adding to the flour that is available to add to the mixture if required. The flour could be all used up already, and therefore this is useful for when the recipe is correct - read below.

 

5-HTP will add the flour regardless of what the mixture requires. Useful for when the recipe is wrong - again, read below.

 

The brain should know the recipe, and thus how much flour is needed, but where medication overwrites and messes up this recipe, we have the option of taking it into our own hands to right the recipe. But either way, you could end up with a very dry, or very wet cake! Ideally we would let the brain continue to reevaluate the bodies needs and get the recipe back to normal that way, which it will eventually do in almost all cases, but sometimes, as in HRT's situation, desperate measures are called for.

 

Apologies if this cake metaphor makes anyone hungry!!

[HRTBroken]

That is all very useful information. Invalid - The reason for the 5HTP and tryptophan tried was she was getting serious waves of depression, going from being ok to having a suicide plan with note written etc, then 6 hours later ok again. From some animal studies I read, SSRI withdrawal has a pattern of going through a drop in serotonin, then later an overproduction but significant wastage, leading to depletion. I know there is more to it than that but the waves of suicide planning needed to be addressed and since she won't take a different SSRI the 5HTP was the logical approach.  The theory was 5HTP would help initially followed by a course of tryptophan. I thought maybe tyrosine would be useful to keep the balance, and in case there was dopamine involved, but as above it just screwed everything.

 

So after this bottle of tryptophan she is going to be just taking sodium Butyrate. Its been linked in some recent studies to act a neural anti-inflammatory. A big study in belgium recently found that is usually produced by two particular bacteria in the colon flora which is often lacking in depressed patients. This angle is in line with Edward Bullmore's theories on depression being partially an inflammatory process. We are trying everything really, especially since she doesn't want to try any other SSRIs yet. I am hoping she stabalises without eventually ending up back on one.

 

Her symptoms for a while resembled a personality disorder, close to borderline, which is known to be related to imbalanced serotonin in all the wrong places. But who really knows what the hell Cymbalta does to the brain!!

[fishinghat]

One reason I do not often recommend L-tryptophan and/or 5 htp too often is its unpredictable results. There are to many variables that can effect its uptake into the "cake". Anyone attempting to use one of these should start with a very small dose.

This is one of the advantages of using Suntheanine or Lion's Mane mushroom extract. They both tend to balance out the gaba and glutamine production and usage which are our primary base nerve blocker and stimulator respectively. Their effects are more predictable for most.