Nutritional Supplement

5-HTP

Also indexed as:5-Hydroxytryptophan, Hydroxytryptophan

  • Negative Interactions

    12

    • 5-HTP

      Citalopram

      Potential Negative Interaction

      Citalopram increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with citalopram may increase citalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as citalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.

      Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with citalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with citalopram or other SSRIs.

      Citalopram
      5-HTP
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.

    • 5-HTP

      Escitalopram

      Potential Negative Interaction

      Escitalopram increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with escitalopram may increase escitalopram-induced side effects. Dietary supplements of L-tryptophan (available only by prescription from special compounding pharmacists) taken with paroxetine (a drug that has similar actions as escitalopram) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms.

      Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase their effectiveness. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with escitalopram or other SSRIs, unless a doctor is closely monitoring the combination. Foods rich in L-tryptophan do not appear to interact with escitalopram or other SSRIs.

      Escitalopram
      5-HTP
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1997.

    • 5-HTP

      Fluoxetine

      Potential Negative Interaction

      Fluoxetine works by increasing serotonin activity in the brain. 5-HTP is converted to serotonin in the brain, and taking it with fluoxetine may increase fluoxetine-induced side effects. Until more is known, 5-HTP should not be taken with any SSRI drug, including fluoxetine.

    • 5-HTP

      Fluvoxamine

      Potential Negative Interaction

      Fluvoxamine works by increasing serotonin activity in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with fluvoxamine may increase fluvoxamine-induced side effects. Until more is known, 5-HTP and L-tryptophan should not be taken with any SSRI drug, including fluvoxamine.

    • 5-HTP

      Frovatriptan

      Potential Negative Interaction

      Triptans work by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them at the same time as 5-HT1 agonists could increase unwanted side effects. However, at the time of this writing there are no known interactions with 5-HT1 agonists and 5-HTP or L-tryptophan.

      Frovatriptan
      5-HTP
      ×
      1. Wolters Kluwer Health, Inc. Facts and Comparisons [online] 2007 [cited 2007 Feb]. Available from http://www.factsandcomparisons.com.

    • 5-HTP

      Paroxetine

      Potential Negative Interaction

      Paroxetine increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with paroxetine may increase paroxetine-induced side effects. Dietary supplements of L-tryptophan (available only by prescriptions from special compounding pharmacists) taken with paroxetine caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms. Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase the effectiveness of the latter. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with paroxetine or other SSRIs, unless the combination is being closely monitored by a doctor. Foods rich in L-tryptophan do not appear to interact with paroxtine or other SSRIs.

      On the other hand, the combination of 45 mg DL-tryptophan (a synthetic variation of L-tryptophan) per pound of body weight (a relatively high dose) with zimelidine, a drug with a similar action to paroxetine, did not cause these side effects in another trial.

      Paroxetine
      5-HTP
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1997, 264q-4r.
      2. Walinder J, Carlsson A, Persson R. 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psych Scand Suppl 1981;290:179-90.

    • 5-HTP

      Paroxetine Mesylate

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Sertraline increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with sertraline may increase sertraline-induced side effects.

      In one report, dietary supplements of L-tryptophan (available only by prescriptions from special compounding pharmacists) taken with paroxetine (a drug similar to sertraline) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms. On the other hand, the combination of 45 mg DL-tryptophan (a synthetic variation of L-tryptophan) per pound of body weight (a relatively high dose) with zimelidine, a drug with a similar action to sertraline, did not cause these side effects in another trial. Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase the effectiveness of the latter. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with sertraline or other SSRIs, unless the combination is being closely monitored by a doctor. Foods rich in L-tryptophan do not appear to interact with sertraline or other SSRIs.

      Paroxetine Mesylate
      5-HTP
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1997, 264q-4r.
      2. Walinder J, Carlsson A, Persson R. 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psych Scand Suppl 1981;290:179-90.

    • 5-HTP

      Sertraline

      Potential Negative Interaction

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Sertraline increases serotonin activity in the brain. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking either of these compounds with sertraline may increase sertraline-induced side effects.

      In one report, dietary supplements of L-tryptophan (available only by prescriptions from special compounding pharmacists) taken with paroxetine (a drug similar to sertraline) caused headache, sweating, dizziness, agitation, restlessness, nausea, vomiting, and other symptoms. On the other hand, the combination of 45 mg DL-tryptophan (a synthetic variation of L-tryptophan) per pound of body weight (a relatively high dose) with zimelidine, a drug with a similar action to sertraline, did not cause these side effects in another trial. Some doctors have used small amounts of L-tryptophan in combination with SSRIs, to increase the effectiveness of the latter. However, because of the potential for side effects, 5-HTP and L-tryptophan should never be taken in combination with sertraline or other SSRIs, unless the combination is being closely monitored by a doctor. Foods rich in L-tryptophan do not appear to interact with sertraline or other SSRIs.

      Sertraline
      5-HTP
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Selective Serotonin Reuptake Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1997, 264q-4r.
      2. Walinder J, Carlsson A, Persson R. 5-HT reuptake inhibitors plus tryptophan in endogenous depression. Acta Psych Scand Suppl 1981;290:179-90.

    • 5-HTP

      Sibutramine

      Potential Negative Interaction

      The amino acids L-tryptophan and 5-hydroxytryptophan (5-HTP) are occasionally used to treat mental depression. Taking sibutramine with L-tryptophan or 5-HTP might result in a rare, but serious group of symptoms known as “serotonin syndrome.” Symptoms associated with serotonin syndrome may include confusion, anxiety, muscle weakness, incoordination, and vomiting. Therefore, individuals taking sibutramine should avoid supplementing with L-tryptophan and 5-HTP.

      Sibutramine
      5-HTP
      ×
      1. Sifton DW, et. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc. 2000, 1509-13.

    • 5-HTP

      Tramadol

      Potential Negative Interaction

      Tramadol, which blocks serotonin reuptake in the brain, has been associated with two cases of serotonin syndrome. 5-HTP and L-tryptophan are converted to serotonin in the brain. While no interactions have yet been reported with tramadol and 5-HTP or L-tryptophan, taking 5-HTP or L-tryptophan with tramadol may increase the risk of tramadol-induced side effects, including serotonin syndrome.

      Tramadol
      5-HTP
      ×
      1. Mason BJ, Blackburn KH. Possible serotonin syndrome associated with tramadol and sertraline coadministration. Ann Pharmacother 1997;31:175-7.
      2. Hernandez AF, Montero MN, Pla A, Villanueva E. Fatal moclobemide overdose or death caused by serotonin syndrome? J Forensic Sci 1995;40:128-30.

    • 5-HTP

      Venlafaxine

      Potential Negative Interaction

      Venlafaxine, a potent serotonin reuptake inhibitor, has been associated with several cases of serotonin syndrome. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with venlafaxine may increase venlafaxine-induced side effects. While no interactions with venlafaxine and 5-HTP or L-tryptophan have been reported, until more is known, people taking venlafaxine are cautioned to avoid 5-HTP or L-tryptophan.

      Venlafaxine
      5-HTP
      ×
      1. Brubacher JR, Hoffman RS, Lurin MJ. Serotonin syndrome from venlafaxine-tranylcypromine interaction. Vet Hum Toxicol 1996;38:358-61.
      2. Weiner LA, Smythe M, Cisek J. Serotonin syndrome secondary to phenelzine-venlafaxine interaction. Pharmacotherapy 1998;18:399-403.
      3. Bhatara VS, Magnus RD, Paul KL, Preskorn SH. Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms. Ann Pharmacother 1998;32:432-6.
      4. Diamond S, Pepper BJ, Diamond ML, et al. Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports. Neurology 1998;51:274-6.

    • 5-HTP

      Zolpidem

      Potential Negative Interaction

      Nine cases of zolpidem-induced hallucinations associated with serotonin reuptake inhibiting antidepressants have been reported, some lasting for several hours. 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with zolpidem may increase zolpidem-induced hallucinations, though no interactions have yet been reported with zolpidem and 5-HTP or L-tryptophan.

      Zolpidem
      5-HTP
      ×
      1. Elko CJ, Burgess JL, Robertson WO. Zolpidem-associated hallucinations and serotonin reuptake inhibition: a possible interaction. J Toxicol Clin Toxicol 1998;36:195-203.

  • Explanation Required

    10

    • 5-HTP

      Almotriptan

      Needs Explanation

      Triptans work by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with eletriptan could increase eletriptan-induced side effects. However, no interactions have yet been reported with eletriptan and 5-HTP or L-tryptophan.

    • 5-HTP

      Carbidopa

      Needs Explanation

      5-HTP and carbidopa have been reported to improve intention myoclonus (a neuromuscular disorder) in some human cases but not others. Several cases of scleroderma-like illness have been reported in patients using carbidopa and 5-HTP for intention myoclonus.

      Carbidopa
      5-HTP
      ×
      1. Van Woert MH, Rosenbaum D, Howieson J, Bowers MB Jr. Long-term therapy of myoclonus and other neurologic disorders with L-5-hydroxytryptophan and carbidopa. N Engl J Med 1977;296:70-5.
      2. Magnussen I, Dupont E, Engbaek F, de Fine Olivarius B. Post-hypoxic intention myoclonus treated with 5-hydroxytryptophan and an extracerebral decarboxylase inhibitor. Acta Neurol Scand 1978;57:289-94.
      3. Growdon JH, Young RR, Shahani BT. L-5-hydroxytryptophan in treatment of several different syndromes in which myoclonus is prominent. Neurology 1976;26:1135-40.
      4. Sternberg EM, Van Woert MH, Young SN, et al. Development of a scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. N Engl J Med 1980;303:782-7.
      5. Joly P, Lampert A, Thromine E, Lauret P. Development of pseudobullous morphea and scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. J Am Acad Dermatol 1991;25:332-3.
      6. Auffranc JC, Berbis P, Fabre JF, et al. Sclerodermiform and poikilodermal syndrome observed during treatment with carbidopa and 5-hydroxytryptophan. Ann Dermatol Verereol 1985;112:691-2.

    • 5-HTP

      Carbidopa-Levodopa

      Needs Explanation

      Several cases of scleroderma-like illness have been reported in patients using carbidopa and 5-HTP (5-Hydroxytryptophan). People taking carbidopa should not supplement 5-HTP without consulting the prescribing physician.

      Carbidopa-Levodopa
      5-HTP
      ×
      1. Sternberg EM, Van Woert MH, Young SN, et al. Development of a scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. N Engl J Med 1980;303:782-7.
      2. Joly P, Lampert A, Thromine E, Lauret P. Development of pseudobullous morphea and scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. J Am Acad Dermatol 1991;25:332-3.
      3. Auffranc JC, Berbis P, Fabre JF, et al. Sclerodermiform and poikilodermal syndrome observed during treatment with carbidopa and 5-hydroxytryptophan. Ann Dermatol Verereol 1985;112:691-2.

    • 5-HTP

      Eletriptan

      Needs Explanation

      Eletriptan works by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with eletriptan could increase eletriptan-induced side effects. However, no interactions have yet been reported with eletriptan and 5-HTP or L-tryptophan.

    • 5-HTP

      Olanzapine-Fluoxetine

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Triptans work by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them at the same time as 5-HT1 agonists could increase unwanted side effects. However, at the time of this writing there are no known interactions with 5-HT1 agonists and 5-HTP or L-tryptophan.

      Olanzapine-Fluoxetine
      5-HTP
      ×
      1. Wolters Kluwer Health, Inc. Facts and Comparisons [online] 2007 [cited 2007 Feb]. Available from http://www.factsandcomparisons.com.

    • 5-HTP

      Rizatriptan

      Needs Explanation

      Triptans work by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them at the same time as 5-HT1 agonists could increase unwanted side effects. However, at the time of this writing there are no known interactions with 5-HT1 agonists and 5-HTP or L-tryptophan.

      Rizatriptan
      5-HTP
      ×
      1. Wolters Kluwer Health, Inc. Facts and Comparisons [online] 2007 [cited 2007 Feb]. Available from http://www.factsandcomparisons.com.

    • 5-HTP

      Selegiline

      Needs Explanation

      Both L-tryptophan and 5-HTP have been used to treat depression. One controlled study showed that taking selegiline at the same time as 5-HTP enhanced the antidepressant effect when compared with 5-HTP alone. Further research is needed to determine whether taking selegiline and 5-HTP together might result in unwanted side effects.

      Selegiline
      5-HTP
      ×
      1. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.

    • 5-HTP

      Sumatriptan

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Sumatriptan works by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with sumatriptan could increase sumatriptan-induced side effects. However, no interactions have yet been reported with sumatriptan and 5-HTP or L-tryptophan.

    • 5-HTP

      Sumatriptan Succinate

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Sumatriptan works by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with sumatriptan could increase sumatriptan-induced side effects. However, no interactions have yet been reported with sumatriptan and 5-HTP or L-tryptophan.

    • 5-HTP

      Zolmitriptan

      Needs Explanation

      Zolmitriptan works by stimulating serotonin receptors in the brain. 5-HTP (5-Hydroxytryptophan) and L-tryptophan are converted to serotonin in the brain, and taking them with zolmitriptan could increase zolmitriptan-induced side effects. However, no interactions have yet been reported with zolmitriptan and 5-HTP or L-tryptophan.

References

1. Kimball RW, Friedman AP, Vallejo E. Effect of serotonin in migraine patients. Neurology 1960;10:107-11.

2. Sicuteri F. The ingestion of serotonin precursors (L-5-hydroxytryptophan and L-tryptophan) improves migraine headache. Headache 1973;13:19-22.

3. Titus F, Davalos A, Alom J, Codina A. 5-hydroxytryptophan versus methysergide in the prophylaxis of migraine. Eur Neurol 1986;25:327-9.

4. Maissen CP, Ludin HP. Comparison of the effect of 5-hydroxytryptophan and propranolol in the interval treatment of migraine. Schweizerische Medizinische Wochenschrift /Journal Suisse de Medecine 1991;121:1585-90 [in German].

5. De Benedittis G, Massei R. 5-HT precursors in migraine prophylaxis: A double-blind cross-over study with L-5-hydroxytryptophan versus placebo. Clin J Pain 1986;3:123-9.

6. Mathew NT. 5-hydroxytryptophan in the prophylaxis of migraine. Headache 1978;18:111-3.

7. Bono G, Criscuoli M, Martignoni E, et al. Serotonin precursors in migraine prophylaxis. Advances in Neurology 1982;33:357-63.

8. De Giorgis G, Miletto R, Iannuccelli M, et al. Headache in association with sleep disorders in children: A psychodiagnostic evaluation and controlled clinical study ñ L-5-HTP versus placebo. Drugs Exp Clin Res 1987;13:425-33.

9. Santucci M, Cortelli P, Rossi PG, et al. L-5-Hydroxytryptophan versus placebo in childhood migraine prophylaxis: a double-blind crossover study. Cephalalgia 1986;6:155-7.

10. Ribeiro CAF. L-5-hydroxytryptophan in the prophylaxis of chronic tension-type headache: a double-blind, randomized, placebo-controlled study. Headache 2000;40:451-6.

11. Edmeads J. Placebos and the power of negative thinking. Headache 1984;24:342-3 [editorial].

12. De Benedittis G, Massei R. Serotonin precursors in chronic primary headache. A double-blind cross-over study with L-5-hydroxytrytophan vs. placebo. J Neurosurg Sci 1985;29:239-48.

13. Longo G, Rudoi I, Iannuccelli M, et al. Treatment of essential headache in developmental age with L-5-HTP (cross over double-blind study versus placebo). Pediatr Med Chir 1984;6:241-5. [in Italian].

14. Fava M, Rosenbaum JF, MacLaughlin R, et al. Neuroendocrine effects of S-adenosyl-L-methionine, a novel putative antidepressant. J Psychiatr Res 1990;24:177-84.

15. Bell KM, Potkin SG, Carreon D, Plon L. S-adenosylmethionine blood levels in major depression: changes with drug treatment. Acta Neurol Scand 1994;154(suppl):15-8.

16. Puttini PS, Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 1992;20:182-9.

17. Moldofsky H, Warsh JJ. Plasma tryptophan and musculoskeletal pain in non-articular rheumatism (“fibrositis syndrome”). Pain 1978;5:65-71.

18. Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res 1990;18:201-9.

19. Van Praag HM, Lemus C. Monoamine precursors in the treatment of psychiatric disorders. Nutrition and the Brain, vol. 7, RJ Wurtman, JJ Wurtman, eds. New York: Raven Press, 1986 [review].

20. Van Praag H, de Hann S. Depression vulnerability and 5-hydroxytryptophan prophylaxis. Psychiatry Res 1980;3:75-83.

21. Angst J, Woggon B, Schoepf J. The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study. Arch Psychiatr Nervenkr 1977;224:175-86.

22. Nolen WA, van de Putte JJ, Dijken WA, et al. Treatment strategy in depression. II. MAO inhibitors in depression resistant to cyclic antidepressants: two controlled crossover studies with tranylcypromine versus L-5-hydroxytryptophan and nimifensine. Acta Psychiatr Scand 1988;78:676-83.

23. Nolen WA, van de Putte JJ, Dijken WA, Kamp JS. L-5-HTP in depression resistant to re-uptake inhibitors. An open comparative study with tranylcypromine. Br J Psychiatry 1985;147:16-22.

24. D'Elia G, Hanson L, Raotma H. L-tryptophan and 5-hydroxytryptophan in the treatment of depression. A review. Acta Psychiatr Scand 1978;57:239-52 [review].

25. Jangid P, Malik P, Singh P, et al. Comparative study of efficacy of L-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian J Psychiatr 2013;6:29–34.))

26. Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Alternative Med Rev 1998;3:271-80.

27. Schneider-Helmert D, Spinweber CL. Evaluation of L-tryptophan for treatment of insomnia: A review. Psychopharmacology (Berlin) 1986;89(1):1-7.

28. Lindsley JG, Hartmann EL, Mitchell W. Selectivity in response to L-tryptophan among insomniac subjects: a preliminary report. Sleep 1983;6:247-56.

29. Wyatt RJ, Zarcone V, Engelman K, et al. Effects of 5-hydroxytryptophan on the sleep of normal human subjects. Electroencephalogr Clin Neurophysiol 1971;30:505-9.

30. Puttini PS, Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 1992;20:182-9.

31. Bruni O, Ferri R, Miano S, Verrillo E. L-5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr 2004;163:402-7.

32. Guyton AC, Hall JE. Textbook of Medical Physiology, 9th ed. Philadelphia: W. B. Saunders, 1996.

33. Schneider-Helmert D, Spinweber CL. Evaluation of L-tryptophan for treatment of insomnia: A review. Psychopharmacology (Berlin) 1986;89(1):1-7.

34. Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res 1990;18:201-9.

35. Soulairac A, Lambinet H. Etudes cliniques de líaction du precurseur de la serotonine le L-5-hydroxy-tryptophane, sur les troubles du sommeil. Schweiz Bundschau Med (PRAXIS) 1998;77(34a):19-23 [in French].

36. Young SN. Behavioral effects of dietary neurotransmitter precursors: basic and clinical aspects. Neurosci Biobehav Rev 1996;20:313-23 [review].

37. Riemann D, Vorderholzer U. Treatment of depression and sleep disorders. Significance of serotonin and L-tryptophan in pathophysiology and therapy. Fortschr Med 1998;116:40-2 [review].

38. Chouinard G, Jones BD, Young SN, Annable L. Potentiation of lithium by tryptophan in a patient with bipolar illness. Am J Psychiatry 1979;136:719-20.

39. Hedaya RJ. Pharmacokinetic factors in the clinical use of tryptophan. J Clin Psychopharmacol 1984;4:347-8.

40. Prange AJ, Wilson IC, Lynn CW, et al. L-tryptophan in mania: contribution to a permissive hypothesis of affective disorders. Arch Gen Psychiatry 1974;30:56-62.

41. Chambers CA, Naylor GJ. A controlled trial of L-tryptophan in mania. Br J Psychiatry 1978;132:555-9.

42. Murphy DL, Maker M, Goodwin FK, et al. L-tryptophan in affective disorders: indoleamine changes and differential clinical effects. Psychopharmacologia 1974;34:11-20.

43. van Praag HM, de Haan S. Chemoprophylaxis of depressions. An attempt to compare lithium with 5-hydroxytryptophan. Acta Psychiatr Scand Suppl 1981;290:191-201.

44. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness. J Affect Disord 1980;2:137-46.

45. Gaby, AR. Nutritional Medicine. Concord, NH: Fritz Perlberg Publishing, 2011.

46. Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res 1990;18:201-9.

47. Byerley WF, Judd LL, Reimherr FW, Grosser BI. 5-hydroxytryptophan: A review of its antidepressant efficacy and adverse effects . J Clin Psychopharmacol 1987;7:127-37 [review].

48. Zmilacher K, Battegay R, Gastpar M. L-5-hydroxytryptophan alone and in combination with a peripheral decarboxylase inhibitor in the treatment of depression. Neuropsychobiology 1988;20:28-35.

49. Poldinger W, Calanchini B, Schwarz W. A functional-dimensional approach to depression: serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 1991;24(2):53-81.

50. Soulairac A, Lambinet H. Etudes cliniques de líaction du precurseur de la serotonine le L-5-hydroxy-tryptophane, sur les troubles du sommeil. Schweiz Bundschau Med (PRAXIS) 1998;77(34a):19-23 [in French].

51. De Benedittis G, Massei R. 5-HT precursors in migraine prophylaxis: A double-blind cross-over study with L-5-hydroxytryptophan versus placebo. Clin J Pain 1986;3:123-9.

52. Titus F, Davalos A, Alom J, Codina A. 5-hydroxytryptophan versus methysergide in the prophylaxis of migraine. Eur Neurol 1986;25:327-9.

53. Maissen CP, Ludin HP. Comparison of the effect of 5-hydroxytryptophan and propranolol in the interval treatment of migraine. Schweizerische Medizinische Wochenschrift /Journal Suisse de Medecine 1991;121:1585-90 [in German].

54. Mathew NT. 5-hydroxytryptophan in the prophylaxis of migraine. Headache 1978;18:111-3.

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