5-HTP and mental health

The following was copied and pasted here from another thread in order to not hi-jack Mr. F's thread. It has relevance in both places. Stagestop is so very knowledgeable in this area that it warranted it's own thread.

Dear Mr. Fantastic,

In looking at all of these letters, it seems that you are no more obsessed than most of the rest of us on this board. Certainly your writing style shows you to be intelligent and educated. My thoughts are more along the way of offering you suggestions with getting your depression cured. Sadly, modern medicine does not do a good job in that area today. I think that if I can describe what the medicines are trying to accomplish, and show you how they work, that you will be able to make up your own mind about how you might best overcome your depression.

There are six classes of medicine that are used to treat depression. They are:
1. SSRI’s (Selective Serotonin Reuptake Inhibitors)
2.SSNRI (Selective Serotonin and Norepinephrine Reuptake Inhibitors) (Norepinephrine is the same thing as Noradrenalin. It seems that the medical estabilshment in the US did not like the word “adrenalin” and just changed it to “epinephrine”, but it is the same thing.
3. MAOI’s (Monoamine Oxidase Inhibitors)
4. TCA’s (Tri Cyclic Antidressants)
5. NRI’s (Norepinephrine Reuptake Inhibitors).
6. Thyroid Hormone Supplementation

As you see above, (or at least I will document this as we progress) all of the efforts of the medicines are trying to either raise your levels of Serotonin, and/or Norepinephrine (also known as Noradrenalin outside of the US) or to raise your thyroid hormone levels.

If this sounds pretty simple, it is. The crux of the problem concerns HOW it is done, as well as the rules regarding what a drug company can patent. That is indeed a very big rub, and sadly the physicians are in the camp of the drug companies rather than using a minor amount of brainpower to realize that what is offered by the drug companies (with the exception of thyroid hormone supplementation) is second rate at best.

Since thyroid supplementation is the easiest to handle, let me just say that if your thyroid levels are low, you will indeed become depressed. You can also get tachycardia (fast heart rate with no reason) and more. To determine if this is your problem, simply take your temperature. If you are at 97 degrees F or higher, (say 36 degrees C) you are fine, and that is not an issue for you.

The other two things that are available to treat depression work by raising levels of Serotonin and/or Norepinephrine. Actually, this is really the issue, because there is no prescription medicine that raises either of the neurotransmitter levels of production at all. They work (or attempt to) in the synapse of the receptor.

Serotonin and Norepinephrine are “neurotransmitters”. That is to say that they move electrical signals in the brain, and along the nervous system. Our bodies are not hard wired like a house would be. In a house, if you want a light to work, you turn the switch, and current flows through the wires, through the light bulb, and then goes to ground.

In our bodies, the nerve starts in one place, and goes to a junction. When something happens in the body where an action needs to take place, a nerve that connects the action area sends an electrical signal to the brain for the brain to analyze. From the point of origin of the message, the signal goes up the nervous system until it arrives at a junction where it is assessed prior to getting to the brain. The “electricity” arrives at the junction, but it needs to be transmitted across the junction to get to the brain. This moving of the electricity from one side of the nerve to the other (called the “synapse”) is the job of the neurotransmitter.

If there is insufficient amounts of the neurotransmitter at the junction, the signal is lost, and the brain cannot respond to the message that was sent to it. The amount of the neurotransmitter at the synapse (the junction) is the critical issue. Having insufficient amount to move the message across means that there is no message relayed. Having too much means that the signal is amplified to levels that are inappropriate and can be just as bad as having no signal.

Maintaining the balance of neurotransmitters is critical. To accomplish this balance, we first have the production side of the neurotransmitter, which is the chemical process by which new amounts of the neurotransmitter is made, and also there are the steps where the neurotransmitter is removed from the system.

There are four means of removing a neurotransmitter from the system. They are:
1. Diffusion. In this case, the brain and nervous system as encased in fluid, and the nerurotransmitter simply float away for the synapse, where they can no longer move ions (electricity) from one side to the other.
2. Glial cells. Glial cells basically eat and then convert the neurotransmitters into other items which cannot carry a signal.
3. Monoamine Oxidase. Monoamine means a “single amine.” An amine is a type of molecule. Serotonin and Norepinephrine are monoamines. MAO works by converting the neurotransmitter into other substances that cannot act as a neurotransmitter.
4. Reuptake.

To understand reuptake you have to understand a bit about how the receptor is put together. When new Serotonin is made, it is (in this example) 5 HTP (hydroxylated tryptophan) is converted by enzymatic action into Serotonin. This happens directly above the “vesicle” and then the Serotonin is stored in the vesicle for future use.

The vesicle is analogous to a “bellows” like the air bellows that you would use to get a fire going. In the bellows example, a full bellows is squeezed and a stream of air is ejected, thereby helping a fire get going. When you open the bellows, more air is sucked back into the bellows for the next use.

Reuptake works the same way. When your body sends a signal on a nerve, it gets to the synapse, and the body responds by squeezing the vesicle, thereby ejecting more of the neurotransmitter into the synapse. When the message is delivered, the vesicle expands, thereby sucking the serotonin back into the vesicle to be used again.

What SSRI and SSNRI’s do is to inhibit the body from sucking the neurotransmitter back into the vesicle. This leaves more of the neurotransmitter in the synapse, and to a degree enables more of a signal to make it to the brain.

What is wrong with the entire approach is that there is not one molecule of new Serotonin (or Norepinephrine) created. So you squeeze out the bellows, but keep it from reopening. More is then left in the synapse, FOR A WHILE. But then it is subject to the other three things that reduce output.

The effectiveness of the SSRI’s and the SSNRI’s depends on HOW MUCH OF THE NEUROTRANSMITTER YOU HAVE TO BEING WITH.

Unfortunately, there are no tests that will tell a doctor what your leaves of Serotonin or NE (norepinephrine is abbreviated as NE) are. There are some urinary metabolite tests, but they don’t help much because you do not know WHERE the existing neurotransmitter are.

So, what is the best course of action? Actually, this is really simple. Add more of the items that make up the neurotransmitter. If you give the body a chance to do this, it will do it in spades.

Serotonin is by far and away the easiest to increase. It is done with an over the counter supplement, 5 HTP. It works, and actually, it is guaranteed to work. Not by the manufacturer, but rather by the rules of chemistry.

The production of Serotonin starts with the amino acid (protein) Tryptophan. You get this in foods that are “whole proteins” such as meat, dairy, eggs. When ingested, Tryptophan goes to the liver, which can do one of four things with it. It can pass it on unaltered for other uses in the body. Or it can make 5 HTP out of it. Or it can make two other substances from it, that do not effect Serotonin.

The conversion of Tryptophan into 5 HTP is the most difficult chemical operation in this equation. To do that, the body needs two enzymes and a donor to give up a “hydroxyl” (two hydrogen atoms in a particular shape). When done with the process of hydroxylation, what is left is hyroxylated Tryptophan which is abbreviated as 5 HTP.

5 HTP is then converted into Serotoin by another enzymatic reaction called decarboxylation. Basically, enzymes are chemical scissors, and this reaction simply cuts a carboxyl (COOH) out of the 5 HTP, and what is left is Serotonin. The critical item here is THAT THE DECARBOXYLATION REACTION IS A NON SATURATED REACTION. What this means is that there is much more of this enzyme in our body than we need, so if there is 5 HTP available, it WILL be converted into Serotonin.

The drug companies know this very well, but since 5 HTP cannot be patented as it is a natural substance, they are forced to find an alternative to supplementing with 5 HTP in order to sell you their Anti depressants. They need to have a compound that can be patented, in order to make any money. And in this case, since the 5 HTP that is sold over the counter is sold cheaply, there is no profit potential for them there, and they do not even make 5 HTP.

What makes this even more interesting is the speed of action. Neurotransmission is a simple process from one point of view, in that if there is sufficient amounts of the neurotransmitter available at the synapse, the message will get through. As it takes about 90 minutes on an empty stomach to digest a 5 HTP pill and get it in the blood stream, it works VERY fast. For depression, it is usually noticed in as little time as 4 hours. For bowel issues such as Irritable bowel syndrome, colitis, and other bowel conditions, it can take up to 12 hours to work due to the number of nerves that are affected.

I did not touch on MAO’is and TCA’s, but basically they are not used because of there many side effects. NRI’s are not widely used just because Serotonin is the neurotransmitter that is more important for mood issues.

The bottom line here is that there is ONLY one way to increase the production of Serotonin, and that is by supplementing with 5 HTP. Every other medication (again with the exception of Thyroid hormone, which is not related to this issue) works (or better said TRY’s to work) by reducing items that are getting rid of Serotonin.

I certainly encourage you to do the research on everything that I have said so that you feel comfortable in the knowledge. It is quite easy to do, just put in “serotonin” into your browser and you fill find tons of information, that will document the process of how Tryptophan makes it into Serotonin. And with the basic principles of what is going on with the prescription drugs, their action should be easy to follow. Then all you need is logic to make your decision.

I have not gone into the NE side, and it has a different pathway, but start with Serotonin if you are so inclined. Then, I will be happy to go into the NE pathway.

Best of luck,

Stage

copied and pasted by kitten

It would seem that there is a bit of confusion as to what you have heard. Certainly this can be a confusing area to work in. But lets see if I can go over the points that you bring up.

As to Serotonin being mostly converted in the gut, that is quite accurate. The big items that Serotonin is the neurotransmitter for in the intestines is the production of mucus in the intestine and peristalsis. Peristalsis is the sequential movement of muscles that moves a liquid along. The easiest example of peristalsis is the act of swallowing. When you swallow, the muscles alternatively expand and contract, forcing what you swallowed down to the stomach.

Peristalsis in the bowel does the same thing. As you have a lot of intestines that must work a good portion of the day to effect digestion and elimination, as well as the need to keep the intestines lubricated with mucus, Serotonin has much to do in the bowels.

There are currently 31 known receptors for Serotonin, but only 17 of them have a known function. The rest of the receptors function is not known at this time, but even without a known function, most of those receptors are in the intestines.

This is why most people with Irritable Bowel Syndrome (IBS) are constipated. The nerves that effect peristalsis are simply not making it to the brain, and the brain cannot get the signal back to the intestines to move things along. Less predominant in IBS is diarrhea issues. Again, it is a neurotransmitter issue, only it is not the function of peristalsis that is being insufficiently supplied, but more likely the ones that work with mucus production. In 41 cases of IBS that I have handled, my success rate with 5 HTP is 100%. Modern medicine will tell you that IBS is an untreatable condition. Hmmm.

When it comes to colitis, (bowel inflammation and pain) the most prescribed drug is best described as “artificial mucus.” And yes, once again 5 HTP has a perfect record (so far) of fixing people that have colitis that I have worked with.

So, yes, it is quite true that most Serotonin is used in the gut. However, it is not used in the stomach, but rather it is delivered by the blood stream to the receptors that need it. 5 HTP itself does not cause a stomach ache.

What you are taking when you take a 5 HTP capsule is a ground up plant stalk. It just so happens that the plant stem is a bit over 20% 5 HTP. So your body has to digest the 5 HTP out of a bunch of dried plant stalks, and of some, it is not their favorite thing to go into the stomach. Usually though, the stomach gets used to it after a while.

Serotonin is not made in the stomach because the enzyme that converts the 5 HTP into Serotonin is only found in the blood. So, what leaves the stomach is digested 5 HTP and digested plant stalks.

As far as 5 HTP being unable to make it to the brain, that is not correct. 5 HTP easily passes the blood-brain barrier all by itself and needs no carrier protein. As the brain gets over 25% of the blood on a regular basis, if you take it, it will get there, and usually pretty darn quick.

Tryptophan does leave the stomach unconverted, but it is digested from some other source of protein, such as meat or eggs or dairy. But in order to be used as Serotonin, it must first be converted into 5 HTP. This is mostly done in the liver, and is a more complex reaction. The first step is to find the hyroxyl donor, which as I recall is part of the M 23 system. The donor has 4 hydrogen atoms, and the enzyme needs to take the hydroxyl out (hydroxyl being two atoms in a particular shape). Then another enzyme is use to open the tryptophan molecule so that the hydroxyl can be joined.

It is true that some tryptophan is converted in the blood, but not very much. Most of it is done in the liver. If your intention is to increase Serotonin, by far and away the best way is to supplement with 5 HTP. So your articles conclusion that it is more efficient to supplement with Tryptophan rather than 5 HTP, assuming that your desire is to increase Serotonin production, is inaccurate.

AS to supplementing with Tryptophan, I think that is great. As you alluded to, Tryptophan is not sold over the counter. But is a part of whey isolate protein, that is used extensively today, especially in the body building arena. You see it sold in all of the health food stores, and is sold as a protein powder. It is there because it is part of milk, and as such there is no problem in taking it that way. The advantage there is that you get all of your protein needs in one helping, and it is in the proportions that you need the amino acids in. So taking your protein shakes each day is a great way to get all of your protein needs handled each day, including tryptophan.

What tryptophan CANNOT overcome is liver dysfunction. If you cannot get all of the components needed to cause the hydoxylation of tryptophan together, you can’t make 5 HTP. Without 5 HTP, you will not get Serotonin. I do think that the best way to fix a low level Serotonin shortage is to take the protein powder first and see what happens. If you are still depressed/get panic attacks/have IBS/ have colitis/ etc, then do take the 5 HTP.

Also, if you do not sleep well, I would suggest that you take 5 HTP first rather than any other thing. The reason for this is that Serotonin is the PRECURSOR (what a substance is made from) to Melatonin. Melatonin is the “sleep hormone.” It is made in the pineal gland, and as you may expect, the pineal gland has the highest concentration of serotonin anywhere in the body. It is not used as a neurotransmitter, but simply as the substance that is the biggest ingredient to the making of Melatonin. The reason that I suggest that 5 HTP be used first is that insomnia is the most consistent symptom to any Serotonin shortage condition. So, if you have insufficient Serotonin to make Melatonin, it is a very good chance that you are short of Serotonin elsewhere in your system.

As an adjunct to that statement, Cortisol and related cortico steroids will reduce Serotonin production. Cortisol is the so called “stress hormone.” So if you are stressed, then start loosing sleep, then find that your stomach hurts/ or you get depressed/ get a panic attack/ etc. the cause is just about certainly a lack of Serotonin.

Getting on to your experience with Serotonin, you have one item that is pretty easily explained and you have hit the main conundrum about Serotonin right on the head.

First, going back to my previous post, I mentioned that having too much of a neurotransmitter is not a good idea. The extreme example of this is the person that abuses cocaine or methamphetamine. Those work by hitting the Serotonin receptors as well as another neurotransmitter, Dopamine. Both are active in the mood perception area of the brain.

The drug abuser intends to achieve ecstasy by taking those drugs, and when he first does, it works just fine. He gets his feelings of ecstasy. The conscious brain is quite pleased with the event. However, the subconscious brain is not happy at all. It is the job of the subconscious brain to regulate all hormonal/neurological and much more, reactions of the body. One of the tools that it uses to do this is “upregulation/downregulation.”

To describe upregulation/downregulation, I use the analogy of a symphony orchestra. The listener to the symphony orchestra (at least a good one) hears all of the instruments playing as one. But imagine that in the middle of the concert, the trombone player stands up and plays his horn as loudly as he can. Pretty soon, all that the audience notices is the trombone player.

Now imagine that the conductor had an electronic dimmer switch to each musician, so that in the event that one of the musicians did stand up and play loudly, that the conductor would then turn down the dimmer switch on the musician, causing his sound to go down in volume.

That is what happens to the druggie, and why he becomes addicted. In the druggies case, he has a tremendous response to the drug, but the subconscious brain knows that this is not as it should be and “downregulates” that nerve/nerves. Then, when the drug wears off, all of a sudden, it is like the musician that sits down to play at a normal level, but still finds that his volume dimmer is dimmed down. Soon enough, since the area that has been dimmed is the area for mood, the druggie feels rather poorly. Then he decides that to feel good again, he needs more of the drug. He takes more, and gets a degree of euphoria that he sought, but only a lot less of it because his circuit has been dimmed (downregulation). But he feels much better than he did without taking the drug. At that point, he is addicted.

The problem with the druggie is that upregulation/downregulation is done by the subconscious brain, and there is nothing that can be done medically to change its responsiveness. Perhaps in the future the brain will notice that the “trombone player is playing rather softly and increase the volume” (upregulation) but that is only a possibility.

So when you take more Serotonin than you need, and force the levels up in your body, the body responds by downregulation the affected nerves. Since you are not doing anything remotely akin to taking drugs, your body adjusts, more or less. However, in your case, the increased neurotransmission is being read by the brain as an overload in the area of your stomach, and you feel the effect. When you stop, that should quickly return to normal.

The issue that you have also hit on, is probably the most perplexing of all, and that is that the ALLOCATION of the available Serotonin varies between people. This is why some people who are depressed (the 5ht b6 receptor class) have nothing in common with the people that have IBS (the 5HT e2 receptor class) except a lack of Serotonin. Most likely both will suffer from insomnia as well, but that only shows that we do not know why some people feel the shortage of Serotonin in one area, and others who are equally short of Serotonin feel it in another receptor area.

In regard to delaying your orgasm, yes, you can do that. However, it would seem most likely that before that happened, your intestines would be telling you that it is not a good idea for you at all. It is just the way that you are wired, so to speak. I would guess that the price that you would have to pay would not be worth the effort.

Hope that helps,

Stage

Stagestop-

I want to thank you for that magnificent two-post explanation of Serotonin and the reuptake process. You have my attention.

I am confused on one thing though. In your second post, you mentioned that most people with serotonin deficiencies also will have insomnia or IBS. I’m on 20 mg paxil for 11 years now and I have the opposite sleep issues. I could sleep at any time of day and 10 hours a night and still feel tired and unrested. Also, I don’t have any stomach issues.

I’m wondering if a person switches over to that 5HTP if the side effects of the SSRI’s will disappear. I would imagine it would be a process to make the transition from an SSRI to the 5HTP, probably not an easy journey for person prone to panic attacks. I appreciate any information you could supply.

Kitten

You are welcome for the explanation. I am glad to be of help.

I think that you may have misinterpreted what I said, or perhaps I did a lousy job of explaining what happens with Serotonin. The most common side effect of someone with things like IBS, depression, panic attacks, etc, IS insomnia. That is not to say that everyone who has IBS or depression etc. does have insomnia, only that it is the most common of the side effects.

Your situation is so typical of what modern medicine does today in this field and it is really disgusting. So that you won’t think that I am just prejudiced, I went to the web site http://www.drug … .com/paxil.html so that I could copy what the manufacturer describes as the common effects of the drug, Paxil. Here goes:

What is the most important information I should know about Paxil?
You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are a child or young adult. Talk with your doctor about this risk. While you are taking Paxil you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself. Paxil may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Paxil, do not stop taking the medication without first talking to your doctor. Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

So, in your case, I think it fair to describe your situation as "trouble sleeping" don’t you? That being the case, you should not now be on Paxil. Further, when you started having this problem you should have been taken off Paxil. And the sad truth is that people who take SSRI’s are MORE likely to commit suicide then if they did not take them.

When you read just this part, and then go back over my description of how the Serotonin system works, it would seem fair to say that you are a victim of both the drug and perhaps your doctor as well.

Going further in the site, to seek confirmation of what I just told you, here is what the manufacturer says:

What should I avoid while taking Paxil?
Avoid drinking alcohol, which can increase some of the side effects of Paxil.
Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, other medication for depression or anxiety). They can add to sleepiness caused by Paxil.

Paxil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of Paxil?
Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:

seizure (convulsions);

tremors, shivering, muscle stiffness or twitching;

problems with balance or coordination; or

agitation, confusion, sweating, fast heartbeat.

Other less serious side effects are more likely to occur, such as:

feeling nervous, restless, or unable to sit still;

drowsiness, dizziness, weakness;

sleep problems (insomnia);

nausea, constipation, loss of appetite;

weight changes;

decreased sex drive, impotence, or difficulty having an orgasm; or

dry mouth, yawning, or ringing in your ears.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Ok so much for all of the good news. I think that by just reading what is happening to you, and comparing that to what the drug manufacturer says, that getting off of Paxil will be a very good idea for you.

The reason for your current sleepiness is simply that you are taking Paxil. Paxil will take a week or so to get out of your system, and when you stop, your sleep should go back to what is was before, only modified by the amount of changes that has happened to you that you may not have noticed. That probably sounds confusing, but basically, in 11 years, things change. If you were taking Paxil to cure panic attacks, which are one manifestation of a Serotonin Shortage, stopping the Paxil will simply allow that shortage to come back. Only in 11 years it may be worse.

The good news is that is no problem at all. And in very short order you will be a new lady, with a couple of proviso’s to that statement.

As to difficulty in switching from Paxil to 5 HTP, there are no difficulties. You should wait at least 5 days after ending Paxil before starting 5 HTP. 5 HTP will work in less than 12 hours on you. I would suggest that your initial dosage be 100 milligrams per day of 5 HTP. When you feel comfortable, and at least after one week at the 100 mg dosage, try out 50 mg as your daily dosage and see what happens. You may well do with the smaller amount.

The first proviso has to do with your adrenal system. In looking at your name here, I am assuming that you are female, and due to the fact that you have been taking Paxil for 11 years, I am assuming that you are at least 30 years old. If you are closer to 40, then the adrenal issues really come up for a lot of women, and it involves another learning experience.

Basically, Paxil is also used to treat "premenstrual dysphoric disorder" or to say it another way, a good case of PMS mood swings. While in some women SSRI’s can reduce PMS symptoms, it is simply a mask. The underlying problem is not solved. Therefore if you have PMS symptoms, 5 HTP will do nothing for those. But there is good news there too.

First, let me say that any PMS symptom is not healthy, and to make a point, let me say that women should not have PMS. Sadly, PMS is so accepted that even the women expect it and consider it to merely a part of being female. Some women are happy to announce to the world that they have PMS and that others should be warned. Well, PMS is simply the manifestations of a hormonal imbalance that is easily corrected. PMS is NOT healthy and the effects of PMS are the reason for hundred of thousands of hysterectomies being performed on women in their 40’s due to Uterine Hypertrophy (basically "a big uterus" and what it means is one that bleeds all the time). It is also the cause of most cases of Cervical Dysplasia.

So, the bottom line here is that if you have PMS, taking 5 HTP will not clear that up, but I can teach you how to fix that, and teach you how to regulate your menstrual cycle so that you do not have problems now, or in the future.

The second proviso has to do with your balance of your essential fatty acids. To distill this down the the essence, take 4 to 5 grams a day of fish oil pills. It makes a difference and it effects just about every cell in the body.

To summarize:
1. The manufacturer of Paxil has told you that you should not be on their product and I agree with them.
2. It is very easy to get off of Paxil and onto 5 HTP. Simply stop taking Paxil, wait 5 days, and then start with 100 mg a day of 5 HTP. Take it in the morning, and you should notice it in your sleep that night. You should also feel better the next day.
3. If you are having PMS symptoms, they can mask the improvement of what 5 HTP will do for you. If so, we can review how to stop PMS and get you PMS free.
4. Take 4 to 5 grams a day of fish oil pills.

One further point, if you have what I call a "female diet" which is one that is low in whole proteins, then make a protein shake "smoothie" every day with at least 40 grams of whey isolate protein in the shake. This can do wonders for you if your are currently short on protein. If you are not sure if you are short or not, take the shake anyway. If you know that you are not short because you eat reasonable amounts of meat, fish, dairy, and eggs every day, then you can probably dispense with the shake.

After you get those things done, (with some of them being only if you need them) you should be a new woman.

Best of luck,

Stage

Hi Kitten This is a repost of what you posted earlier.

Stagestop-

Thank you for your detailed response, I know it took a lot of time and I appreciate it.

You are correct, I’m female, 38. I’ve never had PMS but am surrounded with women who do.

I am interested to make the change off the paxil mostly because of sleep issues and lack of clarity. I’m in a brainfog all the time. Thinking is hard for me and concentration- forget about that. Socializing is hard for me, I get bored and need constant stimulation or I leave the conversation. I usually don’t stay anywhere longer than an hour, I always “gotta go”. If I’m interested in something, I’m good but if I have no interest in it I’m like a 5 yr old, figiting and not paying attention and just wondering can we leave yet? I’ve been on the paxil so long though that I don’t know if it’s the drug or is it just the way I am. The most common complaint of my friends, colleagues and family is- I don’t pay attention. I wish I could but I just see their lips moving and I tune out. (unless of course, it’s something important)

That bit about a heart defect possible in newborns, I was on paxil while pregnant with my last child and wonder if I should get his heart checked, any thoughts? I’m really scared about that now. His father has a bad heart to begin with. He is 6 now.

My only problem with the switching is what will happen to me while I’m not on the paxil during those 5 days. I’ve had occasion where I missed 2 days and was a basket case, and required the xanax to stop the panicked thoughts. You can’t just stop taking paxil, you have to taper off. I’m almost thinking I should go in-house to make the switch but doctors don’t support natural medicine so I’m on my own. The side effects of paxil suck, BUT the thought of getting off it and revisiting that scary, dark lonely place while the transition occurs, seems worse. What to do…. Well I’m going to think on it some and really weigh out the pros and cons of it all. I’d love to be free of the “drug” and it’s bad effects but might be too chicken to try. More research necessary. I’m on it.

HI Kitten,

To respond to your letter, I can understand completely your desire to get off of Paxil. With the new information that you have supplied, lets review what your situation is.

You have had rather serious sleep issues since taking Paxil. In reading the literature from the makers of Paxil, they tell you that you should not be on it.

You currently take 20 mg a day of Paxil. This is in the small/medium size dosage. Paxil comes in 10, 20, 30 and 40 mg sizes.

When you are off of Paxil for two days, panic attacks return with a vengeance.

I suggested that you wait 5 days to get rid of most of the Paxil in your system, however, with your return of symptoms in two days, and the fact that your dosage is not much, I do think that being off of Paxil for one day may be enough time. The half life of Paxil is 15 to 20 hours. This would mean that total elimination should be in about 5 days or so. You may well feel poorly during that period, except that if you do take the 5 HTP, you should not feel the panic attacks.

Regarding the combinations of Paxil and 5 HTP, there is no evidence available that says that you can, or cannot do that. Certainly 5 HTP is natural and bio identical to the 5 HTP that you produce. The only side effect taking too much 5 HTP appears to be anogasmia (inability to have an orgasm). I would wait for as long as you are comfortable just to be cautious, but again, there is nothing that I have seen that indicates any particular caution is necessary in regards to adding 5 HTP to your regimen

As to when your sleep issues would change, I have to say that I don’t know. Certainly the elevation in Melatonin from the 5 HTP should be helpful, but I don’t know if it will offset the issues created by the Paxil. Certainly in 5 days from the time that you first switch, you should feel a lot better. So, as to how you make the change, it is up to you.

When you do make the change, if you still have trouble concentrating then we can go over those possibilities.

Hope that helps,

Stage

Kitten,

Do you think that maybe you should discuss with your doctor before doing this study on yourself?

Obviously Stagestop knows what he is talking about, but I don’t think that you will find any medical evidence that 5-HTP will always be an effective alternative for Paxil.

It is just a little bit of a concern for me that Stagestop is saying that it WILL work, rather than using words like “might”, or “could”.

At least be ready for the possibility that it might not work. I don’t know how severe your panic attacks are, but if you are not ready to experience them again, then I would be very cautious about going off your Paxil.

Thanks Mravg, for your concern..;( That’s so sweet of you to worry about me.

I’m researching studies that have been done and reading everything I can find on the subject first.

I will first find a psychiatrist since I don’t have one. Once you are regulated on medication, they don’t need to see you anymore so I haven’t been to a Psychiatrist in years. I’m way to paranoid to do this by myself. I can’t afford much down time, I have a business to run and a household of 5, who’s going to replace me if I go down during the transition? That’s a big deterrent for me. It’s not just the panic attacks but I also get disoriented when the Paxil is leaving my bloodstream. That’s how I know if I forgot a dose, I feel cobwebs on the brain (that just means you can’t think straight).

FoxMarine went out and bought some and Nick 666 is going to so I’ll see how they do with it.

I need to make a change, that much I’m sure of.

I am a health care professional myself…and I am TOTALLY impressed with this information.

Stagestop, if you are willing, I would love to have you post in the health section on any other real great tips you may have and are willing to share.

A big thanks!!!

My situation and probably Nick’s are different from your kitten. I’m on Cymbalta due to my inability to sleep. I was on Rozeram (a melatonin regulator), and it didn’t help that much, and I was obviously troubled with some personal issues. Cymbalta worked for me, but I’ve become very sleepy and sometime unfocused. I’m not sure it’s only the medicine, could be other factors as well, like quitting smoking, or maybe because I’m not going to the gym as I used to. I went off Cymbalta for 2 weeks, and I seemed to be fine, but I start having anxiety attacks of some sort.

I did some studies of my own and it seems to me that the serotonin pathway is not the best one in long term, and I should try working on the dopamine one. Anyway, I’m afraid to get off cymbalta again, I’ll take the 100mg 5HTP, as recommended by stagestop, only to see if it improves my mood.

Stagestop,

If 5-HTP supports pathways that are usually from serotonin(by conversion to 5-htp),what over-the-counter supplement supports the noradrenaline pathways? I believe I may have inadvertently down regulated my noradrenaline pathways by overuse of ephedrine like supplements over the years. Also is this brain fog that I’ve heard so many complain about on this board, attributable to a specific deficiency or is it just a common symptom of the plethora of events we call aging or disease?

Hello FoxMarine,

One of the problems in giving generalized advice in this field is that there is often more to the puzzle than is offered. Cymbalta is a SSNRI, (Selective Serotonin and Norepinephrine Reuptake Inhibitor). So you are already taking a drug which is working to raise the synaptic levels (the synapse is the area where neurotransmission takes place) of both Serotonin and Norepinephrine. I do not suggest that you use 100 mg of 5 HTP with Cymbalta. The reason is that with the lower levels of Serotonin production that you have, since you seem to be symptom free, you are most likely getting sufficient levels of Serotonin at the synapse. Adding 5 HTP will then increase the levels that you make, and the Cymbalta will then amplify that (since it has more to begin with, the inhibition of reuptake will be more successful).

I would suggest that if you want to try 5 HTP that you get off of Cymbalta first.

Best regards Stage.

Hi Mrvag,

There is a bit of confusion on one item in my earlier posting. When I said that the conversion of 5 HTP to serotonin WILL happen, that is accurate. The reason is that decarboxylation of 5 HTP into Serotonin is done with a non saturated enzyme action. I did NOT say that this will cure Kitten. Certainly I think that it may do that, but I also think that there are adrenal issues to be worked on after she switches to 5 HTP, and there are possible issues with thyroid, GABA, as well as EFA’s.

To be completely fair, there are some very, very miniscule chances that 5 HTP will not convert into Serotonin, but they involve things like a genetic enzyme insuffiency (odds are probably in the millions on that one since she survived to the age of 38) or she could have ischemia at the receptor level (again due to the number of receptors, and the fact that she has not had a stroke, this would be exceptionally remote). Or perhaps there is something that I have missed neurologically. But the chemistry about the production of Serotonin is easy to verify on line, and if there is concern about my statement, please do research it.

Returning to health when we have endocrine and neurological issues can take time as each item is addressed. Doing it on the internet is difficult because there is no interaction. One person describes a problem, and they get responses to that particular problem. What is left out, are all of the other items that may be contributing to that problem.

Certainly I do not want to oversell any treatment modality. That Kitten is doing her homework and reviewing the literature is great. I support her 100% in that effort.

Best regards,

Stage

Is it not true, stage, that Paxil is a drug you should not quit “cold turkey,” instead wean yourself off it?

Yup. SSRI discontinuation syndrome is especially problematic for Paxil (paroxetine) with its short half-life.

Discontinuation symptoms: comparison of brief interruption in fluoxetine and paroxetine treatment.

Abrupt and brief discontinuation of antidepressant treatment: effects on cognitive function and psychomotor performance.

Switch to mania upon discontinuation of antidepressants in patients with mood disorders: a review of the literature.

Focus on paroxetine.

Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial

And a popular overview here: SSRI Discontinuation Syndrome

There is a reason why MDs typically reduce Paxil doses in small increments every four or five days rather than having their patients quit cold-turkey. I’m glad Kitten will be consulting a doctor before changing her drug regimen. In my opinion no one should be playing with their neurotransmitters without medical supervision.

Good points guys. Anyone even thinking about trying something like this on their own is just asking for trouble. The smart way to do something like this is with a Doc’s supervision, as PG said. It may be hard to find a Doc to work with, but getting the right one is worth the trouble I would think.