5-HTP with an MAOI?

[kjb1891]

I've been reading about the supplement 5-HTP recently. It increses the amount of serotonin in the brain causing a lift in mood. I was wondering if you took an MAOI with 5-HTP if it would inhibit the breakdown of the 5-HTP in the digestive system therfore increasing the serotonin levels even higher. Maybe even for a longer period, too. I've seen reports of people saying not to take 5-HTP with SSRIs or MAOIs, but no clinical proof that it would have ANY negative side effects. I did find one report that gave me some hope for future research. Here it is:
Fibromyalgia: In one placebo-controlled study of 200 fibromyalgia patients who were also migraine sufferers, 5-HTP (400 mg/day) was compared to amitriptyline (a tricyclic drug) and pargilyne or phenelzine (MAOI drug). The combination of 5-HTP (200 mg/day) with an MAOI was also evaluated. The study lasted 12 months in which patients kept a daily pain diary. At the end of the study, all treatment forms showed significant improvement over placebo. The combination of 5-HTP with the MAOI was the most effective. 5-HTP alone was as effective as the tricyclic or MAOI drugs. No patients withdrew from the study due to side effects.
This leaves me to think that the 5-HTP with MAOI combo may be of some use to people with depression, and for anyone looking to significantly increase their mood

 

[day_for_night]

nope, that is a dangerous combo. don't have sources at the moment, but i know for a fact you are not supposed to mix the two.

 

[fairnymph]

I haven't specifically mixed a MAOI and 5-htp, but I have mixed st.john's wort (which has mild MAOI properties) and 5-htp and found that the combo had significantly more of an effect than taking 5-htp alone.

5-Hydroxytryptophan (5-HTP) and p-methoxyamphetamine (p-MA) induce dose-dependent, lethal hyperthermia when applied intravenously to monoamine oxidase inhibitor (MAOI) pretreated rabbits.[I.e., combining 5-htp and a MAOI leads to hyperthermia, most likely via serotonin syndrome (hyperthermia being one of the most prominent symptoms of that syndrome)]
Fjalland B. Neuroleptic influence on hyperthermia induced by 5-hydroxytryptophan and p-methoxy-amphetamine in MAOI-pretreated rabbits. Psychopharmacology (Berl). 1979 May 25;63(2):113-7.

Through a controlled double-blind study in 30 hospitalized patients affected with endogenous depression, the antidepressant action of the combination of nialamide+l-5-HTP has been evaluated and compared with a control group which only received nialamide (+ placebo). The patients treated with nialamide + l-5-HTP achieved a fuller recovery than those who were treated with nialamide alone. The treatment with nialamide + l-5-HTP proved to have a shorter delay of onset. Side effects showed no marked differences except for the orthostatic hypotension which was less apparent in those patients treated with nialamide + l-5-HTP.
Alino JJ, Gutierrez JL, Iglesias ML. 5-Hydroxytryptophan (5-HTP) and a MAOI (nialamide) in the treatment of depressions. A double-blind controlled study. Int Pharmacopsychiatry. 1976;11(1):8-15.
It seems that combining MAOIs and 5-htp can be done safely and is usually more effective than a MAOI alone. However, there is still substantial risk of serotonin syndrome.
As for combining SSRIs and 5-htp/l-tryptophan, this is sometimes used for treatment-resistant patients, but the combo has the potential to be dangerous (i.e. the risk of serotonin syndrome).

It has been demonstrated that synthesis of serotonin (5-HT) is dependent on the availability of precursor, as well as the activity of 5-HT neurons. In the present series of experiments, we examined the effects of precursor (5-HTP) loading on extracellular hypothalamic 5-HT after administration of fluoxetine alone or in combination with WAY 100635, a selective 5-HT1A antagonist. In the first experiment, fluoxetine alone (10 mg/kg i.p.) caused 5-HT levels to significantly increase to 150% of basal levels. Subsequent administration of 5-HTP at 10, 20, and 40 mg/kg i.p. caused 5-HT levels to further increase to a maximum value of 254%, 405%, and 618%, respectively. In the second experiment, either vehicle or WAY 100635 (1 mg/kg/hour s.c.) was infused, then fluoxetine (10 mg/kg i.p.) and 5-HTP (10 mg/kg i.p.) were administered. By itself, WAY 100635 led to a slight but significant increase in hypothalamic 5-HT levels one hour after the start of administration (130% of basal levels). In the WAY 100635-treated group, fluoxetine caused an increase to 240% of basal levels after one hour, which rose to 290% of basal levels after two hours. Subsequent administration of 5-HTP further increased 5-HT levels to 580% of basal levels after one hour. In the vehicle-treated group, fluoxetine caused an increase of 160% of basal levels which was stable over two hours, and subsequent administration of 5-HTP led to a slight increase in 5-HT levels of 220% after one hour. These results suggest that combining blockade of 5-HT1A autoreceptors with 5-HT uptake inhibition results in a synergistic increase in synthesis and release of 5-HT when precursor is administered.
Dreshfield-Ahmad LJ, Thompson DC, Schaus JM, Wong DT. Enhancement in extracellular serotonin levels by 5-hydroxytryptophan loading after administration of WAY 100635 and fluoxetine.
If you are looking to get high from combining either an SSRI or a MAOI with 5-htp, I don't recommend this (there are safer, more sure-fire ways of getting high). However, if you choose to experiment, then from what I have read, it seems that the SSRI + 5-htp combo is safer (relatively) than the MAOI + 5-htp combo. Regardless, I strongly suggest that you start with low doses of each and be very cautious all around. Of course, if you do attempt any of this, let us know how it goes...
Hope I've been of help, sorry there isn't more data on this topic (I was quite surprised by the lack of research regarding such combinations).

 

[kjb1891]

Here's another idea I thought of in the last day. What about combining a low dose of AMT with 5-HTP? AMT has been known to be a somewhat effective MAOI. Since it isn't a 100% prescribed MAOI it won't be quite as effective. But, with the good effects of a low dose of AMT combined with the higher serotonin levels(even higher than normal with the MAOI effects of AMT) it might result in a MDMA-like effect. I'm going to try it out and let you all know what if any good comes from it.

 

[kjb1891]

I was thinking more about the AMT having a big effect on the 5-HTP. I want to take a large dose of 5-HTP(300-400mg) with a lower dose of AMT(20-25mg). I'm hoping for a MDMA-like effect with the low dose of AMT and high dose of 5-HTP. I'm not looking for a big visual LSD-like trip. Low doses of AMT cause body tingling, speedy energy, and euphoric feelings with no visuals. 5-HTP increases the level of serotonin("happy hormone") in the brain. The serotonin effects of 5-HTP will be increased with AMT(which has a somewhat
effective MAOI effect). So, I'm hoping it turns out like this:
euphoria+tingling+energy+high serotonin = MDMA effect
This is all theory right now though. I'll be trying it out soon

 

[fairnymph]

kjb -- I think your theory sounds like it might have some validity, and the doses you mentioned sound safe, IMO. This is, of course, presuming that you are experienced with AMT (because for some people 20 mg is a high dose -- as long as it is low for you though then you should be fine).
My one concern is that for some, higher doses of 5-htp (more than 100-200 mg at a time) cause stomach discomfort/nausea. I have never had a problem with high doses but I did want to point that possibility out to you.
If you do have stomach discormfort with high doses of 5-htp, I recommend spreading out the dose throughout the day, eating a small amount of mild, bland food (like bread/crackers/cereal) with the doses, and if possible, getting an enterically coated form of 5-htp (solaray makes one). Enterically coated 5-htp reaches your brain better, meaning that more of the 5-htp gets converted to serotonin. I highly recommend this type of 5-htp.
Let us know how it goes!
[ 25 May 2002: Message edited by: fairnymph ]