Avanza & 5-HTP

[lagger]

I know you shouldnt combine 5-HTP with anti depressants but I have been using 5-htp with avanza. I only get weird effects when sleeping early in the morning where i get bad sleep paralysis and have a seizure but i think kits related to GABA WD and mixing melatonin in the mix as well.

Avanza isn't a maoi or ssri so does anyone know if this is safe. My main use of avanza is to go to sleep. It doesnt help with depression or anxiety. In fact if anything it makes me more angry when something goes wrong.

 

[Mr Blonde]

According to wikipedia, it's drug interaction dangers are near negligible. Given that it can be mixed with SSRI's for combined treatment, and has serotonin antagonist effects, I'd say mixing with 5-HTP is fairly safe.

 

[tomasolab]

what is 5 htp?

 

[Mr Blonde]

^ 5-hydroxy-tryptophan. It's a precursor to serotonin that crosses the Blood-Brain-Barrier, unlike serotonin itself.

There are a lot of threads on BL about it, particularly for mood and for help in MDMA comedowns.

 

[AyahuascaSeeker13]

5-HTP is 5-Hydroxytryptophan, used for appetite supression and depression.

Mirtazapine (Avanza) is a tetra cyclic antidepressant. Currently many doctors are prescribing this as a way to get to sleep easier.

As a serotonin receptor antagonist, mirtazapine will not cause serotonin syndrome at any dose, so you don't have to worry about that. In fact, mirtazapine can actually be used to treat serotonin syndrome. Really, I haven't heard of any studies or seen any proof that taking Avanza with SSRIs or SNRIs etc... can cause the symptoms you are having.

I don't know a lot about Avanza, I would switch to temazepam as an alternative as this would also not interact with the 5-HTP you are taking.

 

[Mr Blonde]

One other thing; mirtazapine can increase the risk of having seizures. If you are going through benzodiazepine WD then perhaps mirtazapine should be avoided in favor of something else?

 

[Jakeperson]

Once you get tolerance to the Mirtaz you won't get angry but it won't help you sleep any more.

Nor does it really do anything to help with depression or anxiety for me.

 

[lagger]

Its the only effective med for sleep atm. Everything else gives me horrid dry mouth that is it so uncomfortable and sedation wise i cant even reach for my water as i am half paralysed due to these meds (doxepin, phenobarbs, alcohol, anti histamines, and all the crappy anti psychs).

I guess i found out the reason for seizures with avanza and gaba WD then.

Once you get tolerance to the Mirtaz you won't get angry but it won't help you sleep any more.

Nor does it really do anything to help with depression or anxiety for me.

ill probably end up cycling it


--

Who thinks Tryptophan itself is better than 5HTP and more safe?

 

[Davevanza]

While I was taking Tenuate ( Diethylpropion), an anorectic, which now been discontinued, i had trouble sleeping.
It was 2005.
I went to a GP, was given Avanza 30mg.

Now I've been taking it for almost 7 yrs. I then was referred to a psychiatrist, he increased the dose to 90mg at night.

So far so good. But, compared to other antidepressants, Avanza's effect is nothing but sedation for the first 15 mins. That's all. it doesn't brighten my mood at all.

Strangely, it's reputed as being a nootropic, if not mistaken i read it in Wikipedia. ( I am taking the SolTab, being faster absorbed and eliminated, not leaving the tab sit longer in the stomach. This minimises the sedation/hangover effect).

Here is a useful link.

http://www.psychotropical.com/Antidepressants_mirtazapine.shtml

I find Moclobemide a better mood brightening drug. Just crush it, mix it with little amount of water, and swallow. This give an instant "mood elevating" effect, a slight euphoria. But just don't mix it with any symphatomimetics like Ephedrine, Phenylephrine, or any amphetamine-like drugs. Also avoid mixing it with Pethidine, Meperidine ot serotonin agonists.

I consider Avanza is only good as an antiemetic ( this is how the apetite is increased), hypnotic, antihistamine.
It's effect more or less like Periactin ( Cyproheptadine), an OTC antihistamine, with additional properties used to reverse serotonin syndrome and to increase appetite.

Benadryl ( diphenhydramine) and Seroquel ( Quetiapine) would be very good hypnotic. But seroquel flattens the mood, it's an antipsychotic, that attaches to D2 receptor in the brain only for a short period of time, so it doesn't cause tardive Dyskinesia. I tried both, and would say, Seroquel is several times stronger than Benadryl and Avanza.

 

[Divine Moments]

As a serotonin receptor antagonist, mirtazapine will not cause serotonin syndrome at any dose, so you don't have to worry about that. In fact, mirtazapine can actually be used to treat serotonin syndrome. Really, I haven't heard of any studies or seen any proof that taking Avanza with SSRIs or SNRIs etc... can cause the symptoms you are having.

Do you have a source for any of this? A quick google of 'mirtazapine serotonin syndrome' gives quite different information...

 

[Mr Blonde]

^ It is used to treat serotonin syndrome and is considered not to reliably produce the state.

Though this case mentions it, they also state that it is rare and is idiopathic in nature.

 

[Divine Moments]

I'm aware it doesn't reliably cause it, but the fact that it is reported (e.g. here, here, here, here and here), both alone and in various combinations, suggests that saying "mirtazapine will not cause serotonin syndrome at any dose" on a harm reduction board is unsafe, does it not?

I'd like to see references about its use in treatment of SS. I know that theoretically it could be used but it isn't approved for that in Australia.

 

[Mr Blonde]

^ Well that is right, it should be changed to 'mirtazapine does not often cause serotonin syndrome' or something like that.

What do you mean by approved? As in on the PBS? Most treatment of serotonin syndrome would be hospital based and hospital based uses of medications aren't listed on the PBS.

 

[Divine Moments]

Aside from that, it's only indication listed in AMH is major depression. I don't have MIMS but I suspect it's the same there.

I see the reference on wiki for the statement that it can be used for treating SS is from 1996 and I can't get the full article so I don't know how reliable it is, is it mentioned elsewhere? Pubmed search for 'mirtazapine serotonin syndrome' easily returns more results for it as cause than as treatment. From one such article:

2.7. Treatment
Management of serotonin syndrome begins with discontinuation of all serotonergic agents. Supportive care is the treatment of choice for most cases, but specific therapies depend on the severity of the syndrome. Mild cases are usually managed by removal of precipitating agents, as well as supportive care including intravenous fluids for hydration and to facilitate diuresis and treatment with benzodiazepines to prevent agitation. Moderate cases appear to benefit from administration of 5-HT2A antagonists, such as cyproheptadine, a histamine-1 receptor antagonist with anticholinergic and antihistaminergic characteristics, as well as chlorpromazine, a 5-HT1A and 5-HT2 receptor antagonist neuroleptic. Severe cases complicated by hyperthermia (temperature ≥41.1°C) are treated with the above therapies, as well as possible intubation, paralysis and sedation. There is no role for antipyretic agents in the treatment of serotonin syndrome, as the hyperthermia associated with serotonin syndrome is the result of increased muscle activity and not central nervous system action. Benzodiazepines are central to the control of agitation, regardless of syndrome severity. Diazepam is the best-studied agent and appears to improve survival in animal models by blunting hyperadrenergic symptoms. Some studies support the use of beta-blockers, which block 5-HT1A receptors [1] and [11].

Can't easily find any that mention the use of Mirtazapine in the treatment of SS in humans.

 

[Mr Blonde]

^ Mmm, interesting... I'll see if I can't copy and paste a full journal article on Tuesday.