5-Hydroxytryptophan plus SSRIs for interferon-induced depression: synergistic mechanisms for normalizing synaptic serotonin

Erick H Turner; Aaron D Blackwell

doi:10.1016/j.mehy.2005.01.026

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5-Hydroxytryptophan plus SSRIs for interferon-induced depression: synergistic mechanisms for normalizing synaptic serotonin

Journal article

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Peer reviewed

5-Hydroxytryptophan plus SSRIs for interferon-induced depression: synergistic mechanisms for normalizing synaptic serotonin

Erick H Turner and Aaron D Blackwell

Medical hypotheses, Vol.65(1), pp.138-144

2005

DOI: https://doi.org/10.1016/j.mehy.2005.01.026

Handle:

https://hdl.handle.net/2376/109006

PMID: 15893130

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Abstract

Serotonin Uptake Inhibitors - metabolism

Synapses - drug effects

Depression - physiopathology

Hepatitis C - drug therapy

Antiviral Agents - therapeutic use

Risk Factors

Interferon-alpha - therapeutic use

Serotonin Uptake Inhibitors - therapeutic use

Drug Synergism

Depression - drug therapy

5-Hydroxytryptophan - therapeutic use

Models, Biological

Antiviral Agents - adverse effects

Depression - chemically induced

Serotonin - metabolism

Brain Chemistry

Hepatitis C - psychology

Interferon-alpha - adverse effects

5-Hydroxytryptophan - metabolism

Drug Therapy, Combination

Interferon-alpha (IFN) is widely used in the treatment of certain cancers and viral infections, including hepatitis C (HCV). Unfortunately, depression is a common side effect of IFN therapy, affecting approximately a third of HCV patients receiving IFN therapy. Studies have shown that selective serotonin reuptake inhibitors (SSRIs) can effectively treat IFN-induced depression in only 63-75% of cases. For the remaining percentage, depression often necessitates dose reduction of or discontinuation from IFN therapy. Emerging evidence indicates that IFN may cause depression by affecting brain serotonin. IFN has been shown to increase serotonin reuptake and to decrease serotonin synthesis. We hypothesize that SSRIs are not fully effective because they affect only serotonin reuptake, not serotonin synthesis, and that effective treatment must address both uptake and synthesis. 5-Hydroxytryptophan (5-HTP) effectively increases central nervous system synthesis of serotonin. It is the immediate precursor of serotonin and is widely available as a dietary supplement, which is well absorbed after an oral dose. Several double-blind studies have shown 5-HTP to be effective in the treatment of nondrug-induced depression. We hypothesize that patients who become depressed on IFN will respond to the synergistic combination of SSRIs plus 5-HTP.

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Title: 5-Hydroxytryptophan plus SSRIs for interferon-induced depression: synergistic mechanisms for normalizing synaptic serotonin
Creators: Erick H Turner - Mental Health Division, Mood Disorders Research Center, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA. Erik.turner@med.va.gov
Aaron D Blackwell
Publication Details: Medical hypotheses, Vol.65(1), pp.138-144
Academic Unit: Department of Anthropology
Publisher: United States
Identifiers: 99900547274101842
Language: English
Resource Type: Journal article