| |  "Re(1):severe anxiety?"
, Sat 7 Dec 08:01
From the book 5htp the natrual alternative to prozac:
"Anxiety is part of life. You can't avoid some anxiety. A moderate amount of anxiety can actually help improve performance in many situations, but when anxiety becomes overly intense, as in extremely stressful situations, or in people with pathologic conditions like panic disorder, obsessive-compulsive disorder (OCD), or post-traumatic stress disorder (PTSD), it can be debilitating and even dangerous. The pharmaceutical industry has made billions of dollars selling drugs that are very effective for reducing anxiety, panic, and OCD, including the benzodiazepines (eg, Librium7, Valium7, and Xanax7) and more recently, the SSRIs. Preliminary evidence suggests that 5-HTP may also be quite effective for relieving acute anxiety states.
Serotonin and Anxiety
Serotonin may be important for regulating anxiety, but the mechanisms involved are less well-understood and more complex than they are for depression. In animal studies, for example, reducing serotonin function with certain drugs appears to reduce anxiety.24 Similarly, benzodiazepines, which reduce anxiety in humans, also reduce serotonin activity.
On the other hand, rapid depletion of tryptophan, leading to a reduction in serotonin, has been reported to exacerbate both panic and aggression,25 while treatment with SSRIs, which enhance serotonergic activity, have clear anti-anxiety activity.26-28 Studies using L-tryptophan or 5-HTP, which increase serotonin activity, suggest that these amino acids may also be effective anxiety-reducing agents.
Evidence for 5-HTP
In one early study, L-tryptophan was found to be effective in reducing the symptoms of OCD.29 The first study investigating the possible anti-anxiety effects of 5-HTP was published in 1985.30 This was a small, uncontrolled pilot study conducted in the Netherlands. The subjects were 10 individuals diagnosed with anxiety disorders according to standard criteria (seven of the patients had "panic disorder;" three had "generalized anxiety disorder"). 5-HTP treatment (300 mg/day) lasted 12 weeks, during which their level of anxiety was assessed weekly using the Spielberger State-Trait Anxiety Inventory (STAI) and the Hamilton Anxiety Scale (HAS).
By week 12, panic attacks had almost completely disappeared in the seven patients suffering from that disorder; overall 9/10 patients showed improvement as measured by the STAI and HAS scales. Improvement was apparent by week 4 and continued until week 8, after which it leveled off. Figure 6 shows the mean symptom scores before 5-HTP treatment (Baseline) and after 12 weeks of 5-HTP. Significant improvement was seen for depression, anxiety and phobic anxiety.
Although this study was limited by the small number of subjects and a lack of proper controls, the same investigators conducted a larger double-blind, comparative, placebo-controlled study a few years later. The results showed that 5-HTP had significant activity that was on a par with the anti-anxiety drug clomipramine (Anafranil7) on some measures, but not on others.31 In this study, 45 patients diagnosed with anxiety disorders (generalized anxiety disorder, panic disorder, agoraphobia, or OCD) were randomly assigned to receive either 5-HTP, clomipramine, or placebo. The trial lasted 8 weeks. The results (Fig. 7) showed that both 5-HTP and clomipramine were about equal and both were significantly superior to placebo in reducing anxiety beginning at week 2 on this measure of anxiety (State-Anxiety Inventory, A-STATE). On other measures, 5-HTP was generally superior to placebo but less effective than clomipramine. Since these investigators used a lower maximum dose of 5-HTP (150 mg/day) in this study than they used in their earlier study (300 mg/day), it is possible that a higher dose would have produced a more dramatic result.
As we noted above, the relationship between serotonin and anxiety appears to be quite complex. For example, anxiety can be relieved both by agents that interfere with serotonergic function (eg, benzodiazepines) as well by agents that enhance serotonergic function (eg, 5-HTP and SSRIs). In addition, treatment with 5-HTP and SSRIs has sometimes been reported to result in an aggravation of anxiety (or depression) during the first week or two of therapy before clinical improvement occurs.
Scientists have not yet pinned down the reason for these paradoxical responses. The hypothesis that has the most support at the present time suggests that reducing serotonergic activity generally lowers anxiety. In people with anxiety disorders, serotonin receptors become hypersensitive. In other words, they overreact to a burst of serotonin molecules that would normally not increase anxiety. Thus, when a person with an anxiety disorder takes 5-HTP or an SSRI, the extra serotonin produced initially overstimulates these hypersensitive receptors and may lead to an aggravation of the anxiety. With continued stimulation, though, these receptors eventually become less sensitive -- a process known as downregulation -- and anxiety levels eventually decline.24
Although the definitive studies on the role of 5-HTP for treating anxiety have yet to be done, considerable research with SSRIs indicates that these drugs can be very effective for reducing excess anxiety. There is every reason to believe that 5-HTP is just as effective while producing fewer unwanted side effects. However, users of 5-HTP (like SSRI users) should not be surprised if they feel more anxious initially before anxiety begins to decline.
MJ DuPont
Posts: 413 | | Registered: Wed 20 Jun 2001 6:19 |
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