SAMe (S-Adenosylmethionine) and 5-HTP —Possible Harmful Interaction St. John's Wort —Possible Harmful Interaction Folate —Possible Helpful Interaction Fish Oil —Supplementation Probably Not Helpful Ginkgo —Supplementation Probably Not Helpful Ephedra —Supplementation Probably Not Helpful

Since the development of Prozac, the first of the selective serotonin-reuptake inhibitors (SSRIs), this family of drugs has been expanding. The SSRIs are used for both severe and mild to moderate depression as well as for a variety of other conditions. These drugs work primarily by altering the action of the neurotransmitter (chemical messenger) serotonin in the brain. SSRI antidepressants include

  • Citalopram (Celexa)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • and others
Other antidepressants that increase serotonin activity include
  • Nefazodone (Serzone)
  • Trazodone (Desyrel)
  • Venlafaxine (Effexor)

5-Hydroxytryptophan (5-HTP)S-Adenosylmethionine (SAMe) The body uses the natural substance 5-hydroxytryptophan (5-HTP) to manufacture serotonin, and supplemental forms have been used for treating depression and migraine headaches . S-adenosylmethionine (SAMe) is a naturally occurring compound derived from the amino acid methionine and the energy molecule adenosine triphosphate (ATP). SAMe is widely used as a supplement for treating osteoarthritis and depression. Based on one case report and current thinking about how they work, SAMe and 5-HTP should not be taken with SSRIs, as they might increase the risk of serotonin syndrome.This syndrome is a toxic reaction brought on by too much serotonin activity. The condition requires immediate medical attention, with symptoms including anxiety, restlessness, confusion, weakness, tremor, muscle twitching or spasm, high fever, profuse sweating, and rapid heartbeat. The report describes a case of apparent serotonin syndrome in an individual taking SAMe with clomipramine, a tricyclic antidepressant that increases serotonin activity. 1Although SAMe is not currently known to affect serotonin, it does appear to have antidepressant effects and may in some way increase serotonin activity.Because SSRIs increase serotonin activity even more than clomipramine, a similar problem might occur if you combine SAMe with an SSRI.The supplement 5-HTP is used by the body to manufacture serotonin, so it could also increase the risk of serotonin syndrome when combined with an SSRI.

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