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5 HTP and Adderall

Adderall is the frontline medication recommended for treating ADHD in kids. However, given the growing concern about the negative effects of psychostimulant especially on the growth of children, alternatives such as 5 HTP are sought. Find out if 5 HTP is effective for treating ADHD and how to give it to ADHD kids.
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What is 5 HTP?

5 HTP is a naturally occurring amino acid commonly sold as a dietary supplement. The source of the 5 HTP included in the supplement is an African plant called Griffonia simplicifolia.

5 HTP is sold as an over-the-counter supplement in many countries. It serves as a better alternative to another amino acid, L-tryptophan, for increasing serotonin levels in the brain.

L-tryptophan, an essential amino acid, is the precursor of 5 HTP. Although there are no dietary sources of 5 HTP, L-tryptophan is widely available from dietary proteins. However, before tryptophan can be converted to 5 HTP and then to serotonin in the brain, it has to cross the blood-brain barrier.

5 HTP crosses into the brain better than tryptophan and since it is the direct precursor of serotonin, it is the supplement of choice.

The conversion of 5 HTP to serotonin involves a decarboxylase enzyme and vitamin B6.

All of the effects of 5 HTP are due to its ability to generated serotonin by this reaction. Serotonin is an important neurotransmitter in the brain. It is responsible for the controlling mood, appetite and sleep as well as contributing to learning and memory.

Given its central nature, serotonin and drugs that act on serotonin pathway are useful for treating a number of disorders including depression and anxiety disorders, obesity and sleep disorders.

Serotonin plays a complex role in the brain but generally it improves mood. Therefore, it is useful in the treatment of disorders where such results are desirable.

Although the major neurotransmitter involved in the presentation of ADHD (attention deficit hyperactivity disorder) is dopamine, serotonin is also involved. For example, serotonin receptors such as 5 HT1B and 5 HT2B can increase the levels of dopamine in the brain.

In addition, mood disorders such as depression often presents along with ADHD. Therefore, drugs or supplements such as 5 HTP that increase serotonin levels are especially effective in the treatment of ADHD.

What is Adderall?

Adderall is the brand name of a common psychostimulant medication used for treating ADHD.

Adderall contains 2 active ingredients (amphetamine and dextroamphetamine) which are represented by 4 salts (racemic amphetamine sulfate, racemec amphetamine aspartate monohydrate, dextroamphetamine sulfate and dextroamphetamine saccharide).

 These amphetamine salts work by preventing the clearance of dopamine and norepinephrine from nerve endings. This action allows the two excitatory neurotransmitters to act longer, and therefore, produce a combined stimulant effect.

Adderall is available as instant release and extended release formulation. Both are used in the treatment of ADHD while the former can also be used to treat narcolepsy.

Because Adderall contains 4 different amphetamine salts, it is more potent and acts longer even at lower doses than its closest competitor, Ritalin (contains methylphenidate).

Even then Adderall has its side effects. These include headache, dizziness, nervousness, fast heartbeat, low blood pressure and weight loss. At the beginning of therapy, Adderall make cause insomnia, anxiety, irritability and make the symptoms of ADHD worse.

There is also an addictive potential for Adderall that can develop following long-term use of Adderall.

Long-term abuse of amphetamines can cause psychosis and stopping the drug after long-term therapy may result in signs of withdrawal syndrome including insomnia, depression and extreme fatigue.

Concurrent use of Adderall and antidepressants (especially those that increase serotonin levels) are not recommended.

Some of these drugs contraindicated with Adderall use are listed in the table below.

Drugs Contraindicated with Adderall
  • MAOIs (monoamine oxidase inhibitors) – to prevent hypertensive crisis, delay Adderall for at least 2 weeks after taking MAOIs
  • SSRIs (selective serotonin reuptake inhibitors) – there is a potential risk of serotonin syndrome although SSRIs and Adderall are commonly combined
  • NRIs (norepinephrine reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors) – increased activity in the norepinephrine pathway and risk of serotonin syndrome for SNRIs
  • Tricyclic antidepressants – increased activity in serotonin, norepinephrine and dopamine pathways
  • Other drugs especially anti-psychotics as well as cocaine and methadone

Adderall contains 75% dextroamphetamine but dextroamphetamine is also amphetamine. Amphetamine exists as 2 molecules: the right-handed, dextro form and the left-handed, levo form.

Therefore, both dextroamphetamine and amphetamine possess the same mechanism of action.

Amphetamine acts as stimulant by increasing the levels of serotonin, norepinephrine but most especially dopamine in the brain. However, although it increases the levels of these neurotransmitters, the effects produced vary from one area of the brain to another.

For example, amphetamine has the biggest effect on the serotonin pathway in select areas of the brain including the mesocorticolimbic projection.

In addition, amphetamine increases the excitatory activity of glutamatergic neurons through serotonin (serotonin receptors control the release of glutamate, another neurotransmitter).

Glutamate is the primary excitatory neurotransmitter in the brain and by increasing its release (through serotonin), amphetamines produce some of the stimulant effect. In addition, this serotonin link is believed to be responsible for the addictive potential of amphetamines.

5 HTP or Adderall

5 HTP and Adderall work differently.

First, while 5 HTP is a dietary supplement obtained from natural sources, Adderall is a drug containing synthetic molecules. Adderall is also a psychostimulant and considering that its chief indication is for the treatment of ADHD, it is take for long-term therapy.

Besides the addictive potential of Adderall, there are early indications that the drug might permanently rewire the way the brain works.

By contrast, 5 HTP is a simple supplement. All it does is increase serotonin levels. It has little or no residual effect and no addictive potential. It is also well tolerated.

However, considering that multiple neurotransmitters are involved in the presentation of ADHD, Adderall offers a better chance at treatment. It improves the levels of dopamine, norepinephrine, serotonin and even glutamate while 5 HTP only increases the level of serotonin in the brain.

Therefore, Adderall will provide a faster and broader therapeutic action that 5 HTP.

However, considering the desirable result of ADHD treatment is to stimulate the brain by releasing excitatory neurotransmitters, 5 HTP provides a much gentler if slower effect.

In addition, ADHD has a spectrum of symptoms including depression and sleep disorders which are conditions that increased serotonin levels correct. Therefore, 5 HTP supplement can help improve these symptoms and do more than simply act stimulate the brain.

While very few physicians will consider 5 HTP over Adderall in the treatment of ADHD, dietary supplements are the mainstay of ADHD treatment in alternative medicine.

The choice of which drug to take will ultimately depend on the patient and his physicians. Where Adderall produces desirable effects with manageable side effects, 5 HTP may not be needed. However, for patients who do not tolerate amphetamines well and who prefer natural supplements, 5 HTP should be considered as one of such supplements to use in the treatment of ADHD.

5 HTP and Adderall

Since 5 HTP and Adderall work differently, some ADHD patients do consider combining both of them.

However, it should be noted that there is no clinical guideline for the combination of these two products. In addition, there is only a very small chance that a physician will recommend the combination of 5 HTP and Adderall.

Although there is no way if such combination is safe without trying, there is a valid concern about suddenly increasing serotonin levels in the brain. This may cause symptoms of serotonin toxicity.

Serotonin syndrome is the most common form of serotonin toxicity. It occurs when two drugs that increase serotonin levels and/or serotonergic activity are combined.

Since both 5 HTP and Adderall can increase serotonin levels and serotonin activity, it follows that the combination of the two products may cause serotonin toxicity.

Symptoms of serotonin syndrome can vary from mild to severe. Mild symptoms include hot flashes, sweating, shivering, tremor, headache and irregular heartbeats. These symptoms will resolve with 24 hours after withdrawing 5 HTP and Adderall.

However, it is the serious side effects such as hyperthermia, hypertension, hyperactivity, mania, hallucination and coma that carries the biggest concerns. These symptoms can proceed rapidly and should be treated as medical emergencies.

Still, the combination of 5 HTP and Adderall only has a potential for causing serotonin syndrome. In fact, reports of such toxicity from the combination of the two products are rare.

Most people who do combine both products find them safe and with little side effects.

In fact, some ADHD patients report better relief from such combination owing to the fact that one complements the other.

Many users report that while Adderall improves attention and reduces hyperactivity, 5 HTP relaxes the mind and promotes sound sleep. In other words, Adderall impacts clarity and mental focus by increasing dopamine levels while 5 HTP improves mood and promotes sleep by releasing serotonin in the brain.

However, care should be taken while combining the two products. The recommendation is to reduce the dose of the two products or at least the dose of 5 HTP.

An initial daily dose of 50 mg of 5HTP should be taken along with Adderall. If well tolerated and if there is a need for improvements, this can be increased to 100 – 200 mg per day.

Sources


http://www.ncbi.nlm.nih.gov/pubmed/16185723

http://www.ncbi.nlm.nih.gov/pubmed/10559387

http://www.ncbi.nlm.nih.gov/pubmed/9109529

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