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Can SSRI Can Be Replaced By HTP 5 Or L- Tryptophan?

Posted on Mon, 27 Oct 2014

Question: can ssri can be replaced by htp5, or L-tryptophan.

Answered by Dr. Jonas Sundarakumar (2 hours later)

Brief Answer:
Need more details...

Detailed Answer:
Hello and thanks for your query.

Please let me know what your diagnosis is and what is the nature and severity of your problem.

Regards,
Dr. Jonas Sundarakumar MBBS, DPM, MRCPsych.(UK)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jonas Sundarakumar (40 hours later)

5 years back I started with 20 mg of escitalopram oxalate due to OCD. and around two years back dr changed it to 10mg ofÂ escitalopram oxalate and 7.5 mg of mirtazapine. And around one year back I was having problem withÂ escitalopram, it was creating problem, I decreased the dose to 5mg then 2.5mg and left it 3 month Â back. I was without medicine for 2 months. I am living in U.S. for 2 years. From last one year I am living alone. Recently I got problem with my hand and leg I was unable to walk without clutches and my hands fingers was also not de to high use of keyboard.it remained for two months, because of such frustrating condition as I was alone I think I got depressed again. RIGHT now I have difficulty while asleep and headache and sinking feeling in my heart. I able to sleep if I take 4mg of mirtazapine. I have problem with continuous sound.Â

Can you tell me is there any blood test for sirotinen level

Answered by Dr. Jonas Sundarakumar (21 hours later)

Brief Answer:
Serotonin blood level not reliable for diagnosis.

Detailed Answer:
Hello and thanks for your clarifications.

Yes, there is a test for checking the Serotonin levels in the blood. However, this test is not done as a diagnostic test for depression and it actually may not be a reliable indicator of depression. This is because in conditions like depression and anxiety disorders, it is the deficiency of serotonin at the "brain receptor" level and not in the blood. So, it is quite possible for a person to have normal blood levels of Serotonin, but still have depression due to a deficiency at the brain neuro-receptor level. Moreover, there are other neurochemicals like nor-epinephrine, etc. which are abnormal in depression. This is why the diagnosis of depression and anxiety disorders remains a clinical diagnosis and there is no reliable blood test to prove or confirm this.

So, if you are currently feeling depressed, I would advise you to consult a psychiatrist for a detailed clinical evaluation and psychological assessment. If a diagnosis of depression is confirmed, then you would benefit from anti-depressant medication. If Escitalopram has not suited you in the past, there are many other alternative anti-depressant medication that can help you.

You have mentioned that you are taking Mirtazapine 4mg for sleep, but this dose is too little and is not an effecive antidepressant dose. So, it is better to get a prescription for a proper dose from a psychiatrist.

Regarding your previous question, supplments like 5-htp and l-tryptophan have been found to help in persons with depression, anxiety and sleep problems. But the major diaadvantage in taking such supplements is that the levels of serotonin can be very unpredictable and thereby have a risk of causing adverse effects.

Best wishes,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych (U.K.)
Consultant Psychiatrist

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Raju A.T