The power and pitfalls of omics part 2: epigenomics, transcriptomics and ME/CFS
Simon McGrath concludes his blog about the remarkable Prof George Davey Smith's smart ideas for understanding diseases, which may soon be applied to ME/CFS.
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tiredness increase. Neurotransmitters?

Discussion in 'General Treatment' started by Gavman, Jul 27, 2012.

  1. Gavman

    Gavman Senior Member

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    Hi guys,

    I have come off effexor, and this time - instead of a 1 month then feeling like shit, its taken about 3 months. I think ive found SAM-e treatment useful, and im also going the zinc/b6 route. But im getting the full lethargy symptoms again.
    I was on 150mgs of effexor
    I'm now on 500mgs each l-methionine and tmg.
    and 75mgs b6/zinc 25mgs
    5htp 100mg before bed. (occasionally - might need more frequently?)

    My dreaming has improved - i seem to wake up from dreams with heart racing, so i'd say sleep may have a major impact on whats going on, also not sleeping for near as long. As far as the effexor helping keep levels of serotonin/norepinephrine - does anyone know how i might tweak whats going on to mimic what effexor did for me, without taking it?

    On effexor i have a zombie mind state, off it i have a body tiredness state.
     
  2. Gavman

    Gavman Senior Member

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    I'm seeing a doctor on the 20th August who deals more specifically with this kind of thing. But i feel as though i may dig myself down energetically if i dont stop this downward slide.
     
  3. jeffrez

    jeffrez Senior Member

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    How is your mood now? What were you originally taking the Effexor for? Depression, anxiety, etc. ?

    Increased dreaming could mean that you are staying in REM longer and not actually getting deeper sleep, which possibly could contribute to the sense of fatigue. Perhaps some low-dose melatonin could help you get deeper, but don't take too much or it could hang you over and make you feel drowsy the next day also.

    Think it would take a lot more info to start to get an idea of what might be the best course to take. There are literally dozens or more of alternative meds you could take that could mimic some of the Effexor's actions, including some of the newer versions (desvenlafaxine, duloxetine, etc.), older tricyclics, maybe MAO-inhibitors, something like Provigil/modafinil, Wellbutrin might be a very good alternative, or you could go the herbal route with trying St. John's Wort, ginseng perhaps, ginkgo, gotu kola, or something like fish oil, etc.

    If you were taking effexor more for anti-anxiety, there would be a whole other list of ideas, including kava, passionflower, and similar herbs, the benzos in last resort, etc. You could be having nutritional/metabolic issues that need supplementation, or it could be a discontinuation syndrome from the Effexor, in which case the remedy would be to add it back and taper more slowly. Really hard to say without knowing more.
     
  4. adreno

    adreno PR activist

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    A norepinephrine reuptake inhibitor like reboxetine might also help you.
     
  5. Lala

    Lala Senior Member

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    Read about Lithium orotate and tyrosine. Both could help.
     
  6. Crux

    Crux Senior Member

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    Hi Gavman ;

    It could be that copper has become low after taking zinc for a time. I don't know if your zinc supplement also contains copper, but if it doesn't, fatigue and depression could result. Copper is involved with neurotransmitter synthesis and cardiovascular function.

    I found that zinc really helped many of my own symptoms, but that some worsened, fatigue being one. Adding copper has really helped.

    It may not need to be much, copper is easily absorbed.
     
    SaraM likes this.
  7. Gamboa

    Gamboa Senior Member

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    How about 5-HTP? It is the precursor to serotonin and supposedly helps your body make more serotonin. I was just speaking to a naturopath yesterday who says she advises it to people who are trying to get off antidepressants. Below is some information about it from the University of Maryland website.
    5-Hydroxytryptophan (5-HTP)

    5-hydroxytryptophan (5-HTP) is a chemical that the body makes from tryptophan (an essential amino acid, which you get from food). After tryptophan is converted into 5-HTP, the chemical is then changed into another chemical called serotonin (a neurotransmitter, which relays signals between brain cells). 5-HTP dietary supplements help raise serotonin levels in the brain. Since serotonin helps regulate mood and behavior, 5-HTP may have a positive effect on sleep, mood, anxiety, appetite, and pain sensation.

    5-HTP is not found in the foods we eat, although tryptophan is. Eating foods with tryptophan does not increase 5-HTP levels very much, however. As a supplement, 5-HTP is made from the seeds of an African plant called Griffonia simplicifolia.
    In 1989, the presence of a contaminant called Peak X was found in tryptophan supplements. Researchers believed that an outbreak of eosinophilic myalgia syndrome (EMS, a potentially fatal disorder that affects the skin, blood, muscles, and organs) could be traced to the contaminated tryptophan, and the U.S. Food and Drug Administration pulled all tryptophan supplements off the market. Since then, Peak X was also found in some 5-HTP supplements, and there have been a few reports of EMS associated with taking 5-HTP. However, the level of Peak X in 5-HTP was not high enough to cause any symptoms, unless very high doses of 5-HTP were taken. Because of this concern, however, you should talk to your health care provider before taking 5-HTP, and make sure you get the supplement from a reliable manufacturer. (See "Precautions" section.)
    5-HTP may help treat a wide variety of conditions related to low serotonin levels, including the following, but there is not much evidence for any of these uses:
    Depression
    Some small studies indicate that 5-HTP may work as well as certain antidepressant drugs to treat people with mild-to-moderate depression. Like the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes fluoxetine (Prozac) and sertraline (Zoloft), 5-HTP increases the levels of serotonin in the brain. One study compared the effects of 5-HTP to fluvoxamine (Luvox) in 63 people and found that those who were given 5-HTP did just as well as those who received Luvox. They also had fewer side effects than the Luvox group. However, these studies were too small to say for sure if 5-HTP works. More and larger studies are needed.
    Fibromyalgia
    Three studies have suggested that 5-HTP can improve symptoms of fibromyalgia, including pain, anxiety, morning stiffness, and fatigue. Many people with fibromyalgia have low levels of serotonin, and doctors often prescribe antidepressants. Since 5-HTP, like antidepressants, raises levels of serotonin in the brain, it may work too. However, it does not work for all people with fibromyalgia, and more studies are needed to understand its effect.
    Insomnia
    In one study, people who took 5-HTP went to sleep quicker and slept more deeply than those who took placebo. These researchers recommend 200 - 400 mg at night to stimulate serotonin, but it may take 6 - 12 weeks to be fully effective.
    Migraines and Headaches
    Antidepressants are sometimes prescribed for migraine headaches. Some studies suggest that high doses of 5-HTP may help people with various types of headaches, including migraines. However, the evidence is mixed, with other studies showing no effect.
    Obesity
    A few small studies have looked at whether 5-HTP can help people lose weight. In one study, those who took 5-HTP ate fewer calories, although they were not trying to diet, compared to those who took placebo. Researchers believe 5-HTP led people to feel more full (satiety) after eating, so they ate less.
    A follow-up study, which compared 5-HTP to placebo during a diet and non-diet period, found that those who took 5-HTP lost about 2% of body weight during the non-diet period and another 3% when they dieted. Those taking placebo did not lose any weight. However, doses used in these studies were high, and many people had nausea as a side effect. If you are seriously overweight, see your health care provider before taking any weight-loss aid. Remember that you will need to change your eating and exercise habits to lose more than a few pounds.
    Dietary Sources:

    You can' t get 5-HTP from food. The amino acid tryptophan, which the body uses to make 5-HTP, can be found in turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and collard greens, and seaweed.
    Available Forms:

    5-HTP is made from tryptophan in the body, or can be taken as a supplement. Supplements are made from extracts of the seeds of the African tree Griffonia simplicifolia. 5-HTP can also be found in many multivitamin and herbal preparations.
    How to Take It:

    Pediatric
    5-HTP should not be given to children.
    Adult
    Health care professionals generally recommend 50 mg of 5-HTP taken 1 - 3 times per day. Some studies have used higher doses, but because 5-HTP can be toxic at high doses, you should talk to your health care provider before raising the dose. Your health care provider can help determine the right dose for you.
    Precautions:

    Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of your health care provider.
    Tryptophan use has been associated with the development of serious conditions, such as liver and brain toxicity, and with eosinophilic myalgia syndrome (EMS), a potentially fatal disorder that affects the skin, blood, muscles, and organs (see "Overview" section). Such reports prompted the FDA to ban the sale of all tryptophan supplements in 1989. As with tryptophan, EMS has been reported in 10 people taking 5-HTP.
    Side effects of 5-HTP are generally mild and may include nausea, heartburn, gas, feelings of fullness, and rumbling sensations in some people. At high doses, it is possible that serotonin syndrome, a dangerous condition caused by too much serotonin in the body, could develop. Always talk to your health care provider before taking higher-than-recommended doses.
    People with high blood pressure or diabetes should talk to their doctor before taking 5-HTP.
    If you take antidepressants, you should not take 5-HTP (see "Possible Interactions" sections).
    People with liver disease, pregnant women, and women who are breastfeeding should not take 5-HTP.
    Possible Interactions:

    If you are currently being treated with any of the following medications, you should not use 5-HTP without first talking to your health care provider.
    Antidepressants -- People who are taking antidepressant medications should not take 5-HTP without their health care provider's supervision. These medications could combine with 5-HTP to cause serotonin syndrome, a dangerous condition involving mental changes, hot flashes, rapidly fluctuating blood pressure and heart rate, and possibly coma. Some antidepressant medications that can interact with 5-HTP include:
    • SSRIs: Citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
    • Tricyclics: Amitriptyline (Elavil), nortryptyline (Pamelor), imipramine (Tofranil)
    • Monoamine oxidase inhibitors (MAOIs): Phenelzine, (Nardil), tranylcypromine (Parnate)
    • Nefazodone (Serzone)
    Carbidopa -- Taking 5-HTP with carbidopa, a medication used to treat Parkinson's disease, may cause a scleroderma-like illness. Scleroderma is a condition where the skin becomes hard, thick, and inflamed.
    Tramadol (Ultram) -- Tramadol, used for pain relief and sometimes prescribed for people with fibromyalgia, may raise serotonin levels too much if taken with 5-HTP. Serotonin syndrome has been reported in some people taking the two together.
    Dextromethorphan (Robitussin DM, and others) -- Taking 5-HTP with dextromethorphan, found in cough syrups, may cause serotonin levels to increase to dangerous levels, a condition called serotonin syndrome.
    Meperidine (Demerol) -- Taking 5-HTP with Demerol may cause serotonin levels to increase to dangerous levels, a condition called serotonin syndrome.
    Triptans (used to treat migraines) -- 5-HTP can increase the risk of side effects, including serotonin syndrome, when taken with these medications:
    • Naratriptan (Amerge)
    • Rizatriptan (Maxalt)
    • Sumatriptan (Imitrex)
    • Zolmitriptan (Zomig)
    Alternative Names:

    5-HTP
    • Reviewed last on: 4/9/2011
    • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
    Supporting Research

    Angst J, Woggon B, Schoepf J. The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study. Arch Psychiatr Nervenkr. 1977;224:175–186.
    Attele AS, Xie JT, Yuan CS. Treatment of insomnia: an alternative approach.Altern Med Rev. 2000;5(3):249-259.
    Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Altern Med Rev. 1998;3:271–280.
    Byerley WF, et al. 5-Hydroxytryptophan: a review of its antidepressant efficacy and adverse effects. J Clin Psychopharmacol. 1987;7:127-137.
    Cangiano C, et al. Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord. 1998; 22:648-654.
    Cangiano C, Ceci F, Cascino A, et al. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. J Clin Nutr. 1992;56:863-867.
    Caruso I, Sarzi Puttini P, Cazzola M, et al. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res. 1990;18:201-209.
    Cauffield JS, Forbes HJ. Dietary supplements used in the treatment of depression, anxiety, and sleep disorders. Lippincotts Prim Care Pract. 1999; 3(3):290-304.
    Ceci F, Cangiano C, Cairella M, Cascino A, et al. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. J Neural Transm. 1989;76:109-117.
    Curcio JJ, Kim LS, Wollner D, Pockaj BA. The potential of 5-hydryxtryptophan for hot flash reduction: a hypothesis. Altern Med Rev. 2005;10(3):216-21.
    DeBenedittis G, Massei R. Serotonin precursors in chronic primary headache. A double-blind cross-over study with L-5-hydroxytryptophan vs. placebo. J Neurosurg Sci. 1985; 29:239-248.
    Elko CJ, Burgess JL, Robertson WO. Zolpidem-associated hallucinations and serotonin reuptake inhibition: a possible interaction. J Toxicol Clin Toxicol. 1998;36(3):195-203.
    Freedman RR. Treatment of menopausal hot flashes with 5-hydroxytryptophan. Maturitas. 2010 Apr;65(4):383-5.
    Gardner DM, Lynd LD. Sumatriptan contraindications and the serotonin syndrome. Ann Pharmacother. 1998;32(1):33-38.
    Iovieno N, Dalton ED, Fava M, Mischoulon D. Second-tier natural antidepressants: Review and critique. J Affect Disord. 2010 Jun 24.
    Joffe RT, Sokolov ST. Co-administration of fluoxetine and sumatriptan: the Canadian experience. Acta Psychiatr Scand. 1997;95(6):551-552.
    Joly P, Lampert A, Thomine E, Lauret P. Development of pseudobullous morphea and sclero-derma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. J Am Acad Dermatol. 1991;25(2):332-333.
    Juhl JH. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90-day open study. Altern Med Rev. 1998;3:367-375.
    Mason BJ, Blackburn KH. Possible serotonin syndrome associated with tramadol and sertraline coadministration. Ann Pharmacother. 1997;31(2):175-177.
    Meyers S. Use of neurotransmitter precursors for treatment of depression. Altern Med Rev. 2000;5(1):64-71.
    Perry NK. Venlafaxine-induced serotonin syndrome with relapse following amitripyline. Postgrad Med J. 2000;76(894):254.
    Puttini PS, Caruso I. Primary fibromyalgia and 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res. 1992;20:182-189.
    Rakel D. Rakel Integrative Medicine, 2nd ed. Philadelphia, PA: Saunders; 2008;47.
    Reibring L, Agren H, Hartvig P, et al. Uptake and utilization of [beta-11c] 5-hydroxytryptophan (5-HTP) in human brain studied by positron emission tomography. Pyschiatry Research. 1992;45:215-225.
    Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic tension-type headache: a double-blind, randomized, placebo-controlled study. Headache. 2000 Jun;40(6):451-6.
    Shaw K, Turner J, Del Mar C. Are tryptophan and 5-hydroxytryptophan effective treatments for depression? A meta-analysis. Aust N Z J Psychiatry. 2002 Aug;36(4):488-91.
    Sternberg EM, Van Woert MH, Young SN, et al. Development of a scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. New Eng J Med. 1980;303:782-787.
    Toner LC, Tsambiras BM, Catalano G, et al. Central nervous system side effects associated with zolpidem treatment. Clin Neuropharmacol. 2000;23(1):54-58.
    Van Praag HM. Management of depression with serotonin precursors. Biol Psychiatry. 1981;16:291-310.
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    © 2011 University of Maryland Medical Center (UMMC). All rights reserved.
     
  8. Sallysblooms

    Sallysblooms P.O.T.S. now SO MUCH BETTER!

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    Gavman, I know you said you take it, 5HTP is amazing. You never know, everyone is diff. My doctors test me for a lot of things so I never take too much or too little. I take it and SAMe also. Both are good.
     
  9. Gavman

    Gavman Senior Member

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    Yeah its not copper as im pyroluric and my copper has been good in the past. The naturopath i saw said to triple my doses of b6/zinc and 5htp as i wasnt taking much of them. And to add in magnesium. Apparently the b6/zinc/magnesium helps build glutamine in pyrolurics. *shrugs* giving it a shot. I will look into the lithium as its come up on my radar a few times - my mother who was bipolar did well on a form of it.

    I was taking effexor for tiredness. I have been increasingly anxious off it and am working through that.
     

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