March 17, 2011

I'm back and hopefully wiser about dosage of 5-HTP

I haven't posted for the past month while I tried to figure out what was causing the blood pressure spiking that had me in the hospital emergency room twice.  In my last post, written after the first visit to the ER, I speculated that the incident was caused by overdoing it in working on this blog.  Wrong!

After the ER visit, I began monitoring my blood pressure on a regular basis. (I have an Omnon home blood pressure monitor.) I found it was spiking and then subsiding throughout the day with no clear pattern as to when the spikes would occur. I tested out a theory that, since the  ER incident coincided with opening a new bottle of my Sinemet generic, a contaminated batch of the med might be causing the problem.  So I began splitting my Extended Release pills and using half of each pill for my regular doses.  Wrong again.

Meanwhile, my daughter who had always been dubious about my use of 5-HTP was insisting that I look at that as the possible culprit.  I was resistant to that idea since I was enjoying the highs I was getting from 5-HTP but I did reduce my bedtime dosage to 50 mg  rather than 100 (while still taking another 50 mg with the Sinemet generic at 11a.m.)

After a few days on this regimen, I went back to the 100 mg at bedtime.  Three days later (March 1), I got up at 4 a.m. for my  bathroom visit and my usual meditation.  I found I was back to the having the feelings of euphoria combined with a bombardment of new ideas that I'd often experienced with 5-HTP.  I was feeling so good that I decided to check my blood pressure. I was surprised to find that the systolic number was 180.  I continued to monitor the bp and when it got to 205/101, I once again called 911. When the emergency crew arrived they got similar readings.

At the hospital, they decided against doing any tests since the appropriate tests already had been done in my first visit two weeks earlier.  The high bp readings began to subside.

The ER doctor was very reassuring about the spikes in blood pressure.  She said that when stressed her systolic reading sometimes jumped to nearly 200.   Here's the advice they gave me in the discharge papers:

"DO NOT BE ALARMED BY YOUR BLOOD PRESSURE UNLESS YOU ARE HAVING CONCERNING SYMPTOMS: CHEST PAIN, HEADACHE, BLURRED VISION, NAUSEA, SHORTNESS OF BREATH, ETC.  CALL 911 IF YOU ARE FEELING FINE BUT YOUR BLOOD PRESSURE IS OVER 240/120."



Given the fairly clear connection between extra dosage of 5-HTP and this incident, I very belatedly took a look at the medications I was taking.  I'm embarrassed to admit that I somehow had been conned into ordering online and taking a weight-loss pill.  I should know better than to fool around with this junk, but I did.  Looking at the label, I found that  it contained, among many other things, 5-HTP with the amount not listed.  This could have contributed to the overdose of 5-HTP.

Serotonin  syndrome is recognized as a possible side effect of a build-up too much serotonin in the body.  High blood pressure is listed as one of the possible results of serotonin syndrome.  See http://en.wikipedia.org/wiki/Serotonin_syndrome.


Given all of this, I cut back to just taking 50 mg of 5-HTP at bedtime. After two weeks on this regimen, the blood pressure spikes subsided.  I'm having no trouble sleeping, in fact I often log in nearly 8 hours contrasted with the more common 7 hours when taking the higher doses.  Go figure!  And my daytime mood is fine.  But, given my addictive tendencies, I miss the euphoria and idea-bombardment that I got from the higher intake.:-)

This experience is yet another reminder that  individual reactions to Parkinson's and to medications are very idiosyncratic. I know many people, particularly those who take 5-HTP for weight control and other issues, often take several hundred milligrams of 5-HTP a day without serious side effects. But I'm different.  Age no doubt is a factor in how one reacts to most medications.  I've found that in my 70's and now 80's I'm well advised to take half the recommended dosage on most medications.

I'm glad the minimal dose of 5-HTP works for me without any discernible side effects.  I would not like to have to experiment with prescription meds to deal with insomnia and/or depression.

Several years ago I experienced what I labeled  "The Summer from Hell" when I was prescribed a half dozen different meds in an effort to deal with a sudden onset of insomnia, depression and anxiety attacks, none of which helped and most of which just made things worse.  I told the doctors and other health care professionals that I dealt with that I suspected the problems I was having stemmed from abusing ambien and Tylenol PM while on an extended trip to Nepal.  But everyone I dealt with got out their prescription pads when they heard "insomnia, depression, and panic attacks."  Fortunately the primary psychiatrist I was seeing finally suggested that I give up on the prescribed meds and try holistic approaches.  This finally worked.

So, given this experience with prescribed meds, I'm delighted that the combination of 5-HTP (taken in moderation!) and meditation works for me on both sleep and mood without the need to experiment again with prescription meds.

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