I began this blog after receiving my Parkinson's diagnosis five years ago. I thought I'd discovered in the serotonin-boosting supplement 5-HTP a treatment for the three major non-motor side effects of Parkinson's disease (PD) -- depression, insomnia, and constipation.
I had successfully used 5-HTP years ago, when I was having lots of trouble with insomnia and depression. So, when I felt those problems returning after my PD diagnosis, I went to my CVS and bought a bottle of 5-HTP pills at the lowest available dose, 50mg. I recalled getting pretty manic when I overdid it years before.
The results amazed me. The depression, insomnia, constipation... gone. In addition, I was also bursting with creative ideas during my early morning "quiet time."
Occasionally I'd feel downright euphoric. But -- what the hell -- that just made the experience more fun. Actually this actually did concern me, I just told myself to avoid the excess intake. (I seem to recall saying the same thing about martinis.)
Here on the blog, I began a vigorous effort to spread the word about 5-HTP's efficacy in treating those PD symptoms. I was sure others like me would experience similar benefits.
In time, I noticed I was the only person marching in the parade. So I began cautioning blog readers that my own experience with the supplement was apparently fairly unique. But I continued my research, eager to discover other connections between 5-HTP and PD.
5-HTP and Me
As I had years before, I learned again about 5-HTP's "dark side." This time around, I ended up in my neighborhood hospital's emergency room -- twice -- after taking too much. Even though I was using only half of the 50 mg pill at bedtime, I'd sometimes pop the other half during the day. It didn't take long to learn the lesson -- too much 5-HTP caused scary spikes in my blood pressure... the reason for those trips to the ER.
Once when I'd taken an extra pill after lunch,I soon realized I was about to pass out, and I called 911. When the ambulance got me to the hospital, my systolic (upper) pressure was well over 200.
Even after the second incident -- call me crazy -- I kept taking the supplement, chopping up the little pills, figuring I could avoid those frightening pressure spikes. On difficult days especially, Id' convince myself, "Just a little more won't hurt me." Yes, the addict in action.
Eager to avoid more 911 calls -- and probably to persuade myself that I'm a sane, responsible person -- I began monitoring my blood pressure throughout the day, and entering the numbers into my log. Tracking those numbers became a kind of obsession, but I was convinced I could strike a balance between my 5-HTP-enhanced serotonin and my carbidopa/levodopa-enhanced dopamine.
Ah... the addict's ability to justify his own craziness!
A Classic Example of an Addict at Work
Last Thursday at bedtime, I took my usual 5-HTP dose -- half a 50mg pill.
I woke up at 3am, knowing right away that something was seriously wrong. I checked my blood pressure -- 207/114.
I took a nifedipine, the medication my doctor prescribed to lower my pressure when I sensed it was spiking dangerously. In about half an hour, my numbers dropped into normal territory -- below 150/90.
I kept monitoring my pressure, aware that nifedipine can work "too well" and drive my systolic reading below 100. Luckily, there's an easy remedy to halt those dipping numbers -- two glasses of cold water.
Those 200+ systolic readings -- like what I experienced early Friday -- put me in danger of a stroke... or worse. It took a fair amount of research on my part to discover that carbidopa does for 5-HTP what it also does for levodopa (PD's gold standard medication) -- enhance its ability to cross the blood/brain barrier and increase its bioavailability by a factor of as high of 8. (A 50 mg pill becomes in effect a 400 mg pill!) I managed to forget that caution when taking my bedtime 5-HTP.
I also forgot the impact my recent hike in carbidopa/levodopa might have. My neurologist added 800mg of the stuff -- a 50 percent increase -- to see if levodopa's "protective shield" might prevent the pressure spikes.
On Friday morning -- as the dust was settling on this last incident -- I fired off a 5-HTP-fueled email to my son and daughter. Concerned that the email clearly showed I was on a 5-HTP high -- and about my recent pattern of experimenting with different pills and dosages, and my continuing pressure spikes and drops -- my kids individually came to the house Friday and pleaded with me to stop taking 5-HTP. In AA, this is known as a "family intervention."
Finally, sobriety, sanity, and common sense prevailed. I haven't taken even a sliver of 5-HTP since Thursday night.
The Bottom Line
What caused most of the problems was the interaction between 5-HTP and carbidopa, which is part of the key Parkinson's med (carbidopa-levodopa). My experience is an example of the dangers we all face when we take a variety of medications. Old folks like me are especially at risk, since we tend to take lots of meds.
Using 5-HTP put me at even greater risk because:
- It's a supplement, and therefore not subject to the regulatory requirements of the Food and Drug Administration.
- It's not a well-known supplement and hasn't been subjected to much independent study. For the hell of it, I just checked drug.com's page on possible drug interactions with 5-HTP. It lists 83 drugs, but there is no mention of carbidopa.
- I'm also a risk factor. I like trying new things. I have a special attraction to things in the medical field that I discover through my own research. 5-HTP as a treatment for Parkinson's major non-motor symptoms was my baby.