l-tryptophan

Therapeutic Classification: mood stabilizers, smoking deterrents, sedative/hypnotics, antidepressants

Indications ⬆ ⬇

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Premenstrual dysphoric disorder (PMDD)
Depression.
Smoking cessation.
Insomnia.

Action ⬆ ⬇

L-tryptophan is an essential amino acid that is converted by the body to 5–hydroxytryptophan (5–HTP) and then to serotonin. Both L-tryptophan and 5–HTP cross the blood-brain barrier and have sedative effects. Depletion of endogenous tryptophan can cause a relapse in depression symptoms.

Therapeutic effects:

Improved symptoms of depression.
Improved sleep.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown

Distribution: Unknown

Metabolism/Excretion: Unknown

Half-Life: Unknown

Time/Action Profile ⬆ ⬇

	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity.
Pregnancy and lactation.

Use Cautiously in:

Eosinophilia.
Kidney disease.
Liver disease.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: visual blurring

GI: abdominal pain, dry mouth, heartburn, nausea

Hemat: eosinophilia-myalgia syndrome

Neuro: ataxia, drowsiness, headache, lightheadedness

Interactions ⬆ ⬇

Natural-Drug Products:

Increased risk of serotonergic effects and serotonin syndrome with SSRIs, dextromethorphan, meperidine, tricyclic antidepressants, monoamine oxidase inhibitors, and tramadol.
Increased sedation with CNS depressants.

Natural-Natural Products:

Additive sedation with herbs or supplements that have sedative properties such as kavaSt. John's wortvalerian5–HTPand others.
Increased risk of serotonin syndrome with St. John's wort..

Route/Dosage ⬆ ⬇

PO (Adults ): Insomnia: 1 gram 20 minutes before bedtime; Depression: 300 mg/day; Prementrual syndrome: 6 grams/day; Smoking cessation: 50 mg/kg/day.

Availability ⬆ ⬇

Capsules: Tablets500 mg

Assessment ⬆ ⬇

Assess sleep patterns prior to and periodically during therapy.
Monitor for signs and symptoms of esosinophilia-myalgia sydrome (severe myalgia, arthralgia, intense eosinophilia) Less common symptoms include respiratory prodrome (cough, dyspnea, pulmonary infiltrates), limb edema, scleroderma, mononeuritis, evanescent skin rash, mild LFT elevations, and leukocytosis. If these symptoms occur, discontinue l-tryptophan.

Implementation ⬆ ⬇

PO: Administer without regard to food.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take as directed; do not take more than directed.
Advise patient to notify health care professional of symptoms of esosinophilia-myalgia sydrome occur.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇