Tryptophan

Indications
Oral
Adjunct in treatment-resistant depression
Adult: As L-tryptophan: 1 g tid. Max: 6 g daily.
Elderly: Dose reduction may be needed.
Renal impairment: Dose reduction may be needed.
Hepatic impairment: Dose reduction may be needed.
Contraindications
History of eosinophilia-myalgia syndrome associated with tryptophan treatment.
Warnings / Precautions
May affect ability to drive or operate machinery. Monitor for suicidal thoughts or clinical worsening of depression during initial treatment period. Renal or hepatic impairment. Elderly.
Adverse Reactions
Nausea (take after food to minimise nausea), headache, lightheadedness, drowsiness, eosinophilia-myalgia syndrome.
Overdose Reactions
Symptoms: Drowsiness and vomiting. Management: Treatment is supportive.
Drug Interactions
Increased risk of serotonin syndrome with SSRI. Possible decrease in levodopa plasma levels with tryptophan.
Potentially Fatal: Increased risk of severe behavioural and neurological toxicity with MAOI, start with lower initial dose of tryptophan if needed.
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Mechanism of Actions
Tryptophan is an essential amino acid which is the precursor of serotonin. It may be used as an adjunctive therapy in treatment-resistant depression. It is sometimes administered with pyridoxine and ascorbic acid. Due to its association with eosinophilia-myalgia syndrome, the use of tryptophan as dietary supplements (e.g. for insomnia) is limited or restricted.
Absorption: Readily absorbed from GI tract.
Distribution: Protein binding: Extensive, to plasma albumin.
Metabolism: By liver to metabolites e.g. hydroxytryptophan and kynurenine derivatives.
Excretion: Elimination half life (oral or IV L-tryptophan): 1-3 hr.
ATC Classification
N06AX02 - tryptophan ; Belongs to the class of other antidepressants.
Available As
  • Tryptophan 100 mg
  • Tryptophan 104 mg
  • Tryptophan 2 gm
  • Tryptophan 3.6 mg
  • Tryptophan 50 mg
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