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Nutr Rev. 2019 Aug 28. pii: nuz039. doi: 10.1093/nutrit/nuz039. [Epub ahead of print]

Effects of 5-hydroxytryptophan on distinct types of depression: a systematic review and meta-analysis.

Author information

1
Clinical Exercise-Neuro-Immunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany.
2
Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
3
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
4
University Hospital of Cologne, Cologne, Germany.
5
Cal Mania Team, Department of Psychology, University of California Berkeley, Berkley, California, USA.
6
Division of Physical Activity, Prevention and Cancer, German Cancer Research Center, Heidelberg, Germany.

Abstract

CONTEXT:

Serotonergic dysfunction, including reduced central serotonin levels, is associated with different psychiatric syndromes, including depression. As a serotonin precursor, 5-hydroxytryptophan has long been used as a nonpharmacological treatment for depression.

OBJECTIVE:

A systematic review and meta-analysis was conducted to determine the antidepressant effects of 5-hydroxytryptophan in depressed patients.

DATA SOURCES:

MEDLINE (via PubMed) and Google Scholar were searched from inception to May 2018.

DATA EXTRACTION:

Thirteen investigations were included in the systematic review (using PRISMA guidelines), and 7 in the full meta-analysis (pre-registered on PROSPERO: CRD42018104415).

DATA ANALYSIS:

Analyses revealed a depression remission rate of 0.65 (95% confidence interval [CI], 0.55-0.78; remission rate [k] = 13), and this was confirmed by the questionnaire results, which revealed a large Hedges' g (1.11; 95%CI, 0.53-1.69). Methodological variability (in treatment duration, type of depression studied, experimental design, 5-hydroxytryptophan dosage) contributes to heterogeneity in the results (I2 = 76%, τ2 = 0.379). In addition, the OHAT (Office of Health Assessment and Translation risk of bias rating) tool suggested that, on the whole, current studies are relatively weak (few include placebo groups).

CONCLUSION:

Further trials should overcome these limitations by using placebo-controlled studies that include patients with well-defined depression diagnoses, along with strong characterization of psychological and physiological patient characteristics.

KEYWORDS:

5-hydroxytryptophan; depression; inclusion criteria; method variability; serotonin

PMID:
31504850
DOI:
10.1093/nutrit/nuz039

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