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Integrative Therapies for Schizophrenia - Tryptophan and Ginkgo

Scott Olson, ND

Tryptophan

Tryptophan is an another essential amino acid (protein) that is necessary for appropriate growth and development. This amino acid is the starting point for the creation of many essential substances in the body such as niacin, and the brain chemical serotonin.

People with schizophrenia have low levels of tryptophan in their bodies. A small study using tryptophan and vitamin B-6 showed some improvements in symptoms of schizophrenia, but the results were not dramatic.

Tryptophan has not been available on the US market after a series of liver failures were tied to improper manufacturing of this amino acid. However, 5-hydroxy-tryptophan (5-HTP) has become available in the US in the last decade. It is assumed that for most applications, 5-HTP can be used instead of tryptophan. In a series of steps in the body, tryptophan is converted to 5-HTP before being changed into serotonin. In most studies, using 5-HTP to increase levels of tryptophan seems to work. It is assumed that 5-HTP does not carry the same risk of liver disease as tryptophan, but this assumption has not been adequately tested.

Safety and Dosing

2-8 grams of Tryptophan is the typical dose in clinical studies.

Tryptophan or 5-HTP must not be used with any other antidepressant medication due to the risk of a rare condition called serotonin syndrome (or serotonin toxicity) that produces mental confusion, agitation, headache, shivering, sweating, hypertension (high blood pressure), tachycardia (fast heart rate), and other symptoms. Tryptophan or 5-HTP also may interfere with lithium (commonly used for treating bipolar disorder).

Side Effects of 5-HTP

  • Agitation
  • Drowsiness
  • Flushing
  • Headache
  • Mild stomach upset
  • Tachycardia (fast heart rate)

WARNING: Any substance that increases serotonin carries with it the risk of causing a manic episode in people with bipolar disorder (manic depression). A manic episode, the high energy component of bipolar disorder, is characterized by a euphoric (joyful, energetic) mood, hyperactivity, a positive, expansive outlook on life, a hyper-inflated inflated sense of self-esteem, impulsive and risk behavior, and a reduced need for sleep. While the use of 5-HTP hasn't been linked to manic episodes, caution is still warranted. Consult your health care provider before taking 5-HTP if you have bipolar disorder.

Ginkgo (Ginkgo biloba)

One of the newest and exciting areas of research on the treatment of schizophrenia is the use of Ginkgo biloba in combination with standard anti-psychotic drugs. Ginkgo biloba is one of the oldest living trees; the fossil record dates its existence as far back as the Mesozoic period (63 million to 230 million years ago). Considered a sacred tree throughout China, it has been used as a medicine for thousands of years. Ginkgo is used for many brain conditions and has enjoyed recent popularity as a memory-enhancing supplement.

Among Ginkgo's many properties is that it functions as an antioxidant. High levels of free radicals have been observed in people with schizophrenia, leading to the theory that treatment with antioxidants (which reduce free radicals) such as Ginkgo would be helpful. While still in the early stages of research, it appears that Ginkgo biloba enhances the effectiveness of anti-psychotic medications and may reduce extrapyramidal side effects. These side effects produce movement disorders such as tardive dyskinesia (involuntary movement of the arms, legs or fingers, or other uncontrollable movements such as grimacing and lip smacking), and are usually the result of long-term use of anti-psychotic medications.

Safety and Dosing

Dosing of ginkgo is typically 360 milligrams a day of a standardized extract.

Ginkgo has few side effects (see box). Ginkgo has a blood thinning effect and should not be used by anyone who takes other blood thinning medications or aspirin. A few cases of intercranial bleeding (bleeding in the brain) have been associated with Ginkgo. If you have a past history of stroke or related conditions, you should avoid using Ginkgo.

Side Effects of Ginkgo biloba

  • Rash
  • Dizziness
  • Allergic skin rash
  • Headache
  • Mild stomach upset

Ginkgo has the potential to interfere with other medications used for depression, such as MAO inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). Check with your health care professional before starting to take Ginkgo.