5-HTP
Serotonin precursor amino acid used for mood, sleep, and appetite regulation; crosses the blood-brain barrier freely.
Multiple double-blind placebo-controlled trials have examined 5-HTP for depression with generally positive but methodologically limited results; sample sizes are often small and older studies predate modern diagnostic criteria. Evidence for sleep improvement and appetite suppression is more robust, with several trials showing reduced caloric intake and improved sleep quality. A preliminary RCT found significant fat mass reduction at 100 mg daily over 8 weeks without changes in lean mass or body fat percentage. Safety concerns include eosinophilia-myalgia syndrome (EMS) linked to contaminated preparations, serotonin syndrome risk when combined with serotonergic drugs, and a case report of reversible hippocampal ischaemia following a 10x overdose. Long-term safety data remain limited.