Reader’s Question

I am a 40-year-old male from Malaysia. I have prolonged depression, currently being treated with Cymbalta, but I still find it very difficult to wake up in the morning. (I am drowsy most of the time.) It does become better when I have eaten. In many cases, I spend much of my time sleeping rather than waking. Do you think I still have serotonin deficit or another neurotransmitter deficit, and can 5-HTP help in restoring my serotonin? Do you have any other idea that I could try out to improve my condition?

Our Clinical Psychologist’s Reply

In my experience, Cymbalta is an excellent antidepressant. It’s especially good for individuals who have medical conditions, such as fibromyalgia, back injuries, etc.

Excessive sleeping may be related to your dose of Cymbalta. I would recommend consulting your physician in this matter. If the Cymbalta is too sedating, he/she may be able to switch medications or add a medication to improve your situation. Lack of sleep and excessive sleep can both be related to Serotonin.

If you are referring to 5-HTP as an over-the-counter product — I don’t recommend treating depression with such products. [Editor's Note: Serotonin itself is also called '5-HT', for '5-hydroxytryptamine'. 5-HTP is a precursor amino acid.] Many products available over-the-counter (without a prescription) suggest they treat depression, anxiety, and a variety of other mental health issues. These substances are ineffective in the treatment of most psychiatric issues. “Serotonin” as a chemical or drug is incapable of being manufactured — even for sale by prescription. Substances labeled “5-HTP” often contain substances thought to help improve Serotonin. In truth, they may influence gastrointestinal (gut) levels of Serotonin, producing bowel problems and nausea.

Returning to your physician is recommended — not adding or experimenting with products that can be sold over-the-counter with no regard for your medical or mental health status.