Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode

IntroductionRole of l-5-hydroxytryptophan (l-5-HTP) in depression is relatively less studied but the literature has shown its robust role in depression. The present randomized double blind study was undertaken to assess the role of l-5-HTP as an antidepressant and to compare its antidepressant efficacy with fluoxetine in first depressive episode patients of Indian population.MethodsA total of 70 patients of first depressive episode, all of whom were diagnosed with ICD-10 criteria, were recruited but only 60 patients completed the study and were randomly divided into two groups, receiving l-5-HTP and fluoxetine, respectively, for a period of 8 weeks. All patients were administered Hamilton Rating Scale for Depression (HAM-D) to assess severity of depression at baseline, 2 weeks, 4 weeks and 8 weeks. The efficacy of treatment was assessed by comparing HAM-D scores obtained at these examinations with the baseline examination; final evaluation of both efficacy and tolerance was assessed using the Clinical Global Impression (CGI) scale at the end of study.ResultsBoth treatment groups showed significant and nearly equal reduction in HAM-D scores beginning at week two and continuing through week eight. Twenty-two patients (73.33%) in the l-5-HTP group and 24 patients (80%) in the fluoxetine group showed positive response at the end of the study.Conclusionl-5-HTP has definitely got antidepressant effect in patients of depression. Antidepressant effect was seen within 2 weeks of treatment and was apparent in all degrees of depression. The therapeutic efficacy of l-5-HTP was considered as equal to that of fluoxetine.

► A randomized double blind study to assess efficacy of l-5-HTP as an antidepressant in first depressive episode patients and compare its efficacy with fluoxetine. ► 70 patients of first depressive episode were randomly divided into two groups, receiving l-5-HTP and fluoxetine respectively and observed for a period of 8 weeks. ► HAM-D, BDI and CGI rating scales were administered to assess severity of depression at baseline, 2 weeks, 4 weeks and 8 weeks. ► 22 patients (70.33%) in l-5-HTP group showed positive response compared to 24 patients (80%) in fluoxetine group. ► l-5-HTP showed antidepressant effect in patients of first depressive episode. ► The antidepressant effect of l-5-HTP was as strong as that of fluoxetine.