Synopsis

Source of validity: Scientific
Rating (out of 5): 2

5-HTP (5-hydroxytryptophan) is an amino acid precursor to serotonin, a neurotransmitter implicated in mood regulation and appetite control. Its use for bulimia nervosa is based on the hypothesis that abnormal serotonin function contributes to the disorder’s hallmark behaviors, such as binge eating and compensatory purging. Several small clinical studies and pilot trials from the 1980s and 1990s have explored this connection. Notably, a randomized controlled trial by C. Ceci et al. (1989) found that 5-HTP supplementation led to a significant reduction in binge-eating episodes among bulimic patients compared to placebo. The presumed mechanism is that increasing central serotonin availability may improve satiety and reduce the compulsion to binge. However, the scientific evidence supporting 5-HTP in bulimia is limited. Most studies are small, short in duration, and sometimes methodologically weak. There is a lack of large, well-controlled, contemporary trials, and 5-HTP is not formally recommended by medical guidelines for bulimia nervosa treatment. Nonetheless, its use is occasionally justified in the scientific literature as an experimental adjunct, particularly when standard treatments (psychotherapy, antidepressants) are not fully effective. Side effects and the risk of serotonin syndrome when combined with other serotonergic agents must be considered. In conclusion, while there is some scientific rationale and preliminary evidence for using 5-HTP in bulimia, the overall quality and quantity of supporting data are modest, and it remains an experimental approach rather than standard care.

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