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Letters From Our Readers: Q & A Session 6-20-07

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Can I Take 5-HTP and Amitriptyline Together?

Q: I have had CFS for just over 13 years and have had particular problems not just with energy and fatigue but also anxiety, depression and poor sleep. I have been taking a low dose of citalopram for the anxiety and depression, and amitriptyline for my sleep problems [both prescription drugs]…but found I was gaining weight at a tremendous rate. Recently I managed to completely wean myself from the citalopram, replacing it increasingly with valerian… As I took less citalopram, sleep disturbances returned, so I have been taking a combination of valerian and other herbs alongside amitriptyline to address this.

I would now like to start weaning from the amitriptyline, too, but worry about further sleep disturbances. I know that 5-HTP is a good product and can help with stabilizing weight. Is it safe to start taking 5-HTP while I am weaning from amitriptyline or should I wean from it completely before starting this? – Helen

A: Anytime two products that increase serotonin are used together, the danger of serotonin syndrome is increased. Serotonin syndrome is a life-threatening drug reaction that causes the body to have too much serotonin. While 5-HTP (which is produced by the body but is also available as a dietary supplement) is known to support mood and sleep, it does promote production of serotonin – as does amitriptyline. It is very important that you keep your doctor and all members of your professional healthcare team fully informed of your health regimen, including use of dietary supplements and herbs as well as pharmaceutical drugs, and consult with your doctor before making any change – particularly one such as this.



Central Nervous System Depressants for CFS – and FM, too?

Q: In the Q&A section of the last CFS newsletter, you mentioned that central nervous system depressants are sometimes used for CFS. Couldn't central nervous system depressants be used for FM, too, because of the belief that FM is at least partially an exaggerated response from the central nervous system? – Shelovescliche

A: Good observation. Yes, central nervous system (CNS) depressants are sometimes used to treat FM. Early studies of the CNS narcolepsy drug XyremTM have shown it to reduce pain and improve sleep in fibromyalgia patients. (See “Research: Narcolepsy Drug Relieves Pain and Improves Sleep in Fibromyalgia Patients,” http://www.immunesupport.com/library/showarticle.cfm/id/6835) Other CNS drugs occasionally used in the treatment of FM include the sleep medication AmbienTM and some of the benzodiazepines.



How Do I Find a Doctor?

Q: I have been seeing a wonderful doctor who has been very involved in chronic fatigue syndrome research. Sadly, he has retired and I am clueless as to where to turn locally for help. Is there any sort of physician referral system you know of to help those of us looking for help? – Suzanne

A: Go to the The Co-Cure Good Doctors list, which you can always access, along with other info about locating a physician, in the Community section of ImmuneSupport.com < http://www.immunesupport.com/community/. Specifically, click on the “Doctors” tab at the top of the Community page, and you’ll see a number of links including one to “The Co-Cure Good Doctors list.”

You can also click on the “Support Groups” tab at the top of the community page to go to a database of FM support groups. Who better to ask about CFS doctors?

And maybe best of all, click on the Message Boards tab to ask your question in the ImmuneSupport.com message boards (anonymous registration takes but a moment), and you’re almost sure to get advice from CFS patients in your area.



Advance Notice of Upcoming Dr. Klimas Chat?

Q: I do hope we get plenty of advance notice of Dr. Klimas' chat. Also, I hope you will publish the transcript for the many, many who will miss the chat. – Nancy

A: Yes, we will definitely provide advance notice, and will also publish the transcript of the chat in the newsletters and on ImmuneSupport.com. Nancy G. Klimas, MD, is a clinical immunologist, professor of medicine at the University of Miami’s Miller School of Medicine, and a national leader in CFS research and treatment who says she has seen more than 2,000 patients with this disease over more than 20 years.

Note: This information has not been evaluated by the FDA. It is generic and not meant to prevent, diagnose, treat, or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or regimen without researching and discussing it in collaboration with your professional healthcare team.

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