For depressed people with a personal or family history of extreme highs and lows -- bipolar disorder, or manic-depression -- antidepressants can be a blight, catapulting them onto the minefields of mania or triggering a long, rocky course of rapid cycling from one extreme to another. For such people, mood regulators are the safest bet.

Lithium is psychiatry's preeminent mood regulator. But tryptophan is a mood regulator, too. Both these natural substances boost serotonin without boosting (like most antidepressants, including, to a slight extent, most SSRIs and 5-HTP) the brain's more stimulating neurotransmitters. In several studies, high doses of tryptophan (6-12 g/day), alone or in combination with lithium, have tended to rapidly bring manic patients down (Sachs, 1989). Indeed, some prominent psychiatrists have made tryptophan a staple of their mood-regulating arsenal (Chouinard et al., 1987).

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• Chouinard, G., et al., "Estrogen-Progesterone Combination: Another Mood Stabilizer?" American Journal of Psychiatry, 144 (June 1987):826.
• Sachs, G. S., "Adjuncts and Alternatives to Lithium Therapy for Bipolar Affective Disorder," Journal of Clinical Psychiatry, 50 (Suppl, Dec 1989): 31-9.