Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Express Relax Natural Cocoa Flavored Lozenge Ingredients & Drug Interactions

by Femiwell

Express Relax Natural Cocoa Flavored Lozenge label
See full label image
Lozenge Category: Botanical With Nutrients
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Express Relax Natural Cocoa Flavored Lozenge against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Express Relax Natural Cocoa Flavored Lozenge is a dietary supplement by Femiwell with 3 active ingredients. Its ingredients are commonly taken for low mood or depression, anxiety and stress, sleep problems.Based on those ingredients, 901 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Passion flower (Passiflora incamata) herbs dry extract, 5-HTP, Glycine. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Express Relax Natural Cocoa Flavored Lozenge by Femiwell

Ask about any prescription or over-the-counter medication and we check it for interactions with Express Relax Natural Cocoa Flavored Lozenge by Femiwell — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Express Relax Natural Cocoa Flavored Lozenge by Femiwell

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 30, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This lozenge contains three active ingredients. 5-HTP is an amino acid precursor that your body uses to make serotonin, a brain chemical involved in mood and sleep.

Glycine is another amino acid with a calming role. Passion flower is a plant extract traditionally used to ease anxiety and support sleep.

Together they're meant to promote relaxation. The product also contains cocoa powder and natural chocolate flavor for taste, plus inactive ingredients like gum arabic, calcium stearate, and aerosil to hold the lozenge together.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: ease stress and tension, support relaxation and sleep.
  • We looked for evidence on: Stress, Anxiety, Insomnia, Adjustment disorders, Panic disorder, Pre-procedural anxiety — and 4 related terms.
  • The strongest evidence on file: 5-htp is rated "Possibly Effective" for Depression (Natural Medicines).
  • Also on file: Passion Flower is rated "Possibly Effective" for Pre-procedural anxiety, Insomnia.
  • Also on file: 5-htp is rated "Insufficient Reliable Evidence To Rate" for Anxiety, Migraine headache, Insomnia, Panic disorder.

5-HTP shows possibly effective evidence for depression — meaning some people see benefit, but the proof isn't rock-solid. For other conditions like ADHD, Alzheimer's disease, and cerebellar ataxia, evidence is currently insufficient to rate it.

Passion flower is possibly effective for insomnia and anxiety before medical procedures. Glycine is possibly effective for schizophrenia, though that's not the primary purpose of this product.

For most of the other conditions these ingredients are studied for, evidence is either lacking or insufficient to draw conclusions.

The evidence, ingredient by ingredient 5-htp Glycine Passion Flower

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

5-HTP is generally well tolerated in the short term, but it affects serotonin and requires careful use with professional guidance. Common side effects include nausea, diarrhea, drowsiness, headache, dizziness, abdominal pain, and loss of appetite — most often dose-dependent and sometimes improving with continued use.

Rarely, it can cause hallucinations, aggression, or mania, especially at high doses or with certain other medications. Glycine is generally well tolerated at typical doses, though long-term safety data are limited; mild sedation, insomnia, irritability, nausea, and soft stools have been reported rarely.

Passion flower is well tolerated short-term but commonly causes drowsiness, dizziness, and confusion. A rare case of severe nausea, vomiting, and heart rhythm changes was reported at very high doses.

The safety data for pregnancy advise against 5-HTP and passion flower; glycine and passion flower data during breastfeeding are insufficient, so caution is advised.

Side effects, ingredient by ingredient 5-htp Glycine Passion Flower

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 3 of the 3 matched ingredients can interact with medications — 5-htp, Passion Flower, Glycine.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: Parkinson's medications.
  • For scale: 902 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check before using this product if you take serotonergic drugs like antidepressants (SSRIs, SNRIs, tricyclics), certain pain or migraine medications (tramadol, triptans), or psychiatric medications like clozapine; CNS depressants like benzodiazepines, sleep aids, or opioids; carbidopa for Parkinson's disease; or medications that rely on liver enzymes like certain heart or blood pressure drugs. No interactions are documented for the specific formulation we have on file, but absence of data is not proof none exist.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

If you struggle with anxiety or sleep and don't take medications that affect serotonin, sedation, or certain psychiatric drugs, this product may be worth discussing with your doctor or pharmacist. But if you take antidepressants, anti-anxiety drugs, sedating medications, pain relievers, migraine drugs, or antipsychotics — or if you're pregnant or breastfeeding — check with your own healthcare provider first before adding it.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 24, 2015.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Express Relax Natural Cocoa Flavored Lozenge, straight from the product label.

Brand Femiwell
Barcode (UPC) 812908020055
Net contents 40 Natural Cocoa Flavored Lozenge(s)
Market status On market
Date entered into DSLD Nov 24, 2015
DSLD ID 53767
Product type Botanical With Nutrients
Supplement form Lozenge
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Express Relax Natural Cocoa Flavored Lozenge by Femiwell, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Lozenge(s)
Maximum serving Sizes:
1 Lozenge(s)
Servings per container
40
UPC/BARCODE
812908020055
IngredientAmount% DV
5-HTP25 mg--
Glycine300 mg--
Passion flower (Passiflora incamata) herbs dry extract80 mg--

Other ingredients: Parteck, Gum Arabic, Cocoa powder, Calcium Stearate, Aerosil, natural Chocolate flavor

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

helps naturally ease stress and tension*

Stress Management

Passion Flower and amino acid support positive mood and relaxation* ~helps balance and ease mood* ~promotes calmness and helps support restful sleep* ~supports normal, healthy relaxation and eases stress*

Manufactured in the Altai Mountains, Russia for Evalar USA

Seals/Symbols

Evalar

GLUTEN FREE~ NON-GMO ~ GMP CERTIFIED FACILITY

Brand IP Statement(s)

Optimal Health by Nature

FEMiWell Express Relax is a unique blend of important botanicals and amino acids that help your body deal with everyday stress, promote calmness and help improve sleep quality.

FDA Statement of Identity

Dietary Supplement

Formula

Passion flower is a botanical used to naturally promote stress relief and relaxation. Glycine and 5-HTP (5-Hydroxytryptophan) are amino acids that provide support for normal, healthy relaxation, restful sleep and a calm mood.

Precautions

Warning: This product is only intended for healthy adults, 18 years of age or older.

Do not use if pregnant or nursing. Before using this product, consult a licensed, qualified, health care professional if: you have any pre-existing medical conditions or if you are taking any other dietary supplement, prescription drug or over-the-counter medication.

Discontinue use 2 weeks prior to surgery. Use only as directed. Do not use if blister pack seal is broken or missing.

Keep out of reach of children.

Storage

Store in a cool, dry place.

Suggested/Recommended/Usage/Directions

Directions: Take 1 lozenge up to 4 times per day as needed.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, teat, cure or prevent any disease.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Express Relax Natural Cocoa Flavored Lozenge by Femiwell label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Express Relax Natural Cocoa Flavored Lozenge label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Express Relax Natural Cocoa Flavored Lozenge by Femiwell

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Lozenge(s) Dosage formLozenge Servings per container40 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

5-HTP

Interacts with
398 drugs
25 mg per serving Form: Griffonia simplicifolia Seed Extract

5-HTP is a compound your body uses to make serotonin, and people take it as a supplement hoping to improve mood, sleep, and headaches. Some early rese...

5-HTP monograph & interactions

Glycine

Interacts with
1 drug
300 mg per serving

Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep q...

Glycine monograph & interactions

Passion flower (Passiflora incamata) herbs dry extract

Interacts with
836 drugs
80 mg per serving

Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restless...

Passion flower (Passiflora incamata) herbs dry extract monograph & interactions

Other (inactive) ingredients: Parteck, Gum Arabic, Cocoa powder, Calcium Stearate, Aerosil, Natural Chocolate flavor. These complete the product’s ingredient list but are not active constituents.

Interaction report

Express Relax Natural Cocoa Flavored Lozenge by Femiwell Drug Interactions

Want to check YOUR meds against Express Relax Natural Cocoa Flavored Lozenge?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
901Drugs
398 Moderate 503 Minor

Ingredients driving the most interactions

Passion flower (Passiflora incamata) herbs dry extract 836
5-HTP 398
Glycine 1

Individual Drug Interactions

The ingredients in Express Relax Natural Cocoa Flavored Lozenge interact with 901 drugs. Click any drug to see the details.

3 of the 3 ingredients in Express Relax Natural Cocoa Flavored Lozenge interact with drugs. Each result below shows which ingredient is responsible. Passion flower (Passiflora incamata) herbs dry extract 5-HTP Glycine

Each ingredient & the kinds of drugs it affects

For each ingredient in Express Relax Natural Cocoa Flavored Lozenge with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Passion flower (Passiflora incamata) herbs dry extract3 drug types · 836 drugs

Cns Depressants

Concomitant use of passion flower with sedative drugs might cause additive effects and side effects.
Research in animals and humans shows that passion flower has sedative effects which can be additive when used with sedative medications like lorazepam.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, passion flower might decrease the effects of CYP3A4 substrates.
In vitro research suggests that passion flower can induce CYP3A4 enzymes, albeit to a much lower degree than rifampin, a known CYP3A4 inducer.

Likelihood Possible Evidence D
Organic Anion-Transporting Polypeptide Substrates (Oatp)

Theoretically, passion flower might reduce the bioavailability of OATP2B1 and OATP1A2 substrates.
In vitro research shows that the passion flower constituents apigenin and vitexin inhibit OATP2B1 and OATP1A2. This inhibition may be dose-dependent. One specific high-flavonoid passion flower extract (Valverde) seems to inhibit OATP2B1 and OATP1A2, while another extract with a lower flavonoid concentration (Arkocaps) shows less potent inhibition. OATPs are responsible for the uptake of drugs and other compounds into the body; however, the specific activities of OATP2B1 and OATP1A2 are not well characterized.

Likelihood Possible Evidence D
Passion flower (Passiflora incamata) herbs dry extract full monograph & interactions

5-HTP3 drug types · 398 drugs

Carbidopa (Lodosyn)

Combining 5-HTP and carbidopa can increase the risk of serotonergic side effects.
Carbidopa is sometimes used with 5-HTP to minimize peripheral 5-HTP metabolism and boost the amount that reaches the brain. However, this combination might also increase the risk of some side effects including hypomania, restlessness, rapid speech, anxiety, insomnia, and aggressiveness. Combining carbidopa and 5-HTP might also increase the risk of scleroderma-like skin changes due to elevated serotonin levels.

Likelihood Possible Evidence D
Cns Depressants

Theoretically, concomitant use of 5-HTP with medications that cause sedation might have additive effects.
In clinical trials, 5-HTP has been associated with drowsiness and somnolence.

Likelihood Possible Evidence D
Serotonergic Drugs

Combining serotonergic drugs with 5-HTP might cause additive serotonergic effects.
5-HTP can increase serotonin levels and cause serotonergic effects. Theoretically, combining serotonergic drugs with 5-HTP might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. However, serotonin syndrome with 5-HTP has not yet been reported in humans. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using 5-HTP with serotonergic drugs.

Likelihood Possible Evidence D
5-HTP full monograph & interactions

Glycine1 drug type · 1 drug

Clozapine (Clozaril)

Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.

Likelihood Probable Evidence B
Glycine full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Express Relax Natural Cocoa Flavored Lozenge, from the product label.

Femiwell

See all Femiwell products
Name
Evalar USA
Street Address
7900 Glades Road Suite 425
City
Boca Raton
State
FL
ZipCode
33434
Web Address
www.evalarus.com
Pharmacist Counseling Corner

Express Relax Natural Cocoa Flavored Lozenge by Femiwell: Common Questions

Does Express Relax Natural Cocoa Flavored Lozenge by Femiwell interact with any medications?
Yes. Based on its ingredients, Express Relax Natural Cocoa Flavored Lozenge has a known interaction with 901 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Express Relax Natural Cocoa Flavored Lozenge contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Will this make me drowsy?
Possibly. 5-HTP and passion flower both commonly cause drowsiness, and glycine can cause mild sedation in rare cases. If you drive or operate machinery, it's wise to test how you react to it first, or take it in the evening.
Can I take this if I'm on an antidepressant?
That depends on which antidepressant and at what dose — 5-HTP raises serotonin, and combining it with most antidepressants carries a moderate risk of serotonergic side effects. Talk to your pharmacist or doctor before adding this product; they know your specific medication and can advise whether it's safe for you.
Is this safe during pregnancy?
No. The safety data advise against 5-HTP and passion flower during pregnancy due to lack of safety information and possible effects on the uterus. If you're pregnant or planning to become pregnant, skip this product and talk to your doctor about safer options.
What does 5-HTP actually do?
5-HTP is an amino acid your body converts into serotonin, a brain chemical that helps regulate mood and sleep. It's possibly effective for depression based on available evidence, though results vary from person to person.
Can I take this with my sleep medication?
Probably not safely. Both passion flower and 5-HTP have sedating effects, and combining them with sleep aids like benzodiazepines or prescription sleep drugs can cause excessive drowsiness or impaired coordination. Check with your pharmacist or doctor first.
What are the most common side effects?
Nausea, diarrhea, drowsiness, and headache are the most frequent, especially early on. Most are dose-dependent and some improve with continued use. Stop and talk to your pharmacist if side effects persist or worsen.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Express Relax Natural Cocoa Flavored Lozenge label
Go deeper

The Full Monographs Behind Express Relax Natural Cocoa Flavored Lozenge’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

5-htp

Interacts with 398 drugs

5-HTP is a compound your body uses to make serotonin, and people take it as a supplement hoping to improve mood, sleep, and headaches. Some early research is promising, but the overall evide...

Read the full 5-htp monograph → Herb & supplement monograph

Glycine

Interacts with 1 drug

Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...

Read the full Glycine monograph → Herb & supplement monograph

Passion Flower

Interacts with 836 drugs

Passion flower is a traditional calming herb that many people use for anxiety and sleep. Early studies hint it may help with mild anxiety and restlessness, but the evidence is limited and mo...

Read the full Passion Flower monograph →
Sources

Sources & How We Checked

Express Relax Natural Cocoa Flavored Lozenge's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 56 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

5-htp 32 references
  1. Birdsall TC. 5-Hydroxytryptophan: A Clinically-Effective Serotonin Precursor. Altern Med Rev 1998;3:271-80.
  2. Michelson D, Page SW, Casey R, et al. An eosinophilia-myalgia syndrome related disorder associated with exposure to L-5-hydroxytryptophan. J Rheumatol 1994;21:2261-5.
  3. Cangiano C, Ceci F, Cancino A, et al. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr 1992;56:863-7. PubMed
  4. U.S. Food and Drug Administration. Impurities confirmed in dietary supplement 5-hydroxy-L-tryptophan. FDA Talk Paper, August 31, 1998; T98-48.
  5. Sternberg EM, Van Woert MH, Young SN, et al. Development of a scleroderma-like illness during therapy with L-5-hydroxytryptophan and carbidopa. N Engl J Med 1980;303:782-7. PubMed
  6. Poldinger W, Calanchini B, Schwarz W. A functional-dimensional approach to depression: serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 1991;24:53-81.
  7. Ribeiro CA. L-5-Hydroxytryptophan in the prophylaxis of chronic tension-type headache: a double-blind, randomized, placebo-controlled study. Headache 2000;40:451-6.
  8. U. S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, Office of Nutritional Products, Labeling, and Dietary Supplements. Information Paper on L-Tryptophan and 5-hydroxy-L-tryptophan, February 2001.
  9. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
  10. Johnson KL, Klarskov K, Benson LM, et al. Presence of peak X and related compounds: the reported contaminant in case related 5-hydroxy-L-tryptophan associated with eosinophilia-myalgia syndrome. J Rheumatol 1999;26:2714-7.
  11. Takahashi S, Kondo H, Kato N. Effect of l-5-hydroxytryptophan on brain monoamine metabolism and evaluation of its clinical effect in depressed patients. J Psychiatr Res 1975;12:177-87. PubMed
  12. Iovieno, N., Dalton, E. D., Fava, M., and Mischoulon, D. Second-tier natural antidepressants: review and critique. J Affect.Disord. 2011;130(3):343-357. PubMed
  13. den Boer JA, Westenberg HG. Behavioral, neuroendocrine, and biochemical effects of 5-hydroxytryptophan administration in panic disorder. Psychiatry Res 1990;31:267-78. PubMed
  14. Jangid P, Malik P, Singh P, Sharma M, Gulia AK. Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian J Psychiatr 2013;6:29-34. PubMed
  15. Ceci F, Cangiano C, Cairella M, et al. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. J Neural Transm 1989;76:109-17. PubMed
  16. Angst J, Woggon B, Schoepf J. The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study. Arch Psychiatr Nervenkr 1977;224:175-86. DOI
  17. Titus F, Dávalos A, Alom J, Codina A. 5-Hydroxytryptophan versus methysergide in the prophylaxis of migraine. Randomized clinical trial. Eur Neurol 1986;25:327-9. PubMed
  18. De Benedittis G, Massei R. Serotonin precursors in chronic primary headache. A double-blind cross-over study with L-5-hydroxytryptophan vs. placebo. J Neurosurg Sci 1985;29:239-48.
  19. Van Woert, M. H., Rosenbaum, D., Howieson, J., and Bowers, M. B., Jr. Long-term therapy of myoclonus and other neurologic disorders with L-5- hydroxytryptophan and carbidopa. N Engl J Med 1-13-1977;296(2):70-75. PubMed
  20. Wyatt, R. J., Vaughan, T., Galanter, M., Kaplan, J., and Green, R. Behavioral changes of chronic schizophrenic patients given L-5- hydroxytryptophan. Science 9-22-1972;177(54):1124-1126. PubMed
  21. Chase, T. N., Ng, L. K., and Watanabe, A. M. Parkinson's disease. Modification by 5-hydroxytryptophan. Neurology 1972;22(5):479-484.
  22. van Hiele LJ. l-5-Hydroxytryptophan in depression: the first substitution therapy in psychiatry? The treatment of 99 out-patients with 'therapy-resistant' depressions. Neuropsychobiology 1980;6:230-40. PubMed
  23. Pranzatelli, M. R., Tate, E., Huang, Y., Haas, R. H., Bodensteiner, J., Ashwal, S., and Franz, D. Neuropharmacology of progressive myoclonus epilepsy: response to 5- hydroxy-L-tryptophan. Epilepsia 1995;36(8):783-791. PubMed
  24. Trouillas P, Serratrice G, Laplane D, et al. Levorotatory form of 5-hydroxytryptophan in Friedreich's ataxia. Results of a double-blind drug-placebo cooperative study. Arch Neurol 1995;52:456-60. PubMed
  25. Bastard, J., Truelle, J. L., and Emile, J. [Effectiveness of 5 hydroxy-tryptophan in Parkinson's disease]. Nouv Presse Med 9-11-1976;5(29):1836-1837.
  26. Auffret, M., Comte, H., and Bene, J. Eosinophilia-myalgia syndrome induced by L-5 hydroxytryptophane: about three cases. Fund Clin Pharmacol 2013;Suppl 1(120):poster P2-204.
  27. Wyatt, R. J., Vaughan, T., Kaplan, J., Galanter, M., and Green, R. 5-Hydroxytryptophan and chronic schizophrenia. In: Barchas J and Usdin E. Serotonin and Behavior. New York: Acedemic Press;1973.
  28. Das YT, Bagchi M, Bagchi D, Preuss HG. Safety of 5-hydroxy-L-tryptophan. Toxicol Lett 2004;150:111-22. PubMed
  29. Pardo JV. Mania following addition of hydroxytryptophan to monoamine oxidase inhibitor. Gen Hosp Psychiatry 2012;34(1):102.e13-4. PubMed
  30. Michelson D, Page SW, Casey R, et al. An eosinophilia-myaligia syndrome related disorder associated with exposure to l-5-hydroxytryptophan. J Rheumatol 1994;21(12):2261-5.
  31. Yousefzadeh F, Sahebolzamani E, Sadri A, et al. 5-Hydroxytryptophan as adjuvant therapy in treatment of moderate to severe obsessive-compulsive disorder: a double-blind randomized trial with placebo control. Int Clin Psychopharmacol. 2020;35(5):254-262. PubMed
  32. Maffei ME. 5-Hydroxytryptophan (5-HTP): Natural Occurrence, Analysis, Biosynthesis, Biotechnology, Physiology and Toxicology. Int J Mol Sci. 2020;22(1):181. PubMed

See these in context on the 5-htp monograph →

Glycine 5 references
  1. Heresco-Levy U, Javitt DC, Ermilov M, et al. Efficacy of high-dose glycine in the treatment of enduring negative symptoms of schizophrenia. Arch Gen Psychiatry 1999;56:29-36.. PubMed
  2. Potkin SG, Jin Y, Bunney BG, Costa J, Gulasekaram B. Effect of clozapine and adjunctive high-dose glycine in treatment-resistant schizophrenia. Am J Psychiatry 1999;156:145-7.. PubMed
  3. Gusev EI, Skvortsova VI, Dambinova SA, et al. Neuroprotective effects of glycine for therapy of acute ischaemic stroke. Cerebrovasc Dis 2000;10:49-60. PubMed
  4. Inagawa K, Kawai N, Ono K, Sukegawa E, Tsubuku S, Takahashi M. Assessment of acute adverse effects of glycine ingestion at a high dose in human volunteers. Seikatsu Eisei. 2006; 50:27-32.
  5. Woods SW, Walsh BC, Hawkins KA, Miller TJ, Saksa JR, D'Souza DC, Pearlson GD, Javitt DC, McGlashan TH, Krystal JH. Glycine treatment of the risk syndrome for psychosis: report of two pilot studies. Eur Neuropsychopharmacol. 2013 Aug;23(8):931-40. PubMed

See these in context on the Glycine monograph →

Passion Flower 19 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Fisher AA, Purcell P, Le Couteur DG. Toxicity of Passiflora incarnata L. J Toxicol Clin Toxicol 2000;38:63-6.
  4. Akhondzadeh S, Naghavi HR, Shayeganpour A, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther 2001;26:363-7. PubMed
  5. Farnsworth N, Bingel A, Cordell G, et al. Potential value of plants as sources of new antifertility agents I. J Pharm Sci 1975;64:535-98. DOI
  6. Mori A, Hasegawa K, Murasaki M, et al. Clinical evaluation of Passiflamin (passiflora extract) on neurosis - multicenter double blind study in comparison with mexazolam. Rinsho Hyoka (Clinical Evaluation) 1993;21:383-440.
  7. Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev 2007;(1):CD004518. DOI
  8. Speroni E., Minghetti A. Neuropharmacological activity of extracts from Passiflora incarnata. Planta Med. 1988;54:488-91.
  9. Capasso A., Sorrentino L. Pharmacological studies on the sedative and hypnotic effect of Kava kava and Passiflora extracts combination. Phytomedicine. 2005;12:39-45. PubMed
  10. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 Dec;23:1795-6.
  11. Smith, G. W., Chalmers, T. M., and Nuki, G. Vasculitis associated with herbal preparation containing Passiflora extract. Br J Rheumatol. 1993;32(1):87-88.
  12. Soulimani, R., Younos, C., Jarmouni, S., Bousta, D., Misslin, R., and Mortier, F. Behavioural effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse. J Ethnopharmacol. 1997;57(1):11-20. PubMed
  13. Nojoumi M, Ghaeli P, Salimi S, Sharifi A, Raisi F. Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ?with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study. Iran J Psychiatry. 2016;1
  14. Rokhtabnak F, Ghodraty MR, Kholdebarin A, et al. Comparing the Effect of Preoperative Administration of Melatonin and Passiflora incarnata on Postoperative Cognitive Disorders in Adult Patients Undergoing Elective Surgery. Anesth Pain Med. 2016;7(1):e4123 PubMed
  15. Dantas LP, de Oliveira-Ribeiro A, de Almeida-Souza LM, Groppo FC. Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction. Med Oral Patol Oral Cir Bucal. 2017;22(1):e95-e101. PubMed
  16. Ozturk Z, Kalayci CC. Pregnancy outcomes in psychiatric patients treated with passiflora incarnata. Complement Ther Med. 2018 Feb;36:30-32. PubMed
  17. da Cunha RS, Amorim KS, Gercina AC, et al. Herbal medicines as anxiolytics prior to third molar surgical extraction. A randomized controlled clinical trial. Clin Oral Investig. 2020. PubMed
  18. Schäfer AM, Gilgen PM, Spirgi C, et al. Constituents of Passiflora incarnata, but Not of Valeriana officinalis, Interact with the Organic Anion Transporting Polypeptides (OATP)2B1 and OATP1A2. Planta Med. 2021. PubMed
  19. Mazzari ALDA, Lacerda MG, Milton FA, et al. In vitro effects of European and Latin-American medicinal plants in CYP3A4 gene expression, glutathione levels, and P-glycoprotein activity. Front Pharmacol 2022;13:826395. PubMed

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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