5-HTPvsNAC (N-Acetyl Cysteine)

5-HTP readily crosses the blood-brain barrier via the large neutral amino acid transporter (LAT1/SLC7A5), unlike serotonin itself which cannot. Once in the brain, aromatic L-amino acid decarboxylase (AADC, also called DOPA decarboxylase) converts 5-HTP to serotonin (5-hydroxytryptamine) using pyridoxal-5-phosphate (active vitamin B6) as a cofactor. This completely bypasses tryptophan hydroxylase (TPH2), the rate-limiting enzyme in the normal serotonin synthesis pathway from dietary L-tryptophan. The result is a reliable, dose-dependent increase in serotonin across multiple brain regions including the dorsal raphe nucleus, hippocampus, and prefrontal cortex. Elevated serotonin activates 5-HT1A autoreceptors (calming), 5-HT2A/2C postsynaptic receptors (mood modulation), and 5-HT3 receptors (gut-brain signaling). In the pineal gland, serotonin is converted by arylalkylamine N-acetyltransferase (AANAT) to N-acetylserotonin, then by hydroxyindole O-methyltransferase (HIOMT) to melatonin — explaining the sleep-promoting effects.

NAC provides cysteine, the rate-limiting substrate for glutathione (GSH) synthesis via gamma-glutamylcysteine ligase (GCLC) and glutathione synthetase (GSS). GSH is the primary intracellular antioxidant, essential for GPx and GST-mediated detoxification of reactive oxygen species in neurons. NAC also modulates glutamate via the cystine-glutamate antiporter (System Xc-, composed of xCT and 4F2hc) — NAC is deacetylated to cysteine, which exchanges for glutamate; the increased extracellular cystine is reduced to cysteine intracellularly, while the exchange increases extrasynaptic glutamate, which activates inhibitory mGlu2/3 autoreceptors on presynaptic terminals, reducing excessive glutamatergic signaling and compulsive behaviors. This glutamate modulation is the basis for psychiatric applications (OCD, addiction). NAC may also directly modulate NMDA receptors via redox sites.