imipramine + nicotinamide + tryptophan

This is a combination therapy consisting of imipramine, nicotinamide, and tryptophan. Imipramine is a tricyclic antidepressant that inhibits the reuptake of serotonin and norepinephrine, increasing their levels in the synaptic cleft and thereby improving mood in depressed individuals. Tryptophan is an essential amino acid and precursor to serotonin; its supplementation can increase central nervous system serotonin synthesis. Nicotinamide (a form of vitamin B3) is included to reduce peripheral breakdown of tryptophan, thus enhancing its availability for central conversion to serotonin. This combination has been studied for the treatment of depression (particularly unipolar depression), with evidence suggesting that at appropriate doses it may be as effective as imipramine alone, and at low doses may potentiate the action of tricyclic antidepressants[1][2][3]. The therapeutic response appears sensitive to dosing, especially regarding plasma tryptophan levels.