Posted by JohnL on October 1, 1999, at 17:04:23
In reply to SAMe, posted by Kathy on October 1, 1999, at 14:04:14
Hi Kathy. Due to its expense, I keep going on it and then off again on about a biweekly rotation. 1200mg a day total (bid). I keep thinking it's my imagination, but each time I return to it I feel much better. Not cured, but much better.
I see several potential benefits of SAMe: 1)Hasten recovery while waiting for an AD to take effect, for me as early as day three, 2)possibly allowing a lower dose of the AD, 3)providing an extra boost when the AD seems to be lagging. Could be an almost ideal augmentation. I say almost because its high cost is not ideal.
I know of no contraindications. The package insert says to use caution in bipolar patients due to potential manic reactions. I think that warning applies to just about anything though, not just SAMe. I know of one person who takes 1600mg a day along with 40mg Prozac, a couple others at 400mg a day with 40mg Prozac. They are very pleased and see the high expense as a worthwhile investment in their mental health. Also mixed with TCAs, Serzone, Wellbutrin, etc. The only one I'm not sure of is MAOIs. Seems to be well tolerated and benign with most ADs.
I believe it works, based on my own experience. But that high cost is a real roadblock. At $1.00 a pill (200mg) it can add up to a couple hundred dollars a month on the high end. In a way, it could be viewed that the patient can purchase his/her freedom from troublesome side-effects by using SAMe. Personally I like it in combination with an AD, but I don't know how well it would work as monotherapy. Its therapeutic benefits, high safety, and low/nonexistent side effects must be weighed against the high dollar expense. All things considered, I would definitely educate patients about SAMe so they will have an alternative choice available in treating depression, with or without an AD.
poster:JohnL
thread:12407
URL: http://www.dr-bob.org/babble/19991001/msgs/12417.html