Posted by Ron Hill on March 23, 2002, at 15:11:39
In reply to Re: SAM-e Trial » Ron Hill, posted by JohnX2 on March 23, 2002, at 9:13:53
John,
I was hoping you would weigh in on this topic. As you can see by some of the posts in this thread, several people are reporting favorable results with SAM-e. It is, of course, not the answer to every psychiatric disorder under the sun, but it sure gave me my life back!
My observation (not a scientific study) is that SAM-e seems to be of particular value to depressive (especially bipolar depressive) patients that are initially hypersensitive to AD's (favorable response in a matter of days to very low dosage), but soon thereafter, suffer anergy (low drive, low energy, etc.) and anhedonia (inability to fully experience pleasure, blunted emotions, etc.). It is my layman's opinion that AD's (SSRI's in particular) lower dopamine levels and or impede DA transmission in some (most?) patients and this, in turn, causes the aforementioned symptoms. I think SAM-e is particularly useful in treating anergy and anhedonia, and that it does so by increasing the amount of DA produced by the body. Further, I (layman) hypothesize that one reason SAM-e works so well is that it increases both serotonin and dopamine in a very balanced synergistic kind of way. Okay, enough rambling, let me respond to the issues you raise.
> Maybe if I try this again I need to address the dosing scheme much more carefully. I did try SAM-E nature made brand a long way back with a placebo effect, even at a high dose. I've also gotton a placebo effect on Depakote.
By "placebo effect" I am assuming you mean that you experienced some initial sense of benefit by taking SAM-e, but the improvement was due to psychological reasons instead of physiological improvement and, therefore, the benefits did not last. Do I understand you correctly? Did you take B-6, folic acid, and SUBLINGUAL bioactive B-12 (methylcobalamin)? If you've read my posts, you know how important I think B vitamins (especially sublingual bioactive B-12) are. Were you able to take the SAM-e on a relatively empty stomach? Each morning, I eat a good breakfast, take my vitamins, wait an hour or so, and take my SAM-e dose. In your prior trial, what meds were you on? How much SAM-e did you take and for how long? Nature Made is a good enough brand, so I doubt that it was a bad product issue.>So I wonder if these enteric coated tablets aren't getting absorbed well into my body. However, other enteric coated tablets do okay (like wellbutrin). What do you think?
I doubt that this is the problem.
> Are there good brands that maybe use different fillers/binders in the pill? Does it need to get absorbed through the intestines?
Yes, as I understand it, the supplemental SAM-e must be able to find its way to the small intestines intact in order for the body to absorb it efficiently. But again, I doubt that this is a problem for you. I go back to my usual mantra; were you taking sublingual bioactive B-12 at the time of the trial?
John, I read a high percentage of your posts so, to some degree, I stay aware of your current meds and your conditions. With the exception of your recent bout with hypomania, it seems like your current med combo is working fairly well. If I remember correctly you're taking Lamictal, Serzone, and I think a benzo or something {I would stop and look it up in one of your previous posts, but too many times I've lost partially completed posts in the dialogue box by surfing other pbabble links before completing and sending off the post. Have you ever done that? Make ya mad? Does me!}.
Since your meds are working, what is prompting you to ponder SAM-e? Due to the fact that AD's were so fickle (work one day, poop-out the next) in their effectiveness for me, I would attempt to replace Serzone with SAM-e if I were in your shoes. SAM-e is smooth, even, and highly repeatable every day. That was definitely not the case with AD's, but this is just my bias.
John, given the fact that merely missing two days of Serzone induced some hypomania, I am concerned that SAM-e might cause some hypomania for you as well. SAM-e induces hypomania in me if I take more than 200 mg/day. Does increasing your Lamictal dosage improve your stability against hypomania? Have you made any decision regarding the lithium add-on to the Lamictal for more anti-mania stability?
-- Ron
poster:Ron Hill
thread:98301
URL: http://www.dr-bob.org/babble/20020322/msgs/99669.html