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Kramer: SAM-e and anxiety - options?

Posted by lizzyg on April 3, 2002, at 4:29:49

Dr Kramer

I have been successfully treated on a few occasions for major depression plus anxiety with a tricyclic (latterly Lofepramine) and a short course of a benzodiazapine until the AD kicks in. Until a few months ago, I had been symptom free for nearly seven years. This time, I have had bad side effects with the Lofepramine (why could that be - general aging? having had three babies?) so discontinued. I tried an SSRI again but couldn't tolerate the increase in anxiety and agitation, and I found Mirtazapine too sedating. I have been on SAM-e for a few weeks now and have felt some antidepressant benefit (though not as good as with Lofepramine previously). However, the anxiety is still with me, and when I try to increase the SAM-e for a greater antidepressant effect, anxiety and agitation becomes worse.

What would you recommend to counteract this anxiety? (Over here in the UK, GPs [family doctors] are extremely paranoid about benzos and are unwilling to prescribe them for longer than two weeks. Also, none of the GPs in my practice have even heard of SAM-e, but it's difficult to get a referral to a psychiatrist). Or would a better route be to try and find a more sedating AD whose side effects I can tolerate? (I haven't tried Nefazodone, for example, yet).

I'd greatly appreciate your opinion as it's difficult to get access to a specialist in this country.





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