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Re: SAM-e Trial » JohnX2

Posted by Ron Hill on April 8, 2002, at 13:11:31

In reply to Re: SAM-e Trial » Ron Hill, posted by JohnX2 on April 6, 2002, at 15:23:05

John,

Thanks for your reply. Just a couple comments:

> I always thought SAM-E was a good concept. I believed it could work. The only thing I don't like about it is the price.

A Double E worried about a couple bucks a day for a month or two to facilitate the trial? ($2 for 800 mg/day). What's wrong with this picture?

> > 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?

> I have a weird problem with Lamictal and some other meds, if I raise the dose above a certain level, they induce myofacial pain and sometimes they blunt out my emotions. Zoloft was really bad. Lamictal does this at doses above 150 mg. Serzone fixes this problem. It seems to be related to a gating of serotonin/dopamine interactions (Serzone blocking offensive serotonin receptors). Specifically blockade of 5-ht2 receptors increases dopamine in the (pre)frontal cortex where there are dopamine neurons that inhibit facial muscle contractions, also hypodopaminergic states in the frontal cortex lead to "blunted emotions" such as symtoms similarly described like a "negative psychosis" in schizophrenia. That's why the atypical neuroleptics block the serotonin 5-ht2a receptors (as does serzone and remeron). (Maybe some swagging on behalf here...)

What about about using a low dose of lithium as an add-on to the Lamictal to improve anti-mania stability? If I remember correctly, you were thinking about doing this a few weeks ago. In your case, I would be concerned that SAM-e might induce hypomania without more mood stabilizer.

-- Ron


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