Posted by bleauberry on January 30, 2008, at 20:15:04
In reply to Sam-e as an adjunct to an AD, posted by bulldog2 on January 28, 2008, at 14:38:33
I have seen SAMe combined with tricyclics in studies. I don't recall seeing it with ssris, though I'm sure it has been done. I took it with prozac for a couple weeks, but prozac was already too stimulating at that time of my life and SAMe made it even more so. It did have a good effect though in the ways you are looking for.
Most people who buy SAMe at the drug store are elderly folks using it for arthritis, joint pains, or liver health. I suspect many of them are on other drugs including psychiatric drugs. So it is my guess these combos happen by the hundreds or thousands every day.
As Racer said, two issues to watch for are homocysteine and mania. Homocysteine can be lowered with suggestion from Racer, or with 200%RDA of folic acid and B12. Deplin would also be a good candidate for the mood and homocysteine stuff. SAMe is usually stimulating, especially in the first weeks before adjusting to it. Common side effects could be agitation, irritation, and insomnia, which would be hard to distinguish as early side effects or triggering a dysphoric type of mania. Just be on the lookout, go slow and easy. Maybe start with 200mg every other day, work up to 200mg every day, then bump it up slowly higher if needed and all is well. If mania happens it is my guess it would creep in with a subtle fashion, not an overnight explosion kind of thing. Keeping a daily diary would help spot any troublesome changes. All that being said, SAMe can be highly effective and free of side effects. It's just that most websites promote all the good stuff but don't warn much about the possible negatives, or they just briefly mention the negatives.
I have browsed a lot of forums looking at people who have tried SAMe. Honestly, most of them do experience the stimulation side of it, most of them do get some kind of benefit from it, and I have not actually seen anyone report mania from it.
Serotonin syndrome. I doubt this would happen. But, it would be a good idea to google it, become familiar with the symptoms, and keep a watch out.
I just like to play it safe. Honestly, I think SAMe should be smooth sailing if you go slow and easy.
poster:bleauberry
thread:809368
URL: http://www.dr-bob.org/babble/neuro/20080114/msgs/809813.html