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Dr. Bob is Robert Hsiung, MD,
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Posted by ben on April 14, 2002, at 12:43:27
Hi
Who takes SAMe in combo with ADs ? Is it dangerous to take SAMe with SSRIs or other ADs - and why ? What are the benefits from SAMe and what are the side effects ?
Posted by Ron Hill on April 18, 2002, at 19:49:38
In reply to SAMe in combo with ADs - dangerous ?!, posted by ben on April 14, 2002, at 12:43:27
Hi Ben,
> Who takes SAMe in combo with ADs ?
My pdoc prescribed SAM-e inconjunction with the SSRI Zoloft. I am bipolar II so I also take Lithobid. I weened off of Zoloft, so I only take Lithobid (600 mg/day) and SAM-e (200 mg/day). I plan to do a trial of 100 mg/day of SAM-e soon.
>Is it dangerous to take SAMe with SSRIs or other ADs - and why ?
Not that I know about, although I guess serotonin syndrome is always a possibility to watch for.
>What are the benefits from SAMe
Here's a few links to get you started:
http://www.immunesupport.com/news/SAMe2txt.htm
http://www.biopsychiatry.com/sameart.html
http://www.boehringer-ingelheim.es/workshop-methionina/anglesa/cap25.htm
http://www.psycom.net/depression.central.same.html
>and what are the side effects ?I began taking SAM-e more than five months ago. Initially I could only take one 200 mg tablet of SAM-e every other day. If I took more, I would experience side effects (flush, nausea, confused thinking, general ill feeling, "skin crawling"). Within a couple of weeks I was able to take 200 mg/day without side effects. Overall, I am very happy with SAM-e. Lately, however, I have been experiencing an irritability thing that I think is connected to taking more SAM-e than I need. Therefore, I plan to do a 100 mg/day trial soon.
Take plenty of B-6, B-12, and folate with the SAM-e to prevent the build up of homocysteine. Also bear in mind that most humans do not absorb B-12 efficiently when taken orally. Therefore, it is very important to take a sublingual (under tongue) tablet (or get B-12 injections). Further, buy the bioactive form of B-12 (Methylcobalamin). Here is a short article on the subject:
Supercharged SAM-e: B Vitamins, Folate Increase the Supplement’s Effectiveness
by ImmuneSupport.com Staff12-01-1999 - Homocysteine is a sulfur-containing amino acid involved in several important methyl and sulfur transfer reactions, and is actually beneficial in small amounts. When homocysteine levels begin to rise in the body, excessive accumulation of homocysteine in the body fluid compartments is normally prevented by degradation through two enzymatic reactions called transsulfuration and remethylation. These two processes have to be functioning for homocysteine to be kept in control and for SAM-e to function in the body. Importantly, these same enzyme reactions cannot occur without proper levels of folate, vitamin B 6 (pyridoxal 5- phosphate), and vitamin B12 (cobalamin). If you take SAM-e to promote better health (lighter mood, comfortable joints and a detoxed liver), you also need adequate levels of B vitamins and folic acid to help the SAM-e do its job.
When the body has proper levels of folic acid, Vitamins B6 and B12, the enzymatic break-down of homocysteine occurs either through remethylation, which converts it into methionine, the SAM-e building block; or through transsulfuration, which turns it into glutathione, a powerful antioxidant.
But when those processes become sluggish, the homocysteine levels in the body begin to rise. Large homocysteine levels left unchecked in the body, become an invitation to disease, including heart attack, stroke, cancer, birth defects, depression and perhaps CFS and FM.
A published Swedish study showed results of which demonstrate consistently high homocysteine levels and low concentrations of vitamin B12 in the cerebrospinal fluid (CSF) of patients meeting established clinical criteria for Chronic Fatigue Syndrome and Fibromyalgia.
Those taking SAM-e should be aware that the healthy benefits they experience are not due to SAM-e alone. SAM-e may be the “team leader” however, folic acid, vitamin B6 and vitamin B12 are crucial members of the team that contribute to its success. It is only by incorporating the entire team that one can achieve the victory of better health and well-being.
Source:
Evarts, Jeremy Lucius. “New Study Links Fibromyalgia and Chronic Fatigue Syndrome to Low Vitamin B12 and High Homocysteine in Cerebrospinal Fluid.” Healthwatch, August 1998.
Cowley, Geoffrey and Underwood, Anne. "What is SAMe?" Newsweek, July 5, 1999.
Brown, Richard, M.D., Bottigileri, Teodoro, Ph.D., Colman, Carol. Stop Depression Now. New York, 1999.
Posted by Lia Mason on April 18, 2002, at 22:40:38
In reply to SAMe in combo with ADs - dangerous ?!, posted by ben on April 14, 2002, at 12:43:27
I take 1200 Sam-e with 37.5 effexor and 120 imipramine. I've taken ame-e at this dose with up to 75 effexor and (before effexor) I took it with 50 prozac.
Sam-e worked alone for me for a good year. Then I had some health problems (unrelated to sam-e) that were major stresses so I added additional antidepressant.
I have no side effects at all from sam-e. The major downside is cost. I'm unfortunately not one of those people who can take a small dose. I didn'tsee results until 1200.
L
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