![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by colin wallace on March 1, 2002, at 14:02:45
Having had unprecedented success on ol' sammy, I find that 300 mg is enough for me- unfortunately it only seems to be available in 200mg doses.Trying to split one of these enterically coated pills is like trying to shave with a swiss army knife- tricky to say the least.Besides which, this compound degrades in seconds when exposed to air, so the other half of the pill is useless.Does anyone know of a manufacturer that churns out sammy at 100mg doses?
Posted by Ron Hill on March 2, 2002, at 9:17:53
In reply to Does Sam-e come in 100mg tabs? , posted by colin wallace on March 1, 2002, at 14:02:45
Colin,
I've wondered the same thing but I've not yet found a 100 mg SAM-e tablet. If you find such a product please post it.
Also, as I understand it, the primary purpose of the coating is to prevent dissolution in the stomach so the SAM-e gets to the small intestines where it can be effectively absorbed. Therefore, it seems to me that by cutting the tablet you may be wasting both halves. Have you tried alternating between 200 mg and 400 mg every other day? When I first started SAM-e 200 mg every day was too much so I alternated between 200 mg and 0 mg every other day. It worked ok, but 100 mg daily would have worked better.
-- Ron
------------------------------------------------> Having had unprecedented success on ol' sammy, I find that 300 mg is enough for me- unfortunately it only seems to be available in 200mg doses.Trying to split one of these enterically coated pills is like trying to shave with a swiss army knife- tricky to say the least.Besides which, this compound degrades in seconds when exposed to air, so the other half of the pill is useless.Does anyone know of a manufacturer that churns out sammy at 100mg doses?
Posted by colin wallace on March 2, 2002, at 12:33:58
In reply to Re: Does Sam-e come in 100mg tabs? » colin wallace, posted by Ron Hill on March 2, 2002, at 9:17:53
Hi Ron,
Well, it seems we're in luck; You can now order Sam-e 100 mg tablets at Fibromyalgiasupport.com, and also they've been newly introduced by GNC at Drugstore.com .(They're on special offer on both sites, but drugstore.com doesn't ship outside the US, so that's me scuppered as far the GNC brand goes).
Like you I've done pretty thorough research on Sam-e,and am now trying the Nature Made brand ;I have been taking Nutralife(Tosylate formation)with great success, but as mentioned I cannot really take the full 400mg without experiencing overstimulation.I'm also sensitive to most meds, and respond best to small doses.As of today, I am reducing my sam-e to 200mg and adding 20 mg prozac.I'll probably increase to 300mg sam-e (when I get around to ordering the new 100mg batch).-I must say, thus far, I feel quite comfortable on this (shockingly expensive) combination.I haven't had any positives with SSRI's previously, and I'm pinning my hopes on the (putative) dopamine elevating properties of sam-e helping with any ssri agitation I may experience.
Incidentally, when splitting a 200mg sam-e pill, Iv'e felt instantaneous uplifting effects from the half I've taken straightaway.The received wisdom is that if sam-e is absorbed in the stomach in this manner, it won't cross the blood/brain barrier, rendering the pill useless.Perhaps it renders it less effective, but I hardly noticed.Still, a 100mg would be much easier.
Posted by Ron Hill on March 3, 2002, at 11:50:35
In reply to Re: Does Sam-e come in 100mg tabs?Ron Hill, posted by colin wallace on March 2, 2002, at 12:33:58
Colin,
Thank you much for the 100 mg web sites and other information.
I take SAM-e on an empty stomach in accordance with product directions. However, it usually leaves me feeling nauseous for a few hours. Does this happen to you also? If so, have you found a solution to the problem? I wonder how drastic the loss of product effectiveness is if it is taken with a small amount of food?
-- Ron
---------------------------------------> Hi Ron,
>
> Well, it seems we're in luck; You can now order Sam-e 100 mg tablets at Fibromyalgiasupport.com, and also they've been newly introduced by GNC at Drugstore.com .(They're on special offer on both sites, but drugstore.com doesn't ship outside the US, so that's me scuppered as far the GNC brand goes).
> Like you I've done pretty thorough research on Sam-e,and am now trying the Nature Made brand ;I have been taking Nutralife(Tosylate formation)with great success, but as mentioned I cannot really take the full 400mg without experiencing overstimulation.I'm also sensitive to most meds, and respond best to small doses.As of today, I am reducing my sam-e to 200mg and adding 20 mg prozac.I'll probably increase to 300mg sam-e (when I get around to ordering the new 100mg batch).-I must say, thus far, I feel quite comfortable on this (shockingly expensive) combination.I haven't had any positives with SSRI's previously, and I'm pinning my hopes on the (putative) dopamine elevating properties of sam-e helping with any ssri agitation I may experience.
> Incidentally, when splitting a 200mg sam-e pill, Iv'e felt instantaneous uplifting effects from the half I've taken straightaway.The received wisdom is that if sam-e is absorbed in the stomach in this manner, it won't cross the blood/brain barrier, rendering the pill useless.Perhaps it renders it less effective, but I hardly noticed.Still, a 100mg would be much easier.
Posted by beardedlady on March 3, 2002, at 15:26:48
In reply to Re: Does Sam-e come in 100mg tabs?Ron Hill, posted by colin wallace on March 2, 2002, at 12:33:58
Colin:
I saw the Nature Made Sam-e at Costco yesterday for $45 (80 pills, I think) and was tempted to buy it, but it was ridiculously expensive. The instructions said to take the pill twice a day on an empty stomach. I didn't notice the mg. (do you know how many?), but I did see that a B complex was recommended.
I'm as sensitive as everyone else, it seems, when it comes to meds. I've been on Serzone for panic related only to sleep, and it has helped me for three years. Now I'm being switched to Gabitril (I'd rather not hear anything negative, please, since we are all different and respond to meds differently), and the Serzone is being tapered off (eventually).
Does Sam-e negatively affect sleep? Are there better times of day to take it? I just started a B complex this morning with breakfast, and I have felt okay--no difference really--today. But because I am new to vitamins, I don't really know what is good and how long it takes to feel changes.
I'd love to know if Sam-e might be good for my sleep problem and my daily lack of energy and at what dose.
Thanks in advance.
beardedlady (not really)
Posted by colin wallace on March 4, 2002, at 3:29:24
In reply to Re: Does Sam-e come in 100mg tabs? » colin wallace, posted by beardedlady on March 3, 2002, at 15:26:48
Hi there,
Sam-e is usually taken in 200 mg tablets-the recommended starting dose being two tabs (400mg),either singly or in divided doses, and preferably an hour or so before meals.Like most meds., the dose related response seems to vary fairly widely amongst individuals (Both Ron and I seem to fare best on lower doses, whereas some need to take as much as 800/1200mg).I have found that as little as 300mg is capable of fending off much of my depression (more so in fact than any other med. I have tried.)It also provides a pleasantly stimulating experience (for me) and seems to help with daytime wakefulness/alertness.I get absolutely zero side-effects (other than a slight overstimulation if I exceed my personal 300mg threshold).
If you are sensitive to meds., if I were you I'd begin at a cautious 100 or 200mg pill; you'll probably find you need less due to being on other meds aswell.Give it a week or so, and if all's fine, move up to 300 or 400mg.It doesn't interact with prescription meds, but you can feel overstimulated as I mentioned.
Also, its best to take sam-e earlier in the day- too late and it can negatively affect sleep.
It's definitely not meant to be used as an aid to sleep.
Give it a try??!
Posted by colin wallace on March 4, 2002, at 3:44:07
In reply to Re: Does Sam-e come in 100mg tabs? » colin wallace, posted by Ron Hill on March 2, 2002, at 9:17:53
Hi Ron,
I did get a (very mild) stomach upset when I first started taking sammy at 400mg.You've nailed the answer though- taking it closer to/with meals until the irritation subsides is the ploy I used- worked for me, and didnt impact its effectiveness either to be honest.Within a few weeks I could take it as normal (empty stomach).
I've added prozac recently, but seem to get that annoying jitteriness, and lack of mental clarity, forgetfulness.I'm only taking one 20mg capsule on alternate days, but I'm not sure I can put up with feeling 'spaced' for long.On the other hand, perhaps it's worth persevering for month or so trial. hmmmm.I like unmedicated normality of sam-e, but really need just a little something extra!!
Posted by Ron Hill on March 4, 2002, at 14:50:23
In reply to Re: Does Sam-e come in 100mg tabs?ron hill, posted by colin wallace on March 4, 2002, at 3:44:07
Thanks for your response Colin. Good luck with the low dose Prozac trial!
-- Ron
------------------
> Hi Ron,
>
> I did get a (very mild) stomach upset when I first started taking sammy at 400mg.You've nailed the answer though- taking it closer to/with meals until the irritation subsides is the ploy I used- worked for me, and didnt impact its effectiveness either to be honest.Within a few weeks I could take it as normal (empty stomach).
> I've added prozac recently, but seem to get that annoying jitteriness, and lack of mental clarity, forgetfulness.I'm only taking one 20mg capsule on alternate days, but I'm not sure I can put up with feeling 'spaced' for long.On the other hand, perhaps it's worth persevering for month or so trial. hmmmm.I like unmedicated normality of sam-e, but really need just a little something extra!!
Posted by Ron Hill on March 4, 2002, at 16:20:56
In reply to Re: Does Sam-e come in 100mg tabs? » colin wallace, posted by beardedlady on March 3, 2002, at 15:26:48
Ms. B. Lady;
May I also respond to this post that you addressed to Colin?
> I saw the Nature Made Sam-e at Costco yesterday for $45 (80 pills, I think) and was tempted to buy it, but it was ridiculously expensive.
If you take two of the 200 mg tablets daily, the cost is only about a buck a day which is cheap if it works for you.
> Does Sam-e negatively affect sleep? Are there better times of day to take it?
Like Colin said, it is best to take it earlier in the day (say before 5 pm) so that the SAM-e does not interfer with your sleep. However, having said that, SAM-e gives me energy during the day AND as a result I sleep better at night.
> I just started a B complex this morning with breakfast, and I have felt okay--no difference really--today. But because I am new to vitamins, I don't really know what is good and how long it takes to feel changes.
Take plenty of B-6, B-12, and folate if you take SAM-e to avoid a build up of homocystiene. Use a sublingual (dissolves under tongue) form of B-12.
> I'd love to know if Sam-e might be good for my sleep problem and my daily lack of energy and at what dose.
It has done wonders for my lack of energy problems and has also improved my sleep.
I have discussed my SAM-e experience in greater detail in prior posts. Please click on the link below to one of my earlier posts, read it and access the links provided therein.
http://www.dr-bob.org/babble/20020301/msgs/96055.html
Best Wishes,
Ron
Posted by beardedlady on March 4, 2002, at 18:47:56
In reply to Re: Does Sam-e come in 100mg tabs? » beardedlady, posted by Ron Hill on March 4, 2002, at 16:20:56
Posted by lizzyg on March 6, 2002, at 5:32:12
In reply to Re: Does Sam-e come in 100mg tabs?Ron Hill, posted by colin wallace on March 2, 2002, at 12:33:58
Hi Colin
You seem pretty knowledgeable about SAM-e, and I wonder if you're based in the UK as I am? Having read up, I decided to give SAM-e a go because of bad side effects from a previously tolerated tricyclic (Lofepramine) and from Citalopram (agitation/anxiety) and Mirtazapine (total somnolence). The only brand of SAM-e I could get hold of from local health food shops is Natrol which is extremely expensive (£32 for 20 X 200mg) and I haven't seen it mentioned in any articles about 'gold standard' products.
Do you know which internet stockists ship overseas or - if you're based in the UK - where you can buy the recommended brands (Nature Made, GNC, Solgar etc)?
Many thanks for your help.
Lizzy
> Hi Ron,
>
> Well, it seems we're in luck; You can now order Sam-e 100 mg tablets at Fibromyalgiasupport.com, and also they've been newly introduced by GNC at Drugstore.com .(They're on special offer on both sites, but drugstore.com doesn't ship outside the US, so that's me scuppered as far the GNC brand goes).
> Like you I've done pretty thorough research on Sam-e,and am now trying the Nature Made brand ;I have been taking Nutralife(Tosylate formation)with great success, but as mentioned I cannot really take the full 400mg without experiencing overstimulation.I'm also sensitive to most meds, and respond best to small doses.As of today, I am reducing my sam-e to 200mg and adding 20 mg prozac.I'll probably increase to 300mg sam-e (when I get around to ordering the new 100mg batch).-I must say, thus far, I feel quite comfortable on this (shockingly expensive) combination.I haven't had any positives with SSRI's previously, and I'm pinning my hopes on the (putative) dopamine elevating properties of sam-e helping with any ssri agitation I may experience.
> Incidentally, when splitting a 200mg sam-e pill, Iv'e felt instantaneous uplifting effects from the half I've taken straightaway.The received wisdom is that if sam-e is absorbed in the stomach in this manner, it won't cross the blood/brain barrier, rendering the pill useless.Perhaps it renders it less effective, but I hardly noticed.Still, a 100mg would be much easier.
Posted by colin wallace on March 6, 2002, at 12:15:05
In reply to Re: Does Sam-e come in 100mg tabs?Ron Hill » colin wallace, posted by lizzyg on March 6, 2002, at 5:32:12
Hi Liz,
Yeah, I'm here in Gloomsville UK too; I'm surprised you managed to discover anywhere here that actually sells sam-e.In every health store I've ever inquired at, I've been met with blank stares, and suggestions that I must have got the product name wrong!I didn't think it was approved for sale here yet.
Anyway, 32 quid is extortionate, especially for a little known brand that may not even be a stable compound (maybe it is, but it's still steep)>Here's where I got mine from the States:http://www.store.yahoo.com/sam-esource/index.html
(I got stung for a hefty import tax on one brand, but not when I ordered six boxes from this site- I think its just (bad)luck if you do!)
Posted by Ron Hill on March 6, 2002, at 14:11:40
In reply to Re: Does Sam-e come in 100mg tabs?Ron Hill » colin wallace, posted by lizzyg on March 6, 2002, at 5:32:12
Lizzy,
Hope its ok if I jump in and add my 2 cents. May be of help or maybe not, but click here to find out: http://www.dr-bob.org/babble/20020301/msgs/96734.html
-- Ron
-------------------------> Hi Colin
>
> You seem pretty knowledgeable about SAM-e, and I wonder if you're based in the UK as I am? Having read up, I decided to give SAM-e a go because of bad side effects from a previously tolerated tricyclic (Lofepramine) and from Citalopram (agitation/anxiety) and Mirtazapine (total somnolence). The only brand of SAM-e I could get hold of from local health food shops is Natrol which is extremely expensive (£32 for 20 X 200mg) and I haven't seen it mentioned in any articles about 'gold standard' products.
>
> Do you know which internet stockists ship overseas or - if you're based in the UK - where you can buy the recommended brands (Nature Made, GNC, Solgar etc)?
>
> Many thanks for your help.
>
> Lizzy
>
> > Hi Ron,
> >
> > Well, it seems we're in luck; You can now order Sam-e 100 mg tablets at Fibromyalgiasupport.com, and also they've been newly introduced by GNC at Drugstore.com .(They're on special offer on both sites, but drugstore.com doesn't ship outside the US, so that's me scuppered as far the GNC brand goes).
> > Like you I've done pretty thorough research on Sam-e,and am now trying the Nature Made brand ;I have been taking Nutralife(Tosylate formation)with great success, but as mentioned I cannot really take the full 400mg without experiencing overstimulation.I'm also sensitive to most meds, and respond best to small doses.As of today, I am reducing my sam-e to 200mg and adding 20 mg prozac.I'll probably increase to 300mg sam-e (when I get around to ordering the new 100mg batch).-I must say, thus far, I feel quite comfortable on this (shockingly expensive) combination.I haven't had any positives with SSRI's previously, and I'm pinning my hopes on the (putative) dopamine elevating properties of sam-e helping with any ssri agitation I may experience.
> > Incidentally, when splitting a 200mg sam-e pill, Iv'e felt instantaneous uplifting effects from the half I've taken straightaway.The received wisdom is that if sam-e is absorbed in the stomach in this manner, it won't cross the blood/brain barrier, rendering the pill useless.Perhaps it renders it less effective, but I hardly noticed.Still, a 100mg would be much easier.
Posted by lizzyg on March 7, 2002, at 7:30:57
In reply to Re: Does Sam-e come in 100mg tabs?Lizzy G., posted by colin wallace on March 6, 2002, at 12:15:05
Colin and Ron - thanks for your help on SAM-e sources, I'll do my next order online. Are you working with your doctors on using this medication? My GP (family doctor) practice is supremely uninformed/uninterested in depression, so I'm going it alone, and would appreciate your input. I'm only on my fourth day (starting at 200mg in the morning), and haven't felt any benefits yet. But - on the upside - no major side effects: slight nausea, headache and dry mouth, and a bit 'out of kilter' with thought and concentration as with any AD. I'm just taking a high dose vitamin B complex as well; do you recommend anything else? Have you tried EPA (fish oil) capsules as there seems to be some scientific validity for these?
Would appreciate any other tips.
Lizzy
Posted by Ron Hill on March 7, 2002, at 12:58:51
In reply to Re: Does Sam-e come in 100mg tabs?Lizzy G. » colin wallace, posted by lizzyg on March 7, 2002, at 7:30:57
Lizzy,
>Are you working with your doctors on using this medication?
My pdoc told me to take it.
>My GP (family doctor) practice is supremely uninformed/uninterested in depression, so I'm going it alone, and would appreciate your input.
Why not see a pdoc instead of the GP?
>I'm only on my fourth day (starting at 200mg in the morning), and haven't felt any benefits yet. But - on the upside - no major side effects: slight nausea, headache and dry mouth, and a bit 'out of kilter' with thought and concentration as with any AD.
I hope SAM-e works for you, it sure does for me. Stay with it. I had simillar side effects initially, but they subsided, for the most part, after finding the correct dose. I still get slight nausea and/or vertigo if I take it on an empty stomach. Therefore, I often take a small portion of food with the SAM-e. The small amount of food does not seem to adversely alter the effectiveness of the SAM-e. Lizzy, please continue to post regarding the effectiveness/ineffectiveness of this SAM-e trial.
>I'm just taking a high dose vitamin B complex as well; do you recommend anything else?
Remember, it is very important to take adequate amounts of B-6, B-12, and folate to prevent the build up of homocystiene. I'm sure your B-complex is adequate to supply the B-6 and folate. However, most people do not absorb B-12 effectively when taken orally. In other words, a very high percentage of the B-12 in your B-complex vitamin probably ends up in your urine. Therefore, it is important to take B-12 sublingually (under the tonge) so that the B-12 can be routed directly to your bloodstream. I take 1000 mcg of the bioactive form of B-12 (methylcobalamin) in a sublingual tablet daily. Buy some. It is important.
>Have you tried EPA (fish oil) capsules as there seems to be some scientific validity for these?
Yes, omega-3 essential fatty acids (salmon oil) is beneficial to me as a bipolar patient. For me the fish oil acts like a mood stablizer, whereas, the SAM-e acts as an antidepressant
> Would appreciate any other tips.Keep in mind that SAM-e can induce mania in bipolar patients without a mood stablizer. Nothing I've read of your posts state that you have a bipolar dx. However, I list the counterindication for completeness.
-- Ron
Posted by colin wallace on March 8, 2002, at 4:54:31
In reply to Re: Does Sam-e come in 100mg tabs?Lizzy G. » colin wallace, posted by lizzyg on March 7, 2002, at 7:30:57
Hi Liz,
I'm afraid I'm going it alone with the sam-e too-My GP was at best sceptical of my intended sam-e experiment (especially as it entailed coming off effexor completely- a course which he seemed to believe was tantamount to suicide in my case).
Puzzlement and incredulity might best describe the reaction now- although I have 'switched' GP's and found one who is receptive to new ideas.
I think you said you'd recently come off prescription medication (lofepramine, zispin?)
If so, the sam- e effect will be less noticable at first as your brain re-adjusts itself for a few weeks.It should actually help with the transition (coming off meds).Personally, I took 400 mg at the end of my first week, then daily for a few months.As the effexor effects wore off, the sam-e effects became more apparrent, and I discovered that 400mg left me feeling overstimulated, and 200mg was too little (hence the pill splitting/alternating).Remember, coming off meds. is fraught with side effects in itself-this could account for the confused feelings etc.(or it may well be the sam-e).
Either way, it will settle down.Personally, I'd move up to 400 mg after a week, and keep it there for perhaps a month, to give everything a chance to normalize and re-adjust.People's responses to different doses sam-e seem to vary widely,and I'd say that after a month at 400mg, you 'll be better placed to gauge your own response.Overstimulation or anxiety,upset stomach etc, then perhaps 300mg would suit you too (or even 200mg).Nothing noticable-then move up to 600mg etc.This of course is just the way I approached it, and it worked for me.
Perhaps Ron may have a different angle/input, although we both seem to respond to lower doses.It is defeinitely worth persevering here, because this stuff brought me back into the land of the living where all else failed!
Hope it goes well anyway.
Right now, I'm idling by at 300mg of sam-e for two days, and 20 mg of prozac alone on the third.Because of the long half-life of prozac, it roughly works out at 7mg per day- enough for me as I'm med. sensitive.(I only added the small dose prozac because 400 mg sam-e daily is too much of an overstim. for me.)
When I think that two years ago I was on 90 mg (yes, 90mg!) of mirtazapine, I feel i've worked things out for myself the hard way!!!
Posted by lizzyg on March 8, 2002, at 6:59:44
In reply to Re: Sam-e » lizzyg, posted by Ron Hill on March 7, 2002, at 12:58:51
Ron - thanks for your advice on this. I'll get a sublingual B12 and will try the fish oil. I'm unipolar, but I've read articles that seem to feel it helpful for both bipolar and unipolar.
Re: psychiatrists, here in the UK you have to have be referred by your GP, which isn't always easy, unless you're really desperate. It would be nice to have a bit more consumer choice, I must admit!
Will keep you posted as to progress.
Lizzy
Posted by lizzyg on March 8, 2002, at 8:03:57
In reply to Re: Does Sam-e come in 100mg tabs?Lizzy G., posted by colin wallace on March 8, 2002, at 4:54:31
Colin - thanks for your help and advice. I'll try 400mg of SAM-e next week, but I have a small frame and am quite sensitive to medication, so I suspect 300mg might suffice for me, too.
The Lofepramine and Citalopram had washed out of my system before I tried the Mirtazapine, and I couldn't stick with that at all as I just couldn't function. 90mg sounds a lot; I suppose it must be true that it's less sedating at higher doses?
So I think I was pretty 'clear' before I started the SAM-e. Fingers crossed it will kick in soon; I'll let you know...
Lizzy
Posted by Ron Hill on March 8, 2002, at 14:06:11
In reply to Re: Does Sam-e come in 100mg tabs?Lizzy G. » colin wallace, posted by lizzyg on March 8, 2002, at 8:03:57
Liz,
Keep in mind that both Colin and myself are taking a very small dose of SSRI in conjunction with the SAM-e. On the average, Colin takes about 7 mg of Prozac daily and I take 12.5 mg of Zoloft.
I plan to eventually stop the Zoloft because I feel sure that the SAM-e will provide a good antidepressant effect without the SSRI add-on. However, until I try it, I do not have first hand experience regarding the effectiveness of SAM-e without a small amount of SSRI add-on.
I am currently doing absolutely great and I refuse to change anything in my meds 'cause I don't want to take any chance on messing up a good thing. This is my only reason for continuing the low dose of Zoloft.
I've written this post only to make it clear to you that, based on the research I've read, I feel sure that SAM-e can function as an effective AD on it own. However, as it currently stands, I have no first hand experience using SAM-e alone.
-- Ron
------------------------------------------------> Colin - thanks for your help and advice. I'll try 400mg of SAM-e next week, but I have a small frame and am quite sensitive to medication, so I suspect 300mg might suffice for me, too.
>
> The Lofepramine and Citalopram had washed out of my system before I tried the Mirtazapine, and I couldn't stick with that at all as I just couldn't function. 90mg sounds a lot; I suppose it must be true that it's less sedating at higher doses?
>
> So I think I was pretty 'clear' before I started the SAM-e. Fingers crossed it will kick in soon; I'll let you know...
>
> Lizzy
Posted by Lizzy G on March 12, 2002, at 9:20:22
In reply to Re: Sam-e in conjunction with AD » lizzyg, posted by Ron Hill on March 8, 2002, at 14:06:11
Ron - thanks for all your information. In the US you are much more at ease with combining meds than in this country - we seem really behind on the experimentation front.
So far the SAM-e seems to be working pretty well, but this depressive episode is different from my history.
All previous attacks have been biochemical in origin - at times when I have been content with life - so when the medication has reached a therapeutic level, the depression and anxiety have lifted, and I've been back to my usual self. However, this time, the depression has been triggered by an external event (bereavement) and is not as severe as previously. Mixed in with the 'abnormal' depression and anxiety are 'normal' feelings of grief and loss, so I'm not experiencing the same mood lightening from the medication as I have in the past. But I've definitely noticed some improvement and am going to keep on trying with an elevated dose.
Do you have any experience/views about augmenting the SAM-e with 5-HTP? Also, have you ever tried an alternative remedy for anxiety, such as kava kava? I have a supply of Oxazepam in my armoury, but haven't taken any since being on the SAM-e, and wondered if you could recommend anything other than the benzos.
With thanks
Lizzy
Posted by Ron Hill on March 12, 2002, at 12:44:03
In reply to Re: Sam-e in conjunction with AD » Ron Hill, posted by Lizzy G on March 12, 2002, at 9:20:22
Lizzy,
> So far the SAM-e seems to be working pretty well, but this depressive episode is different from my history.
I'm glad to hear that you are finding some benefit from SAM-e. Please continue to post periodically regarding the effectiveness/ineffectiveness of the SAM-e.
> However, this time, the depression has been triggered by an external event (bereavement) and is not as severe as previously.I am very sorry for your loss. Do you think it might help if you met with a counselor (psychologist)?
> Do you have any experience/views about augmenting the SAM-e with 5-HTP?
No, I've never tried 5-HTP nor have I read anything regarding this combination. I might try it when I wean myself off of my small Zoloft dose (my daily meds; 600 mg Lithobid, 12.5 mg Zoloft, 200 mg SAM-e). One thing that SAM-e and 5-HTP have in common is that they are both expensive supplements!
>Also, have you ever tried an alternative remedy for anxiety, such as kava kava?
I have very little experience with kava kava. I used it a couple of times as a sleep-aid and I felt a slight "hangover" the next day. However, your mileage may vary. What are your anxiety symptoms? Is it an irritable rage thing or a fear and hiding thing?
>I have a supply of Oxazepam in my armoury, but haven't taken any since being on the SAM-e, and wondered if you could recommend anything other than the benzos.
For quite sometime I have been considering adding a small amount of gabapentin (Neurontin) to my Lithobid. As you know, Neurontin is an anti-epileptic drug (AED) used also as a mood stabilizer. It has some anti-anxiety features. Does the addictive potential of the benzos concern you?
-- Ron
Posted by lizzyg on March 13, 2002, at 7:04:31
In reply to Re: Sam-e in conjunction with AD, posted by Ron Hill on March 12, 2002, at 12:44:03
Ron - a couple more answers and questions...
Thanks for your kind thoughts - I might pursue seeing a bereavement counsellor. My anxiety symptoms are physical agitation, lightheadedness, racing thoughts and a sense of impending doom; no rage or irritability. I'm not particularly concerned about the addictive potential of benzos: I've only used them on an 'as needed' basis rather than to a regular schedule. As usual, however, our uninformed GPs (family doctors) over here seem very uptight, and are only prepared to write prescriptions for small amounts.
As cost isn't really an issue, do you think the 5-HTP might help both with the depression and anxiety - I seem to remember reading that it had sedative/anxiolytic properties? I assume there wouldn't be any bad reaction from the combination of SAM-e and 5-HTP?
Thank you for your help again.
Lizzy
> Lizzy,
>
> > So far the SAM-e seems to be working pretty well, but this depressive episode is different from my history.
>
> I'm glad to hear that you are finding some benefit from SAM-e. Please continue to post periodically regarding the effectiveness/ineffectiveness of the SAM-e.
>
> > However, this time, the depression has been triggered by an external event (bereavement) and is not as severe as previously.
>
> I am very sorry for your loss. Do you think it might help if you met with a counselor (psychologist)?
>
> > Do you have any experience/views about augmenting the SAM-e with 5-HTP?
>
> No, I've never tried 5-HTP nor have I read anything regarding this combination. I might try it when I wean myself off of my small Zoloft dose (my daily meds; 600 mg Lithobid, 12.5 mg Zoloft, 200 mg SAM-e). One thing that SAM-e and 5-HTP have in common is that they are both expensive supplements!
>
> >Also, have you ever tried an alternative remedy for anxiety, such as kava kava?
>
> I have very little experience with kava kava. I used it a couple of times as a sleep-aid and I felt a slight "hangover" the next day. However, your mileage may vary. What are your anxiety symptoms? Is it an irritable rage thing or a fear and hiding thing?
>
> >I have a supply of Oxazepam in my armoury, but haven't taken any since being on the SAM-e, and wondered if you could recommend anything other than the benzos.
>
> For quite sometime I have been considering adding a small amount of gabapentin (Neurontin) to my Lithobid. As you know, Neurontin is an anti-epileptic drug (AED) used also as a mood stabilizer. It has some anti-anxiety features. Does the addictive potential of the benzos concern you?
>
> -- Ron
Posted by Ron Hill on March 13, 2002, at 9:37:09
In reply to Re: Sam-e in conjunction with AD » Ron Hill, posted by lizzyg on March 13, 2002, at 7:04:31
Lizzy,
>My anxiety symptoms are physical agitation, lightheadedness, racing thoughts and a sense of impending doom; no rage or irritability.
The "racing thoughts" makes your symptoms sound to me (a total layman) a little bit like a dysphoric hypomania, but you've never posted a dx of bipolar.
> As cost isn't really an issue, do you think the 5-HTP might help both with the depression and anxiety - I seem to remember reading that it had sedative/anxiolytic properties?
Lizzy, I know virtually zero about 5-HTP. Others on this board can better help you with 5-HTP questions. All I know is what you already know, which is that 5-HTP is a precussor to serotonin. As such, it would seem unlikely to me (a layman) that it would have substantial anxiolytic properties. I (a layman) typically associate anxiolytic effects with meds, herbs, or supplements that influence the neurotransmitter GABA.
Yesterday Misty posted an interesting link to a site with good information on St. John's Wort. According to the documentation on the site, St. John's Wort is a reuptake inhibitor of GABA (as well as serotonin, norepinphrine, and dopamine) and, therefore, has anxiolytic properties. Here is a link to Misty's post:
http://www.dr-bob.org/babble/20020307/msgs/97197.html>I assume there wouldn't be any bad reaction from the combination of SAM-e and 5-HTP?
The only thing that comes to my mind is Serotonin Syndrome since both SAM-e and 5-HTP can increase serotonin in the brain. I doubt this is very likely since it appears safe to combine SAM-e with an SSRI. I've never read of any adverse reaction, so I'm just guessing. As I read your past posts I gather that you are not currently taking any prescription medication but, instead, just SAM-e. Is this correct?
-- Ron
PS You have two screen names, huh? Lizzy G and lizzyg.
-------------------------------------------Lizzy,
> > > So far the SAM-e seems to be working pretty well, but this depressive episode is different from my history.
> >
> > I'm glad to hear that you are finding some benefit from SAM-e. Please continue to post periodically regarding the effectiveness/ineffectiveness of the SAM-e.
> >
> > > However, this time, the depression has been triggered by an external event (bereavement) and is not as severe as previously.
> >
> > I am very sorry for your loss. Do you think it might help if you met with a counselor (psychologist)?
> >
> > > Do you have any experience/views about augmenting the SAM-e with 5-HTP?
> >
> > No, I've never tried 5-HTP nor have I read anything regarding this combination. I might try it when I wean myself off of my small Zoloft dose (my daily meds; 600 mg Lithobid, 12.5 mg Zoloft, 200 mg SAM-e). One thing that SAM-e and 5-HTP have in common is that they are both expensive supplements!
> >
> > >Also, have you ever tried an alternative remedy for anxiety, such as kava kava?
> >
> > I have very little experience with kava kava. I used it a couple of times as a sleep-aid and I felt a slight "hangover" the next day. However, your mileage may vary. What are your anxiety symptoms? Is it an irritable rage thing or a fear and hiding thing?
> >
> > >I have a supply of Oxazepam in my armoury, but haven't taken any since being on the SAM-e, and wondered if you could recommend anything other than the benzos.
> >
> > For quite sometime I have been considering adding a small amount of gabapentin (Neurontin) to my Lithobid. As you know, Neurontin is an anti-epileptic drug (AED) used also as a mood stabilizer. It has some anti-anxiety features. Does the addictive potential of the benzos concern you?
> >
> > -- Ron
Posted by lizzyg on March 13, 2002, at 10:05:18
In reply to Re: 5-HTP in conjunction SAM-e » lizzyg, posted by Ron Hill on March 13, 2002, at 9:37:09
Hi Ron - no, definitely not bipolar. With me, the depression and anxiety go hand-in-hand, and when the depression lifts so does the anxiety.
I think I'll do a bit more research on 5-HTP before giving it a whirl. I've tried St John's Wort and it did nothing for me: all the studies seem to suggest it is suitable for mild to moderate depression, but unproven for anything more severe. If the anxiety symptoms become too much, I'll stick with the Oxazepam.
Yes, I'm just taking the SAM-e at the moment and will keep you posted as to how it works on its own. Thanks again for your help.
Lizzyg (only Lizzy G when it's not my own PC!)
This is the end of the thread.
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