Posted by Ritch on March 19, 2002, at 0:18:46
In reply to Re: SAM-e Trial » Ritch, posted by Ron Hill on March 18, 2002, at 16:16:00
> Mitch,
>
> Thanks for the progress report. Give the SAM-e trial at least a week or two before drawing any firm conclusions.
I always will take something at least two weeks to see how it will fare unless it has clearly unbearable startup side effects that I feel intuitively aren't going to improve with time.>
> I'm surprised by your sleepiness side effect. Most people find it to be slightly stimulating (increase in dopamine) in a smooth calm kind of way. My pdoc warned me against taking it to close to bedtime since it can make it hard to sleep. In fact, I did this once and sure enough I had a very poor nights sleep. As I have mentioned before in my prior posts, SAM-e is an important methylating agent essential for our bodies to manufacture neurotransmitters (serotonin and dopamine, in particular). SAM-e is also involved in the production of melatonin which, as you know, is a neurotransmitter that regulates the sleep/wake cycle. Just a guess, but maybe your daytime sleepiness is somehow connected to melatonin production. And further, this may be a short term effect provided you implement good sleep hygiene protocol ASAP.Actually, I was going to mention something else, but forgot to. It really seemed like taking a small dose of Mirapex without the nausea. BTW, DA agonists never goofed with my sleep.
> Mitch, as you read in my previous post above, I discontinued my low-dose (12.5 mg/d) of Zoloft a couple of days ago due to breakthrough anergic side effects. Therefore, SAM-e is my sole "AD" at this point. So far I'm doing extremely well! It's been many years and many med trials looking for the right med combo. I truly think I've finally found an "AD" that will work long term for me, a bipolar. A little Lithobid (600 mg/d) and a little SAM-e (400 mg/d) and I'm good to go. I expect this good result to last, but only time will tell for sure.Lithium was the only thing that I could take as a sole RX med that could keep me above water. It didn't do as well as Neurontin for bipolar depression, didn't do as well as Depakote for hypomania, but it is a quite decent and cheap multipurpose drug. I just had big tolerability issues with Li due to GI distress (similar to SSRi's).
>
> >I just got the cheapest stuff-hey it's a trial.
>
> Cheap in the short run is not necessarily cost effective in the long run. The problem with SAM-e is that it is expensive to manufacture in a biochemically stable form. Also, care must be taken in packaging and shipping to retain product integrity and freshness and, thereby, to maintain true stated SAM-e content quantity. What brand did you buy? What formulation (e.g. tosylate)?It's a blue bottle I got at Walgreen's. Something good is happening with it. Sorry, but I am not going to pay more than $20 a month that likely will not work as well. Hey, I could add another digital cable option!
> >I must say that whatever it does-mustn't be too bad. I feel calm enough to restart dexedrine again.
> I will not presume to tell you what to do, but if it were me, I'd limit it to one trial at a time. Give the SAM-e at least a week or two. Please refresh my memory by listing all of your current meds. Also, your formal dx is BP II with comorbid ADHD, right? Will you also tell me the active ingredient in your sublingual B-12. Is it the bioactive form, methylcobalamin? It is sublingual, correct?
>
> -- RonWell, it is sublingual (primitive?):-). Yes, on the dx. Nope, cyanocobalimin. Yes, restarted Dexedrine, but a daily microdose of 5mg.
So....
Depakote 125-250mg hs (no tremor with Flax oil and the SAM-e!)
Klonopin .5mg hs
Neurontin 100mg tid
Dexedrine 5mg/day
Celexa 2.5mg every other dayMitch
poster:Ritch
thread:98301
URL: http://www.dr-bob.org/babble/20020318/msgs/98728.html