Posted by JohnX2 on March 23, 2002, at 9:13:53
In reply to Re: SAM-e Trial » Ritch, posted by Ron Hill on March 18, 2002, at 16:16:00
Hi Ron,Maybe if I try this again I need to address the dosing scheme much more carefully. I did try SAM-E nature made brand a long way back with a placebo effect, even at a high dose. I've also gotton a placebo effect on Depakote. So I wonder if these enteric coated tablets aren't getting absorbed well into my body.
However, other enteric coated tablets do okay (like wellbutrin).What do you think?
Are there good brands that maybe use different fillers/binders in the pill? Does it need to get absorbed through the intestines?
John
> Mitch,
>
> Thanks for the progress report. Give the SAM-e trial at least a week or two before drawing any firm conclusions.
>
> 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.
>
> Mitch, you know more about this brain chemistry stuff than I do. I'm just offering my opinion in hopes of helping you. Good sleep hygiene includes (among other things) staying awake during the day. I encourage you to use whatever tricks needed to stay awake during the daytime. Drink coffee; go for brisk walks, etc. And I don't need to tell you how important it is for us bipolars to get good regular sleep. SAM-e has improved my sleep, but no daytime sleeping is allowed.
>
> Here is the SAM-e dosing schedule that seems to work best for me:
>
> 1. Get up in the morning and eat a good healthy breakfast within thirty minutes of rising.
>
> 2. Immediately after breakfast, take oral (down-the-hatch) vitamins followed by sublingual (under the tongue) B-12.
>
> 3. Wait for at least 30 minutes or an hour, and then take a 200 mg tablet of SAM-e. This wait time is important because SAM-e is adsorbed in the small intestines more effectively if there is not food present to compete for absorption. IMHO, I think it is important to have the B vitamins in the body ready and waiting for the SAM-e dose. I also think it is VERY IMPORTANT to take the B-12 in a bioactive sublingual form.
>
> 4. About mid-afternoon, at least an hour after lunch and at least an hour before dinner, I take my second 200 mg tablet of SAM-e
>
> As side notes, I also take a 500 mg gel cap of a phosphatidylserine complex containing 100 mg of phosphatidylserine (PS). This helps my brain with a mood stabilizer kind of effect, whereas, SAM-e helps my brain in an AD kind of way. Although it is like comparing apples and oranges (MS vs. AD), the benefits I experience from SAM-e are much more profound than that of PS. IMHO, PS helps because it improves brain cell plasticity. Unfortunately, PS is expensive (about $1 per gel cap). Also included on my list of helpful "medications" are exercise and omega-3 fatty acids.
>
> 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.
>
> >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)?
>
> >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?
>
> -- Ron
> ----------------------------------------------
>
>
> > Hey Ron,
> >
> > You wanted to know how my SAM-e trial would go. Well, I bought some yesterday after checking out several stores. I just got the cheapest stuff-hey it's a trial. Well, I must say that I got very *tired* and *sleepy* after I ate lunch and took all my vitamins and the SAM-e (just one 200mg tablet). I got so drowsy I started to nap (that was around 5-6pm-about three hours later). I slept plenty the nite before-so I think it could be attributable to the SAM-e. It was a pleasant kind of nap-like thing. I didn't get any nausea or anything. I took a 2nd dose of it today at the same time and re-experienced a pleasant *grogginess* at about the same time of day. I must say that whatever it does-mustn't be too bad. I feel calm enough to restart dexedrine again.
> >
> > Mitch
poster:JohnX2
thread:98301
URL: http://www.dr-bob.org/babble/20020322/msgs/99630.html