![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 53 to 77 of 101. Go back in thread:
Posted by lizzyg on March 22, 2002, at 4:06:47
In reply to Re: SAM-eLizzy G., posted by colin wallace on March 21, 2002, at 15:43:15
Colin and Ron
Many thanks for your feedback. I saw my GP this morning and - as you rightly predicted - she didn't have a clue about SAM-e. She almost had a fit when I suggested combining ADs ('we only like monotherapy') and was preaching about how benzos can give you withdrawal symptoms after just one week. So not satisfactory on that front.
She took my pulse and said it seemed OK, and that most heartbeat irregularities are benign, and mine is probably due to the anxiety. But shes's booked me in next week to have a blood test to check out my thyroid.
Like you, Colin, with me the anxiety goes hand-in-hand with the depression. I've found with TCAs that the anxiety went when the depression lifted, but that effect doesn't seem to be happening (yet?) with the SAM-e. Any other ideas of what I can do for the anxiety? (Ron - it's not irritability, but being unable to sit still and feeling panicked. At the moment, obsessing that my heart's about to give out at any moment!)
Thanks again
Lizzy
Posted by colin wallace on March 22, 2002, at 4:14:30
In reply to Re: SAM-eLizzy G. » colin wallace, posted by Ron Hill on March 22, 2002, at 1:36:28
Hi Ron,
What prompted me? If I tell you that when I was in my teens, my nickname was 'Arnhem' (a beer too far....), that may best sum it up!!!
One's good, two must be better mentality.
(well, actually, I get more muscle pain/stiffness
reduction with 400mg, but if I can't get along with it after 4 1/2 months, I guess it's 200mg for me till the cows come home too.
Today, my head's still buzzing slightly, so I'll consider yesterdays 400mg adequate for today too.
Tomorrow's my prozac day.Drooling at the thought of it!!!!!! (plan is to keep with the prozac-only three per week, for as long as I can afford it.Read a medline article on other's who have benefitted from only 60 mg weekly.However, if my GP wants to insist on giving me free Zoloft, I may crumble and go with 12.5mg daily instead!)
It's a hoot ain't it?Col.
Posted by beardedlady on March 22, 2002, at 6:02:11
In reply to Re: One (no make that three) more Sam-E questions » beardedlady, posted by Ron Hill on March 22, 2002, at 3:54:03
Ron:
I have to argue with you for just a second. Half an hour to an hour after that breakfast of yours? That's not an empty stomach!
I take my Serzone at bedtime, but I'm tapering off right now. So I'll be looking for a replacement. I have to take my B vitamins with food, so I'll take SAMe in the morning with my decaf coffee? Then I'll have breakfast an hour later and take the Bs. (Is adding a sublingual B12 to 12mcg worth of pill-form B12 going to be dangerous?)
Please don't hate me because I'm beertiful. I usually only drink one beer. I don't do it every day, but almost. (I like the taste. Bass.) Since I don't have depression, it doesn't counteract the Serzone; I take the lower anti-anxiety dose. Since I do have anxiety, it relaxes me some.
Thanks for your help.
the beertiful, beardtiful lady
Posted by beardedlady on March 22, 2002, at 6:03:53
In reply to Re: One more Sam-E question--Ron, Colin?, posted by colin wallace on March 22, 2002, at 4:01:44
It's okay, though; you answered my question. Thanks!
beardy : )>
P.S. Oh, I don't shave. I am proud of my full head of beard.
Posted by Ron Hill on March 22, 2002, at 6:18:39
In reply to Re: SAM-eLizzy G. » colin wallace, posted by lizzyg on March 22, 2002, at 4:06:47
>I've found with TCAs that the anxiety went when the depression lifted, but that effect doesn't seem to be happening (yet?) with the SAM-e. Any other ideas of what I can do for the anxiety? (Ron - it's not irritability, but being unable to sit still and feeling panicked. At the moment, obsessing that my heart's about to give out at any moment!)
Lizzy, are you taking only SAM-e currently or are you also taking med(s)? I thought sure you said just SAM-e, but in your post you mention AD monotherapy in connection with your GP visit. If you are on meds, what are they?
You're taking 400 mg/day SAM-e, right? And it is helping the depression but not the anxiety, right? Are you fully satisfied with the level of antidepressant relief? In other words, are ya bustin' a gut rollin' in the isles laughin' with Colin and I, or are you just kinda getting by?
As far as the anxiety goes, there are a lot of people way more qualified than I on this board to address an anxiety med question. To me (layman) it sounds like it might be a GABA issue, in which case, I'd say try a benzo or maybe gabapentin (Neurontin), an AED used off label as a moodstabilizer. How about rigorous exercise to help in the relief of your anxiety? Helps me, how about you?
Forgive me Lizzy, but please tell me your dx again. I'm going to have to start a file on each person I talk to in order to keep their "vital statistics" (meds, dx, etc.) straight in my head. It's too difficult and time consuming to try to go back through old posts for this type of information.
Thanks for being redundant. Thanks for being redundant.
--Ron
Posted by Ron Hill on March 22, 2002, at 6:45:19
In reply to Sam-E questions--don't hate me cuz I'm beertiful! » Ron Hill, posted by beardedlady on March 22, 2002, at 6:02:11
> I have to argue with you for just a second. Half an hour to an hour after that breakfast of yours? That's not an empty stomach!
Ya, you're right. Instructions on box insert says minimum 30 minutes.
> I take my Serzone at bedtime, but I'm tapering off right now. So I'll be looking for a replacement. I have to take my B vitamins with food, so I'll take SAMe in the morning with my decaf coffee? Then I'll have breakfast an hour later and take the Bs. (Is adding a sublingual B12 to 12mcg worth of pill-form B12 going to be dangerous?)No, not dangerous at all because 11.99999999999999 mcg of the pill-form B-12 winds up going down the toilet as yellow urine.
> Please don't hate me because I'm beertiful. I usually only drink one beer. I don't do it every day, but almost. (I like the taste. Bass.) Since I don't have depression, it doesn't counteract the Serzone; I take the lower anti-anxiety dose. Since I do have anxiety, it relaxes me some.
Sounds good. Is anxiety your full dx? Why the Serzone taper if it's working for you? From what Lizzy G says, I'm not so sure SAM-e will successfully treat your anxiety disorder.
-- Ron
Posted by beardedlady on March 22, 2002, at 7:18:21
In reply to Re: Sam-E and Anxiety Disorder » beardedlady, posted by Ron Hill on March 22, 2002, at 6:45:19
What's a full dx? Was it diagnosed? Yes, but it's totally related to sleep. I started not sleeping, I freaked out, I gave myself a panic disorder because I was scared I wouldn't be able to sleep. So it's that self-fulfilling prophecy. When you get anxious because you can't sleep, you can't sleep, and you stay anxious.
Serzone is, according to my pdoc, an anti-anxiety med at low doses (300) and an AD at high doses.
So the key to curing my panic is curing my insomnia, and if SAMe helps me use my energy wisely and lets me sleep at night (which the B vitamins seem to do!), I won't be worried into a panic about not sleeping.
As far as yellow urine goes, it sort of freaks me out because I'm a big water drinker, and it's usually pretty clear! So while I'm watching for signs of liver failure (dark yellow urine), I'm wondering if I'd even notice it!
beardy : )>
Posted by vincent on March 22, 2002, at 10:33:13
In reply to Re: Sam-E and Anxiety Disorder » Ron Hill, posted by beardedlady on March 22, 2002, at 7:18:21
Hi,
this is the most interesting thread on the board!
I began 20 days ago on sam-e and it was a revelation for me.
After all the heavy side effects of SSRI, sam-e renewed me to life.
1) It works in few days, since day #2 i began to feel more attentive and energized, in the following week it enhance my mood slowly but regulary.
Three weeks ago i wanna go to sleep, now i wanna go to the Gym!
2) It works without any side effects at all.
Dizzy? Drowsy? Somnolence?
What are these?????? (hehehe).
The only side effect i reported, but is not a disease for me, is elation: my mood enhanced so much that i am still attentive, energic ad alert at evening,....so i don't wanna to go to sleep.
So I use a verrrry small dosage of benzo to sleep.
Good luck and good health to evrybody and don't minimize efficacy of sam-e!!
Posted by colin wallace on March 22, 2002, at 11:17:42
In reply to Re: Sam-E and Anxiety Disorder » Ron Hill, posted by beardedlady on March 22, 2002, at 7:18:21
Just thought I'd mention that I first got my anxiety/panic under control with Remeron.This med. was wondrous for sleep and anxiety (I used to get nocturnal panic attacks, waking up suffocating etc.)It's sedating effects can linger throughout the day, and it took me at least a month to get get over the daytime lethargy.After that, I was able to take it at staggered daytime doses, without difficulty.
If anxiety/sleep were still troublesome for me, I'd happily go back on 15/30mg Remeron at night, and take my 200mg Sam-e in the morning, as it helps (me) with daytime alertness/energy.(BEERDY)> I saw a rheumatologist last year, when I was dx'd with fibromyalgia, and he recommended
beer and cannabis for relaxation !!!So swill that beer, it's officially good for us....(?)
Posted by Ron Hill on March 22, 2002, at 11:45:41
In reply to Re: Sam-E and Anxiety Disorder » Ron Hill, posted by beardedlady on March 22, 2002, at 7:18:21
> What's a full dx?
A "full dx" is when the author of the post has been up all night and has become incapable of writing a coherent sentence. What I was trying to ask (and you have already answered, no) was: Have any other disorders been identified in addition to the anxiety disorder?
> Serzone is, according to my pdoc, an anti-anxiety med at low doses (300) and an AD at high doses.
Yes, but what does this have to do with the reason you are tapering off Serzone?
> So the key to curing my panic is curing my insomnia, and if SAM-e helps me use my energy wisely and lets me sleep at night (which the B vitamins seem to do!), I won't be worried into a panic about not sleeping.
SAM-e might help ease your insomnia, but it might not! SAM-e does a lot of cool stuff like improves mood, eases joint pain, and detoxifies the liver, to name a few. However, to my knowledge, SAM-e is not necessarily an excellent sleep aid. In fact, as I mentioned in an earlier post, if one takes it later than about 5 pm, not only is it not a sleep aid, it can CAUSE insomnia.
What or who gave you the impression that SAM-e is an appropriate treatment for insomnia? What does your pdoc think of the SAM-e trial? I feel sure that SAM-e will not harm you in any way, however, using it specifically to treat insomnia is, as I understand it, untried.
Why hasn't your pdoc prescribed either sleeping pills or benzos to combat the insomnia?. About a year ago or more, I had insomnia as a side effect to an AD trial. Therefore, I did some research, decided that I wanted to try the prescription sleep aid Sonata, and therefore, asked my pdoc to prescribe Sonata so that I could have some in my headboard to use on an as needed basis. It worked good and I still have half a bottle left in my headboard (although it's probably expired by now). Sleeping pills should not be used for more than a few weeks. But if it is as you say (insomnia causing panic), then maybe a couple weeks of good quality sleep could solve your problem. You could keep the remaining sleeping pills on hand for use on an infrequent, as needed basis.
I have zero experience with benzos, but, as I (layman) understand it, these too can be used to treat insomnia. Also you can do a search on the web (and on this site also) for the term "sleep hygiene" which is a set of rules (e.g. no sleeping during the day, etc) for the patient to follow in order to facilitate better quality sleep. I'm probably telling you a bunch of stuff that you already know and you're just eager for me to shut up.
Do you have the type of insomnia that causes you to wake up in the middle of the night and then preclude you from getting back to sleep, or do you have the kind of insomnia that makes it hard to fall asleep from the get go? Or do you have trouble with both? Also, how do you know that the key to curing your panic is to cure the insomnia (first). How do you know it is not the other way around (solve panic to cure insomnia)? What does the pdoc think, chicken or egg?
-- Ron
Posted by colin wallace on March 22, 2002, at 11:46:58
In reply to Sam-e was amazing for me: it worked in 2 days!, posted by vincent on March 22, 2002, at 10:33:13
How much do you take? Did you have a major depression, dysthmia, anxiety??
Glad it's working anyhow,Col.
Posted by vincent on March 22, 2002, at 13:04:16
In reply to Re: Sam-e was amazing for me: Vincent, posted by colin wallace on March 22, 2002, at 11:46:58
Hi Col and everybody,
I'm actually on 1200 mg/d (400 tree times a day).
I've began on 400+400 mg/d and it was already effective and after only 2 days.
I still use complex vitamine B (1,6,9,12) useful for well work of Sam-e.
You must know that i'm xxxtremely sensitive to SSRI, for an example, Paxil kills me, Remeron sink me into the grave, Effexor make me stay at bed most part of the day....but on sam-e i've no reported side effects at all.
The real only but very important side effect on same is.....elation,but i'm very glad about it!
Do you need other information? Ask me in this thread!
Bye Vince
Posted by vincent on March 22, 2002, at 13:10:18
In reply to Re: Sam-e was amazing for me: Vincent » colin wallace, posted by vincent on March 22, 2002, at 13:04:16
Posted by beardedlady on March 22, 2002, at 13:33:27
In reply to Re: Sam-E and Anxiety Disorder » beardedlady, posted by Ron Hill on March 22, 2002, at 11:45:41
> Yes, but what does this have to do with the reason you are tapering off Serzone?
Oh, the liver thing. Serzone has that new black box, so I thought it best if I either switch to something else (but I dunno what) or try to live as I have for the 36 years before this happened to me.
> What or who gave you the impression that SAM-e is an appropriate treatment for insomnia? What does your pdoc think of the SAM-e trial? I feel sure that SAM-e will not harm you in any way, however, using it specifically to treat insomnia is, as I understand it, untried.No one gave me that impression. But I will try anything that's not a drug. And if it makes me feel good, maybe I won't worry so much about sleep.
> Why hasn't your pdoc prescribed either sleeping pills or benzos to combat the insomnia?
When this first happened three and a half years ago, we tried Ambien (one pill, one time), but I was so anxious I couldn't break through it, so it didn't work. Then we tried Xanax, which worked for short spurts of nap (but I was only on about .5 mgs!). Then we tried Zoloft and Xanax, and I got worse. Then we tried Trazodone and Xanax, and that worked for a month. Then we changed some timing, and it worked again for a month. Then we tried Serzone and quit the Xanax (yea! I hated it!), and my sleep returned to normal in about a week, and it hasn't stopped working.
Occasionally, when real life stuff interferes, I have breakthrough anxiety, and I use Sonata--a great drug (we discussed this before re: shelf life, which my pharmacist says is bunk because it's already months old in the pharmacy, and it has an expiration date of longer than a year on his bottle).
>
> Also you can do a search on the web (and on this site also) for the term "sleep hygiene" which is a set of rules (e.g. no sleeping during the day, etc) for the patient to follow in order to facilitate better quality sleep. I'm probably telling you a bunch of stuff that you already know and you're just eager for me to shut up.Yes. I know everything about it. I have great sleep hygiene. I never had this problem until my daughter quit nursing cold turkey the weekend before I started a new teaching job, which was right after my father-in-law's funeral!
> Do you have the type of insomnia that causes you to wake up in the middle of the night and then preclude you from getting back to sleep, or do you have the kind of insomnia that makes it hard to fall asleep from the get go?
It started while I was nursing with waking up at 2:00 a.m. and lying there until I fell asleep at 4:00. This happened maybe five times in four months. On the rare nights (rare now, anyway) that I can't fall back to sleep at all (I lie there in bed "resting" all night anyway because I often can get another three hours if I'm patient), I have trouble falling asleep the next night.
> Also, how do you know that the key to curing your panic is to cure the insomnia (first). How do you know it is not the other way around (solve panic to cure insomnia)? What does the pdoc think, chicken or egg?
It's obviously the insomnia that caused the panic. I forgot to add that I took a diet pill (phentermine) when she quit nursing. I was on them for about a month or two a year before I got pregnant, and they not only worked on my weight but made me feel happy and energetic, so I wanted that again after nursing a baby. But it gave me insomnia, and I stopped taking it. The insomnia didn't go away, so I started to panic that I wouldn't be able to take care of my daughter. I panicked because of sleep, and that's all.
Thanks for asking.
So the reason I'm thinking SAMe is that I might stop worrying if I feel good, which might let me rest at night once I'm off the Serzone (or on a really reduced dose). Otherwise, it might keep my liver healthy to counteract the possible liver toxicity of Serzone.
beardy : )>
Posted by beardedlady on March 22, 2002, at 13:41:22
In reply to Re: Sam-e was amazing for me: Vincent » colin wallace, posted by vincent on March 22, 2002, at 13:04:16
Vincent:
I have chronic insomnia. If I take this in the morning, do you think it will keep me up all night?
beardy : )>
Posted by vincent on March 22, 2002, at 19:08:42
In reply to Re: Sam-e was amazing for me » vincent, posted by beardedlady on March 22, 2002, at 13:41:22
Hi Beardy.
No I think sam-e used in the morning will not damage your night sleep at all.
My personal opinion is that sam-e has an activant effect cause it improves dopamine absorption into the cells.
My personal experience is that activant effect fade away within 6-8 hours (the dopamine cicle has the form of a bell), so i think you should sleep well taking sam-e in the morning.
But this is my personal experience and it could be different from me to you.
Bye
Posted by IsoM on March 22, 2002, at 19:14:51
In reply to Re: Sam-e and insomnia. » beardedlady, posted by vincent on March 22, 2002, at 19:08:42
Well, it looks like I won't be getting any SAM-e to try after all. Health Canada removed it from stores - don't know when this happened but I had seen it sold before here. Ordering over the internet is out as it's bloody expensive, then I pay exchange & shipping, which can almost double the cost.
I'll just make sure I keep my protein intake good & make sure I'm getting enough protein containing methionine. My B complex intake is already very good anyway. Ah well, considering all this, maybe it wouldn't have made a major difference, & the cost...
Posted by Ron Hill on March 22, 2002, at 21:25:37
In reply to oy vey! » Ron Hill, posted by beardedlady on March 22, 2002, at 13:33:27
Ms. Lady,
Thank you so much for taking the time to help me understand your case history. Having read your response, I have completely changed my mind. I think there is a very high probability that SAM-e will fix both your insomnia and your anxiety if you do the trial correctly. Sorry to have come off so negative before. I just did not have enough of your case history. Please read my responses to your answers. It’s kinda cluttered with 49 posts crammed into one, but you can figure it out.
> > Yes, but what does this have to do with the reason you are tapering off Serzone?
> Oh, the liver thing. Serzone has that new black box, so I thought it best if I either switch to something else (but I dunno what) or try to live as I have for the 36 years before this happened to me.My recommendation: Don't worry too much about those "lawyer (shark) TV adds". JohnX2 takes Serzone, and he has posted that he is not concerned about it. John seems to think it's a lot to do over nothing. Personally, I have not taken the time to look into it since it does not affect me directly. However, I would be willing to bet dollars to donuts that John has looked into this Serzone issue VERY extensively because he takes the stuff (and because he is John!). John knows a lot about meds. I'd trust his judgment unless you have something that shows without a doubt that Serzone is dangerous.
I'm like you, I'd rather be off all man made medications. But you write that the Serzone is working well. If it ain't broke don't fix it. If it were me, I'd keep the Serzone in place while ramping up the SAM-e. Do this for one week, and if all is well, begin to carefully wean yourself off Serzone.
> > What or who gave you the impression that SAM-e is an appropriate treatment for insomnia? What does your pdoc think of the SAM-e trial? I feel sure that SAM-e will not harm you in any way, however, using it specifically to treat insomnia is, as I understand it, untried.
> No one gave me that impression. But I will try anything that's not a drug. And if it makes me feel good, maybe I won't worry so much about sleep.I'm on your side now. Start with 200 mg/day, and take the dose in the am.
> > Why hasn't your pdoc prescribed either sleeping pills or benzos to combat the insomnia?
>
> When this first happened three and a half years ago, we tried Ambien (one pill, one time), but I was so anxious I couldn't break through it, so it didn't work. Then we tried Xanax, which worked for short spurts of nap (but I was only on about .5 mgs!). Then we tried Zoloft and Xanax, and I got worse. Then we tried Trazodone and Xanax, and that worked for a month. Then we changed some timing, and it worked again for a month. Then we tried Serzone and quit the Xanax (yea! I hated it!), and my sleep returned to normal in about a week, and it hasn't stopped working.Serzone is working for you. Do not throw it away too soon. To reiterate; ramp up the SAM-e first, then slowly taper the Serzone, reversing course is it ends up that you can't sleep without it.
> Occasionally, when real life stuff interferes, I have breakthrough anxiety, and I use Sonata--a great drug (we discussed this before re: shelf life, which my pharmacist says is bunk because it's already months old in the pharmacy, and it has an expiration date of longer than a year on his bottle).
Good. One more tool in the tool box if it is needed.
> > Also you can do a search on the web (and on this site also) for the term "sleep hygiene" which is a set of rules (e.g. no sleeping during the day, etc) for the patient to follow in order to facilitate better quality sleep. I'm probably telling you a bunch of stuff that you already know and you're just eager for me to shut up.
> Yes. I know everything about it. I have great sleep hygiene. I never had this problem until my daughter quit nursing cold turkey the weekend before I started a new teaching job, which was right after my father-in-law's funeral!
This is one of two important bits of information that made me change my mind regarding the probable effectiveness of SAM-e to treat your insomnia and anxiety. I now believe that your insomnia is due to low serotonin and not related to GABA. SAM-e is quite capable of increasing serotonin levels so you should be good to go.
> > Do you have the type of insomnia that causes you to wake up in the middle of the night and then preclude you from getting back to sleep, or do you have the kind of insomnia that makes it hard to fall asleep from the get go?
> It started while I was nursing with waking up at 2:00 a.m. and lying there until I fell asleep at 4:00. This happened maybe five times in four months. On the rare nights (rare now, anyway) that I can't fall back to sleep at all (I lie there in bed "resting" all night anyway because I often can get another three hours if I'm patient), I have trouble falling asleep the next night.This also sounds like low serotonin.
> > Also, how do you know that the key to curing your panic is to cure the insomnia (first). How do you know it is not the other way around (solve panic to cure insomnia)? What does the pdoc think, chicken or egg?
> It's obviously the insomnia that caused the panic. I forgot to add that I took a diet pill (phentermine) when she quit nursing. I was on them for about a month or two a year before I got pregnant, and they not only worked on my weight but made me feel happy and energetic, so I wanted that again after nursing a baby. But it gave me insomnia, and I stopped taking it. The insomnia didn't go away, so I started to panic that I wouldn't be able to take care of my daughter. I panicked because of sleep, and that's all.
Okay, I hear you now. Your reaction to the diet pill is the second important bit of information that made me change my mind regarding the probable effectiveness of SAM-e to treat your insomnia and anxiety. This diet pill story makes me think that you will benefit from a small boost of dopamine. And SAM-e can certainly do that.
> Thanks for asking.
I feel like I hurt your feelings with my last post. At the time, I needed more info. Thanks for filling me in. I'm sorry that I caused hurt. Forgive me?
> So the reason I'm thinking SAM-e is that I might stop worrying if I feel good, which might let me rest at night once I'm off the Serzone (or on a really reduced dose). Otherwise, it might keep my liver healthy to counteract the possible liver toxicity of Serzone.
One thing is for sure, we won't know unless you try the SAM-e. Have you bought it yet? What day do you plan to start the SAM-e trial? Please post your results daily. You have my best wishes and I will try to remember to pray for you daily this coming week.-- Ron
P.S. My wife teaches fourth grade at a public charter school. Are you still teaching?
Posted by Ron Hill on March 22, 2002, at 22:54:34
In reply to No SAM-e after all..., posted by IsoM on March 22, 2002, at 19:14:51
IsoM,
Another, less expensive approach is to supplement your diet with the raw materials used by the human body to synthesize SAM-e. The idea is to improve the body's ability to make SAM-e (as opposed to feeding the body "ready-made SAM-e", as we have been discussing on this board).
A couple months ago, I bought one such supplement product called "SAM-e Kick Start". I have not yet tried it. Here is what the label says:
Serving Size: 2 capsules
Amounts listed are per serving (i.e. 2 capsules)Trimethylglycine (TMG); 695 mg
L-Methionine; 250 mg
Dimethylglycine (DMG); 185 mgB-6; 15 mg
Folic Acid; 800 mcg
B-12; 200 mcgDirections: One capsule twice daily, as a nutritional supplement.
Since you are already taking your B-vitamins, and provided you eat enough meat, you're getting enough l-methionine. Therefore, forget about the "SAM-e Kick Start" product and just go to the health food store and buy some TMG and DMG. Take them and your vitamins with you meal (include meat or an alternate l-methionine source with meal). Some people say you just need TMG, while others say it's best to take both (TMG and DMG).-- Ron
-----------------------------------------> Well, it looks like I won't be getting any SAM-e to try after all. Health Canada removed it from stores - don't know when this happened but I had seen it sold before here. Ordering over the internet is out as it's bloody expensive, then I pay exchange & shipping, which can almost double the cost.
>
> I'll just make sure I keep my protein intake good & make sure I'm getting enough protein containing methionine. My B complex intake is already very good anyway. Ah well, considering all this, maybe it wouldn't have made a major difference, & the cost...
Posted by IsoM on March 23, 2002, at 2:57:28
In reply to More Than One Way To Skin A Cat » IsoM, posted by Ron Hill on March 22, 2002, at 22:54:34
Thanks Ron. I'll look up TMG & DMG tomorrow morning to find more about it - getting too tired now, bed-time soon. I don't think my body chemistry is malfunctioning so I figure if I provide the needed precursors, I'll do pretty good. Thanks again!
Posted by beardedlady on March 23, 2002, at 6:06:50
In reply to Hola, toma notas! » beardedlady, posted by Ron Hill on March 22, 2002, at 21:25:37
Oh, heavens no, you didn't upset me! I felt a little "iffy" about SAMe, but not upset by you. (I have my own design/writing business, and I write articles and poetry, so I don't have a problem being "out there." I have a little pile (3) of rejection letters this year because my goal is to send everything out and have nothing sitting here. I also have a huge self-esteem problem. (The problem is that my self-esteem is HUGE!)
Anyway, enough about me. I'll take your advice, but I have to talk to the pdoc on Thursday to make sure it's okay with Serzone. I'm already tapering off (at 250, down from 300, for the past month); it's better to be on a lower dose, at least. I'm really sleeping like a rock since I started Bs and a Tums at night before bed! I am not eager to mess with anything at the moment. But when I reduce to 200, I'll probably add SAMe. I'll let you know!
I teach English at a local university.
So thanks for caring, but no hurt feelings here. Just hurt fingers and wrists (carpal tunnel). (Maybe SAMe can cure that? Otherwise, I'm having surgery in May.)
Buh-bye,
Beardy : )>
Posted by Mauro on March 23, 2002, at 7:35:17
In reply to Re: Sam-e was amazing for me » vincent, posted by beardedlady on March 22, 2002, at 13:41:22
Hi to all,
I've found out an interesting article at the link:
http://sopsi.archicoop.it/rivista/1999/vol5-1/delle.htm
"Combined analysis of two controlled, multicentric, double blind studies to assess efficacy and safety of Sulfo-Adenosyl-Methionine (SAMe) vs. placebo (MC1) and SAMe vs. clomipramine (MC2) in the treatment of Major Depression"
It's from the Italian Review of Psicopatology, and it is indipendent from any producer or seller of meds.
The most part of the article is in italian, but summary is even in english.
The results are that sam-e is less effective than cloromipramine (tca) but it has a real efficacy and, most important, it has the same side effect than "fresh water".
Bye
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
Posted by BarbaraCat on March 23, 2002, at 10:46:01
In reply to Re: SAM-e Trial » Ron Hill, posted by JohnX2 on March 23, 2002, at 9:13:53
John,
Nature's Made is reportedly the best brand. Some lab analyses were done about 2 years ago to test the bioavailability and accuracy of actual product levels in a number of nutritional products and Nature's Made won hand's down. It's also the brand Costco carries for the best price. I take mine with coffee which seems to rev it up. Also, you might be interested in exploring glutathione. Taking glutatione by itself doesn't seem to be effective. N-acetyl-cysteine which you mentioned is a good precursor to it. There were some studies that showed large amounts were neurotoxic if taken daily. Also, some leaching out of zinc and copper with high daily doses. There are also some denatured whey protein products that claim to raise glutatione levels in the cells. I'm taking one to combat my fibromyalgia and it seems to lesson some of the symptoms. Anyhow, here's a chem profile:
http://www.genome.ad.jp/kegg/pathway/map/map00480.html
Posted by Ron Hill on March 23, 2002, at 15:11:39
In reply to Re: SAM-e Trial » Ron Hill, posted by JohnX2 on March 23, 2002, at 9:13:53
John,
I was hoping you would weigh in on this topic. As you can see by some of the posts in this thread, several people are reporting favorable results with SAM-e. It is, of course, not the answer to every psychiatric disorder under the sun, but it sure gave me my life back!
My observation (not a scientific study) is that SAM-e seems to be of particular value to depressive (especially bipolar depressive) patients that are initially hypersensitive to AD's (favorable response in a matter of days to very low dosage), but soon thereafter, suffer anergy (low drive, low energy, etc.) and anhedonia (inability to fully experience pleasure, blunted emotions, etc.). It is my layman's opinion that AD's (SSRI's in particular) lower dopamine levels and or impede DA transmission in some (most?) patients and this, in turn, causes the aforementioned symptoms. I think SAM-e is particularly useful in treating anergy and anhedonia, and that it does so by increasing the amount of DA produced by the body. Further, I (layman) hypothesize that one reason SAM-e works so well is that it increases both serotonin and dopamine in a very balanced synergistic kind of way. Okay, enough rambling, let me respond to the issues you raise.
> 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.
By "placebo effect" I am assuming you mean that you experienced some initial sense of benefit by taking SAM-e, but the improvement was due to psychological reasons instead of physiological improvement and, therefore, the benefits did not last. Do I understand you correctly? Did you take B-6, folic acid, and SUBLINGUAL bioactive B-12 (methylcobalamin)? If you've read my posts, you know how important I think B vitamins (especially sublingual bioactive B-12) are. Were you able to take the SAM-e on a relatively empty stomach? Each morning, I eat a good breakfast, take my vitamins, wait an hour or so, and take my SAM-e dose. In your prior trial, what meds were you on? How much SAM-e did you take and for how long? Nature Made is a good enough brand, so I doubt that it was a bad product issue.>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?
I doubt that this is the problem.
> Are there good brands that maybe use different fillers/binders in the pill? Does it need to get absorbed through the intestines?
Yes, as I understand it, the supplemental SAM-e must be able to find its way to the small intestines intact in order for the body to absorb it efficiently. But again, I doubt that this is a problem for you. I go back to my usual mantra; were you taking sublingual bioactive B-12 at the time of the trial?
John, I read a high percentage of your posts so, to some degree, I stay aware of your current meds and your conditions. With the exception of your recent bout with hypomania, it seems like your current med combo is working fairly well. If I remember correctly you're taking Lamictal, Serzone, and I think a benzo or something {I would stop and look it up in one of your previous posts, but too many times I've lost partially completed posts in the dialogue box by surfing other pbabble links before completing and sending off the post. Have you ever done that? Make ya mad? Does me!}.
Since your meds are working, what is prompting you to ponder SAM-e? Due to the fact that AD's were so fickle (work one day, poop-out the next) in their effectiveness for me, I would attempt to replace Serzone with SAM-e if I were in your shoes. SAM-e is smooth, even, and highly repeatable every day. That was definitely not the case with AD's, but this is just my bias.
John, given the fact that merely missing two days of Serzone induced some hypomania, I am concerned that SAM-e might cause some hypomania for you as well. SAM-e induces hypomania in me if I take more than 200 mg/day. Does increasing your Lamictal dosage improve your stability against hypomania? Have you made any decision regarding the lithium add-on to the Lamictal for more anti-mania stability?
-- Ron
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