Posted by Ron Hill on March 2, 2002, at 8:53:36
In reply to SSRI Dopamine depletion...., posted by colin wallace on March 1, 2002, at 12:27:29
Colin,
Based on personal experience, I subscribe to the theory that SSRIs may reduce dopamine levels. However, for me the decrease in dopamine (if that's what it is) causes me to become lethargic, unmotivated, void of energy, blunted emotions, etc. In contrast, your symptoms (restlessness/agitation/aggression) I have always attributed to elevated norepinephine levels. These symptoms present when I take Wellbutrin.
Like you, I also have found great success using SAM-e. Please allow me to use this as an opportunity to post my SAM-e testimonial again. As you know, SAM-e is a naturally occurring compound and is manufactured by the human body. However, some people do not produce enough of it and supplementation may be beneficial.
SAM-e is involved in a plethora of various biochemical reactions in the human body. It functions as a very important methyl group donor. With regard to mood and related brain chemistry, SAM-e serves as the methylating agent in the biochemical reaction mechanism whereby various neurotransmitters (serotonin and dopamine in particular) are synthesized from amino acids in dietary protein.
For me personally, SAM-e has turned out to be a lifesaver! I have waited to post on this topic until I gave it some time to make sure it did not poop out right away. I do not want to post a proSAM-e testimonial only to find out later that it did not last. However, I have experienced positive results for four consecutive months and, therefore, I am ready to post.
I'm BPII. Lithium adequately controls my hypomania but does nothing for my depression. Any of the SSRI's will take away my "I want to die" mood but leaves me with side effects (loss of ambition, loss of energy, lack of motivation, blunted emotions, etc). I have tried a ton of other ADs over the years, but I will not bore you with the details.
Four months ago I went to my regular visit with my pdoc. At the time, I was only taking Li because of the AD side effects. Depression was a problem for me at the time. My pdoc had recently reviewed several studies showing success in treating depression using SAM-e in conjunction with an AD and success using SAM-e alone. He suggested that I take two 200 mg SAM-e tablets daily in conjunction with 25 mg of Zoloft. I am hypersensitive to most medication so I take small doses.
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"). Currently, I take one 200 mg tablet daily without any adverse side effects. I currently take 600 mg Lithobid, 12.5 mg Zoloft, and 200 mg SAM-e. Eventually, I plan to discontinue the small amount of Zoloft.
Bottom line: 200 mg SAM-e daily has helped me more than any of the many ADs I've tried over the years. It is very important to take plenty of B-6, B-12 (sublingual form) and folate with the SAM-e. Also take SAM-e on an empty stomach.
Here are some links to articles on the topic. Do some research (use "SAM-e" in search engine). Buy a good name brand to ensure product quality.
http://www.biopsychiatry.com/sameart.html
http://more.abcnews.go.com/sections/living/inyourhead/allinyourhead_36.html
http://www.psycom.net/depression.central.same.html
http://www.mhsource.com/expert/exp1041299b.html
http://www.arthritissupport.com/track/goto/rtgoto30l.cfm
-- Ron
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> It was insinuated by my psych. that my adverse reaction to ssri's, which did not usually reveal itself until three or four weeks into treatment, was a figment of my imagination.Restlessness/agitation/aggression usually present immidiately, if they are to present at all, he said.Some of the posts here have made mention of the fact that increased seratonin can lead to a corresponding decrease in dopamine.I'm wondering whether perhaps this interplay may account for a delayed adverse reaction, suggesting maybe a dopamine deficiency?After all, it would take a few weeks to deplete the dopamine, surely?I'm about to give an ssri a final shot at redeeming itself (in a low dose sam-e combo.)
> If I start to slide, I'm figuring wellbutrin may be the answer.******* me off though, to have to figure these things out for myself, the hard way.Anyone else had a similar ssri experience ,presenting only after some time, without dose increments to account for the reaction?? Any thoughts appreciated.
poster:Ron Hill
thread:95961
URL: http://www.dr-bob.org/babble/20020301/msgs/96055.html