Posted by Ron Hill on March 14, 2002, at 12:07:11
In reply to Re: CRF Antagonists, posted by OldSchool on March 13, 2002, at 13:21:01
> There is some info on this site regarding "SSRI poopout." Its in the tips and tricks section. Basically, the most common hypothesis as to why ADs poop out over the long haul is dopamine depletion. Many ADs, particularly the serotonergic ones, dampen the dopamine system when taken long term.
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Mr. Old School;
I share your belief that SSRI's dampen the dopamine system when taken long term. I do not have hard data to support this belief, but instead it is merely a layman's antidotal self-observation.
For years I was stuck. Without an AD to increase serotonin I was severely depressed. When using an AD to raise serotonin I struggled with what I consider to be low dopamine symptoms (very low motivation, low energy, blunted emotions, etc). At the risk of sounding too overly simplistic, SAM-e has by and large solved this problem for me. I fully realize that we patients are all different and, therefore, what works for me may not work for others. At the same time, however, I have a hunch that there are a lot of people here in Babbleland that could potentially be helped by this over-the-counter (in US) product, albeit an expensive OTC product.
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 the amino acids in dietary protein.
My layman's opinion regarding the mechanism by which SAM-e helps me is that it raises the serotinin and dopamine levels in my brain in a "balanced" fashion. The following paragraphs give a little more detail regarding my particular situation and the specifics of my SAM-e dosing. Also check out the links at the bottom of this page.
I'm Bipolar II. Lithobid 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 leave 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 regularly scheduled visit with my pdoc. At the time, I was only taking Li because of the AD side effects and, therefore, depression was a problem. 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 was skeptical because over the years I have taken a lot of over-the-counter supplements, most of which did very little to ease my depression. But I told my pdoc that I would give it a try.
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"). However,within about five days, my depression began to lift and I now have my life back. Yeah!!! Currently, I take one 200 mg tablet daily without any adverse side effects. In total I daily 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. 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. So far I have four months of excellent results and absolutely no hint of poop out.
It is very important to take plenty of B-6, B-12 (use sublingual form) and folate with the SAM-e to prevent the build up of homocystiene. Also, SAM-e is absorbed more efficiently by the small intestines when it is taken on an empty stomach. However, I usually eat a small bite ot food to reduce nausea. SAM-e, like many perscription ADs, can induce mania in bipolar patients if the patient is not taking an adequate amount of a mood stablizer.
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
poster:Ron Hill
thread:97638
URL: http://www.dr-bob.org/babble/20020313/msgs/97982.html