Posted by dennison on April 2, 2002, at 11:14:18
In reply to Kramer: SAM-e and Serzone, posted by beardedlady on April 1, 2002, at 6:15:43
> Hi, Dr. Kramer:
>
> My psychiatrist prescribed Serzone (after Ambien, Xanax, Zoloft/Xanax, Xanax/Trazodone failed), and I have been on it for three years. I now take a reduced dose of 250 mg. and will be reducing further on April 15th. (In emergencies, I take Sonata, too.) I am not depressed, but I developed a panic problem related solely to insomnia.
>
> Right now, I sleep wonderfully (though I wake up groggy when I sleep more than eight hours). I started a Super B complex over one month ago, and I am feeling great. I have not needed a sleeping pill since I started the B vitamins! But I am worried about taking Serzone for much longer--the liver thing, you know. Some folks suggested I try SAM-e. My pdoc knows nothing about it but says it's okay to take with the Serzone.
>
> Questions:
>
> 1.) Is it? (Okay with Serzone?)
> 2.) Should I wait until the day I reduce my Serzone dose to 200 mg.? (So I notice the Serzone less?)
> 3.) Will SAM-e, which is supposed to promote liver health, counteract the possible liver problem?
> 4.) Could you explain Serzone's black box, in layman's terms, so that I understand my risk (patient years is a tough one)?
> 5.) Will SAM-e cause problems if you discontinue use suddenly, like other anti-depressants?
> 6.) Know any good sleep disorder meds for someone who doesn't really have any big problems? (Sleep is really it for me, but if I don't get it, I panic the next night, and then I don't get it again. And then I get depressed.) I don't want sexual side effects or weight gain, of course.
>
> Phew. That's a lot. Thanks in advance.
>
> bearded lady : )>Hi BeardedLady --Actually Sam-e-- " s-adenosyl-L-methionine " - Which produces it's effect through methylation. Sam-e is a "methyl" (((ch3))) group donor. Sam-e is an endogenous "intrinsic" compound in your body, your body produces it naturally so essentially you are augmenting the natural reserve pool that is formed in the body, but having additional, sam-e " which is biologically active" , whereas the body must produce it through combining the amino acid "methionine" & " that always important energy molecule "adenosine triphosphate-atp" , thus the name - s-adenosyl-L-methionine-- ""SAM-e".......................................................................Ok here's the correlation with your serzone liver toxicity issue-- . Sam-e has been shown to improve "glutathione" levels in liver . Glutathione is one of two primary antioxidant and """"""""""""""""Detoxifying""""""""""""""""""""""" enzymes produced by the liver. Many many liver toxicities occur as glutathione reserves are exceeded in the liver, or somehow diminished, after it is no longer avaliable- drugs, toxic chemicals "poisions essentially" are no longer detoxified but allowed to build to excessive levels. Although sam-e effects on liver obviously aren't what are looked for to help depression, sam-e is a so called ""ubiquitous"" substance-meaning it's functions are extremely diverse and has significant effects on many body functions--""one being--helping to prevent liver toxicity"" ............................................................................................................Btw in depression sam-e "putative " --meaning supposed modality is #1 aiding transmethylation rxn's essential for proper membrane formulation -"hence proper permeabilty" of the proper lipid soluble substrates as well as basic membrane function--which forms core of all nervous system activity--""ions"" electrochemical gradients - and ability to polarize and of course "depolarize" -which causes the action potential--(((((nerve fires))))) transmitts impulse. .............................................................................................................#2 - neurotrasmitters and sam-e - synthesis of which requires methyl group in active avaliable form -- #3 That crazy enzyme "comt" catechol -O-methyltransferase-which requires S-adenosyl-methionine to donate a methyl group to function. ""COMT"" is essential for maintaining proper synaptic levels of dopamine-norepinephine -epinephrine ""the 3 catecholamines"" #4 Sam-e is essential for conversion of phosphatidyl ethanolamine into phosphatidyl choline --an extremely important important compound for proper nervous system function "acetylcholine" etc and essential membrane lipids as stated before!!
poster:dennison
thread:101243
URL: http://www.dr-bob.org/babble/20020402/msgs/101457.html