Posted by JohnX2 on April 8, 2002, at 17:41:14
In reply to Re: SAM-e Trial » JohnX2, posted by Ron Hill on April 8, 2002, at 13:11:31
> John,
>
> Thanks for your reply. Just a couple comments:
>
> > I always thought SAM-E was a good concept. I believed it could work. The only thing I don't like about it is the price.
>
> A Double E worried about a couple bucks a day for a month or two to facilitate the trial? ($2 for 800 mg/day). What's wrong with this picture?
>It was much more expensive when I tried it a while back! Actually, money is not a big concern for me (unless what I am spending it on is not helping). It seemes like I'd have to walk out of the store with a cart full of boxes though, the way the package just a few pills in a huge box. :-)
> > > 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?
>I don't know about increasing my Lamictal dose because I can't tolerate it. I don't think lamictal in general is good for mania. I think it is good for cycling and depression.
> > I have a weird problem with Lamictal and some other meds, if I raise the dose above a certain level, they induce myofacial pain and sometimes they blunt out my emotions. Zoloft was really bad. Lamictal does this at doses above 150 mg. Serzone fixes this problem. It seems to be related to a gating of serotonin/dopamine interactions (Serzone blocking offensive serotonin receptors). Specifically blockade of 5-ht2 receptors increases dopamine in the (pre)frontal cortex where there are dopamine neurons that inhibit facial muscle contractions, also hypodopaminergic states in the frontal cortex lead to "blunted emotions" such as symtoms similarly described like a "negative psychosis" in schizophrenia. That's why the atypical neuroleptics block the serotonin 5-ht2a receptors (as does serzone and remeron). (Maybe some swagging on behalf here...)
>
> What about about using a low dose of lithium as an add-on to the Lamictal to improve anti-mania stability? If I remember correctly, you were thinking about doing this a few weeks ago. In your case, I would be concerned that SAM-e might induce hypomania without more mood stabilizer.
>
I'm supposed to get some testing done this week and then try a lithium add-on. Any more ADs at this stage will likely set me off. I would however consider swapping in SAM-E for Serzone, but the problem is that Serzone is doing something specific to help with myofacial pain that I'm not sure SAM-E would help. If the lithium helps with the myofacial pain, then I may be open for more strategies.Regards,
John> -- Ron
poster:JohnX2
thread:98301
URL: http://www.dr-bob.org/babble/20020408/msgs/102412.html