Posted by Ron Hill on May 21, 2002, at 15:45:40
In reply to Ron Hill--How is the sam-e going?, posted by johnj on May 19, 2002, at 11:51:06
John,
Thanks for your post. Sorry that it has taken me a couple of days to get back to you.
> Is the sam-e still working well for you? I know your were thinking about 100 mg tablets and was wondering if you ever found a 100 mg tablet or divided a tablet?
John, as you recall, about six weeks ago I began to periodically experience an extremely irritable mood which flashed into episodes of rage. I felt sure that the foul mood was caused by one or more of the vitamins and/or supplements that I was taking and, therefore, I began the process of trying to identify the culprit.
The first thing I tried was to reduce my daily SAM-e dose from 200 mg to 100 mg. The irritability seemed to subside somewhat, but not a lot. However, I also began to feel depressed. So after three or four days at the lower dose, I resumed the 200 mg/day of SAM-e and I began removing a vitamin or supplement one-by-one from my daily dose matrix looking for the "bad egg(s)".
However, that process was taking too long and I was not willing to subject my wife to any further rage. Therefore, ten days ago, I pulled the plug and stopped all vitamins and supplements (including SAM-e). Of course, I continued taking my medication (600 mg/day Lithobid).
A day or so after I quit taking the vitamins and supplements I cycled into a very deep dark depression. No rage, but lots of depression. I think it was the discontinuation of the 200 mg/day of SAM-e that contributed most to the depression. I continued to abstain from all vitamins and supplements for the duration of the depressive episode which lasted four days.
In the five days that have elapsed since I came out of the depression, I have consistently felt great. No depression and no irritability. Each day I am slowly (and methodically) adding an appropriate amount of a particular vitamin, mineral or supplement (e.g. phosphatidyl serine, omega-3 PUFA's, myo-inositol, SAM-e, etc) to determine by trial and error what helps and what causes problems. As it currently stands, I plan to add SAM-e to the matrix last. This will likely occur in about two weeks.
If it turns out that SAM-e is the culprit that causes the irritability, then I am going to feel a little sheepish since I was such an outspoken advocate for the benefits of SAM-e. Further, if it is the SAM-e, I wonder why it worked great for six months before this irritability problem came about? Also, what's up with the fact that I seem to be doing great without the SAM-e now, whereas, six months ago it was essential to my mental health?
Here's one possible speculation: Years of various AD trials drained my body's SAM-e tank bone dry. By taking 200 mg/day of supplemental SAM-e, my tank was refueled over time. However, after about six months, my tank was completely filled to the brim and it began to overflow. The overflow caused irritability. When I quit SAM-e cold turkey I went into depression for a few days because my body had gotten accustom to being spoon fed the SAM-e as a dietary supplement and it took a couple days for my body to retrain itself to manufacture SAM-e and/or draw out of the tank. Of course, this word picture is all pure conjecture on my part and likely has little or no basis in fact.
I also wonder if the irritability is caused by low relative amounts of GABA compared to serotonin and dopamine. In other words, since SAM-e raises serotonin and dopamine, perhaps GABA becomes out of balance with SE and DA after an extended period of SAM-e supplementation.
>I tried to switch to another TCA, but any increase in meds hits me with a horrible batch of side effects so the cross-over is proving to be very tricky. I finally had to go back on my old dosage of tranzene(benzo) since the anxiety just became too great. Somewhat disappointing, but I am still thinking about a trial of sam-e since the switch to the TCA proved to difficult. I just don't know if it is something a person on benzo's should do or not?
I personally think that SAM-e would go well with a benzo. When I was going through my "irritable mood syndrome" adding a benzo was something I seriously considered. My rational goes back to the GABA imbalance conjecture discussed above. The benzo would have helped me by increasing the available GABA. I've never been on a benzo and I would rather not because of the difficulty associated with withdrawal. Therefore, instead of a benzo, I was considering either Neuronin or Gabtril (moodstablizers) to augment my Lithobid and elevate my GABA levels.
John, refresh my memory by posting your dx, a list of the meds you have tried and your reactions to them, and a list of your current meds. After I get the information, let's talk more regarding the efficacy of a SAM-e trial for you.
>I don't know if sam-e would cause more anxiety or not, I would like to find something that would give me more energy, but not send me into overdrive.
John, tell me what you mean by "overdrive". Do you mean worry and fear or do you mean hyperactivity or something else?
>Finding something to help with the anxiety/depression has been extremely frustrating since I am so med sensitive.
Define what you mean by "anxiety". Is it worry or fear or irritability or something else? Have you tried Serzone?
>I hope Colin is fairing well in cyber jail.
Me too! Hope he got the ball and glove that Beardy sent to him.
-- Ron
poster:Ron Hill
thread:106963
URL: http://www.dr-bob.org/babble/20020517/msgs/107176.html