adjunctive medication that has been found safe and effective in combination with
monoamine oxidase inhibitors.^22
The 2010 study co-authored by Mischoulon (cited above) showed the safety of using
SAM-e as an adjunct to SSRIs.
The Mayo Clinic says that SAM-e can react with antidepressants, but no other source
agrees with that caution. See Adjunctive Use for Depression above.
Consumer Reports lists a risk of a toxic reaction when taken with the cough suppressant
dextromethorphan, certain (undefined) anti-depressants, narcotic pain relievers or
levodopa (for Parkinson’s disease). Brown, Gerbarg and Mischoulon all dissent from
the concern expressed about adjunctive use (see discussion above under that title)
and levadopa. Brown et al. assert that SAM-e is beneficial in Parkinson’s disease.
Levodopa depletes SAM-e causing depression and other problems.^23 Administration
of SAM-e counteracts some of the adverse effects of levodopa. It does not interact
adversely.
- SIDE EFFECTS
In Brown et al. II, Bottigleri states the most obvious advantage of SAM-e: “Unlike many
prescription antidepressants, SAM-e does not cause weight gain, sexual dysfunction,
sedation, or cognitive interference.”^24
SAM-e is activating, and can exacerbate underlying agitation, panic or anxiety, like any
other activating anti-depressant. Brown et al. emphasize that SAM-e is most effective
against enervating depression: It helps to energize persons whose depression is
characterized by low energy, low motivation, tiredness, and hypersomnia. For the same
reason, according to Brown et al., if depression is accompanied by anxiety or agitation, it
may be necessary to use benzodiazepine, buspirone, or another anxiolytic for two to
three weeks, until the activating effects of the SAM-e are subside.
In Brown et al. II, Bottigleri cautions that people who are sensitive to the activation
produced by SAM-e may need to use a “calming agent” until jitters, agitation and
anxiety subside.
