Because of its activating effects, SAM-e generally should not be taken after 4 p.m.
All of the sources warn that SAM-e can induce mania in persons with bipolar disorder.
Thus, bipolar disorder needs to be ruled out or controlled before initiating use of SAM-e.
A careful psychiatric evaluation is the appropriate way to make this diagnosis
Mild and transient anxiety, insomnia, loose bowels and heartburn are the only
physical effects noted by Fugh-Berman and Cott.
Brown et al. cite “mild nausea” as the most common side effect of SAM-e. Related
symptoms like loose bowels, flatulence and abdominal pain can also occur. Although
SAM-e is best taken with an empty stomach, about 20-30 minutes before breakfast or
lunch. If nausea is problematic, it may be alleviated by eating a small snack right before
taking SAM-e. Persistent irritable bowel effects, nausea or diarrhea may require
discontinuation of SAM-e treatment. Occasionally, patients complain of a headache.
As side effects, Consumer Reports lists gastro-intestinal symptoms, dry mouth,
headache, mild insomnia, anorexia, sweating, dizziness, anxiousness and nervousness,
especially in “high doses” (undefined).
According to Brown et al., SAM-e has far fewer side effects than other anti-
depressants, works more rapidly, and does not cause weight gain or sexual
dysfunction. SAM-e does not cause sedation or cognitive interference, making it
preferable to many other treatments for depression. It is also better tolerated by
elderly people and by people on medications that compromise liver function.
Lake and Spiegel assert flatly that SAM-e presents “no known medical risks.”^25
Mischoulon and Rosenbaum describe the potential benefits of orally-administered
SAM-e for depression, including ease of administration and lack of sexual and weight-
gain side effects, as well as a shortening of the latency (delay) of the anti-depressant
effect of the drug.
If SAM-e is combined with a nutriceutical formulation, the side effect and drug
interactions of the other constituents must be considered as well. Folate and omega- 3
essential fatty acids are dealt with in separate chapters of this outline.
sharon
(sharon)
#1