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A molecule found in every cell in the body, SAM-e is a promising agent for generalized anxiety, depression and SSRI withdrawal.
Comorbid depression is a common problem in PNE. I have found SAM-e at a dosage of about 600 mg a day to be a very effective agent in treating depression and nonpanic anxiety. It needs to be taken with B12 and folate and it takes about 10 days to 15 days to work. Side effects are minimal compared to usual antidepressants. Currently it is my antidpressant of choice for my patients.
I see a fair number of people who
want to withdraw from SSRIs. For some it is fairly uneventful while for others it is an intense and
unpleasant experience. Severe depression with a characteristic easy tearfulness is one of the more
difficult symptoms to deal with. I have been looking for agents which will help with not only SSRI
withdrawal depression, but also with the other problems such as visual lag, nausea, zaps etc.
Some anecdotal information concerning SAM-e being a possible agent to combat SSRI
withdrawal came my way via Australia. SAM-e is a natural substance found in the body. The
manufacturing process is difficult so you need to make sure that it is of good quality. It is a "methylating" agent, donating a methyl group in chemical reactions. This
turns out to be useful for the synthesis of monoamines like norepinephrine and serotonin. It also is
useful for arthritis and fibromyalgia (connective tissue repair requres methylation) as well as to
repair damaged cell membranes (thought to occur in SSRI neurotoxicity).
SAM-e has been well studied as an antidepressant but has not been studied as an anxiolytic. My clinical experience is that it can be quite effective for anxiety.
It certainly mixes with Xanax and it seems safe enough that I endorse trying it for comorbid
depression at 600 mg a day for depression/anxiety and at 1200 mg a day for SSRI withdrawal symptoms.
