Sam-e supplement...patient taking..not sure its ok..

Altra, BSN, RN · Oct 2, 2011

I can't find much about the supplement Sam-e. I looked for old threads here but nothing really.. A patient is taking this (low dose) in addition to 2 other antidepressants..I am concerned this is too much...I don't know anything about this supplement..if it actually works..all I can seem to find is it can help with depression, joint pain but not anxiety and yet she swears it helps with anxiety. Her primary doctor does not know she is taking it and has been for about 6 weeks..I told her I would need to call him in the a.m. to let him know..she said she is not going to stop taking it..so..anyone have any professional or personal experience w/this supplement? I am not seeking medical advice..just opinions:)

If you don't know anything about the supplement, what is specifically triggering your concern that it is "too much"? Too much what?

I agree that the patient's prescribing physician should be made aware of all prescribed meds and OTC supplements she is taking. But your post seems to indicate that you took an approach with the patient that the supplement may be unnecessary or even harmful, when you yourself state that you don't know anything about it.

Altra, BSN, RN · Oct 2, 2011

Most drug guides include a chapter on common OTC supplements with potential contraindications and interactions.

Lucky724 · Oct 2, 2011

I have read the drug book and looked online and I was familiar with the supplement but not as this patient is using it...I am concerned about too much Serotonin..this supplement plus 2 other SSRI's seems like a lot to me though I realize people metabolize substances differently based on chemical make up, age, sex, etc.. There are some studies that support using this in addition to one AD but not two..I was looking for opinions/experience from others who may have encountered this therapy..that was all.

caliotter3 · Oct 2, 2011

This information needs to be communicated to the doctor.

Esme12, ASN, BSN, RN · Oct 2, 2011

http://www.ncbi.nlm.nih.gov/pubmed/15537554

http://www.medscape.com/viewarticle/495861

Here are two studies . We are not able to provide advice and my opinion is that any drug taken to excess is detrimental to one's system. I would think toxic symptoms would be the same as SSRI's. I'd notify the MD and allow him to advise the patient.

AJPV · Oct 2, 2011

I have personal experience with an MD who is the head of the integrative medicine department at a large teaching hospital. She prescribes SAM-e quite frequently and her patients find it effective. But I can't speak to the precise issue of how it interacts with SSRIs. You'll have to find a pharmacist or MD who has in-depth knowledge about it - that can be challenging with some of the non-traditional supplements.

Whispera, MSN, RN · Oct 2, 2011

SAM-e is an SSRI. Taking it with other medications that raise levels of serotonin can lead to more of the side effects serotonin causes, as well as raising the likelihood of serotonin syndrome, which isn't pleasant.

The patient's doctor needs to know she's taking it.

Trauma Columnist · Oct 3, 2011

This is asking for medical advice as we can't provide interactions or know what other meds this pt is taking - need to talk with the provider.