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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by g_g_g_unit on October 24, 2009, at 2:37:13
my depression is characterized by lethargy, anhedonia, and a worsening of executive function issues, which makes me think it's partly catecholamine related.
anyway, before going on Parnate, i tried SAM-e twice, and tyrosine once.
i used a low dose (100mg) of N-Acetyl-Tyrosine and felt really happy and stimulated - talkative, etc. - for the first time in months. more so than on Parnate even. too high a dose (300mg) just left me angry and tense.
the same thing happened on SAM-e (400mg), though it was almost too much, like an overstimulation.. usefully socially, but it didn't actually improve concentration etc.
i was just wondering if that's a common reaction or if it indicates some kind of hypomania, since i know both substances are contraindicted in Bipolar (something i've never been diagnosed with)? what's the difference between 'overstimulation' and hypomania?
Posted by TenMan on October 24, 2009, at 10:49:58
In reply to hypomania or overstimulation? SAM-e / tyrosine, posted by g_g_g_unit on October 24, 2009, at 2:37:13
SAM-e is a wonderful compound which works almost instantly to relieve my depressive symptoms which mirror yours. Unfortunately I have found that it also can make me quite irritable. Interestingly in combination with Alpha-GPC, a choline donor, the irritability is relieved substantially. I would probably continue using the combination if the cost weren't prohibitive. But the two did provide most of what my body seemed to need and relieved substantially my anhedonic symptoms and executive dysfunction.
I know someone who had great success on SJW and tyrosine combined so maybe you could try that?
Posted by g_g_g_unit on October 24, 2009, at 23:19:56
In reply to Re: hypomania or overstimulation? SAM-e / tyrosine, posted by TenMan on October 24, 2009, at 10:49:58
oh i am definitely interested in trying SAM-e once i taper off Parnate. i was just worried that speedy reaction might actually be hypomania, which would not be such a good thing. otherwise, i was thinking of combining it with calming agents like inositol and niacinamide. i responded, like i say, to a pretty low dose (400mg), so i don't think it would be too cost prohibitive. choline unfortunately just seems to made my depression worse.
Posted by g_g_g_unit on October 25, 2009, at 5:33:27
In reply to Re: hypomania or overstimulation? SAM-e / tyrosine, posted by TenMan on October 24, 2009, at 10:49:58
> SAM-e is a wonderful compound which works almost instantly to relieve my depressive symptoms which mirror yours. Unfortunately I have found that it also can make me quite irritable. Interestingly in combination with Alpha-GPC, a choline donor, the irritability is relieved substantially. I would probably continue using the combination if the cost weren't prohibitive. But the two did provide most of what my body seemed to need and relieved substantially my anhedonic symptoms and executive dysfunction.
>
> I know someone who had great success on SJW and tyrosine combined so maybe you could try that?
>
>i guess the irritability was an NE thing which choline would antagonise? what dose did you try? apparently you're meant to stay on a certain dose to start with (200/400mg or whatever), and then *lower* it as it builds in your system - from what i've read in some places anyway.
there's some studies where methylation changes induced personality changes in rats. on methyl-b12, b6 and folic acid i fell into a kind of internalized, schizoid state, so i hope the same thing doesn't happen with too much S-AMe :/
Posted by bleauberry on October 27, 2009, at 18:31:49
In reply to hypomania or overstimulation? SAM-e / tyrosine, posted by g_g_g_unit on October 24, 2009, at 2:37:13
I am one of the few that frown on the terms used in psychiatry, such as bipolar. It is merely a word to describe a rather vague set of symptoms that are subjectively viewed differently from one doctor to another. It could be a form of anxiety, a subset of psychosis, a type of stimulation, a variant of ADHD, or some other thing that no one has invented a word for yet! It may be something having nothing at all to do with the brain.
It is not as if any of these things have distinct boundaries. They don't. They overlap. They have similarities. It can be a piece of this and a part of that. So I personally find these labels somewhat helpful as an initial guide, but not very useful in the big picture.
I try to view it more simply. Your reaction to Tyrosine or SAMe tells me several things:
1. Your hunch that the deficit is somewhere in the NE/DA circuitry is probably close or accurate.
2. There could be a methylation problem, in which SAMe repairs it, or tyrosine supplies what the missing methylation was supposed to do without the tyrosine.
3. The doses were too high. The amount needed to overcome the deficit is less.
I am also one of the few in a camp that says doses suggested on bottles of supplements are way too high. I think 5htp for example should come in 5mg and 10mg choices, not just 50mg or 100mg. I consider those to be massive doses. I felt the same way about DHEA for years and got laughed at for my ridiculous stance. It was only available as 50mg. Well, guess what, now you can get it 5 mg. Somewhere along the line I wasn't the only one thinking this way.
I learn a lot at other forums. Real people. Real results. No science. Just experience.
How about this one. A guy found that 5htp helped, but with experimentation he found his total daily dose needed to be 13mg split into 5 small chunks throughout the day. Five different doses where the total intake of a 24 hour period was just 13mg. But tyrosine was also important. His optimal dose for that was 35mg in the morning and another 35mg in the afternoon.
Another person, 75mg tyrosine at bedtime. Yeah, bedtime. Weird, but it makes the point.
A lady who takes SAMe as needed...not continuously. Maybe every day for a few days, then once every three days, going back to daily during flare-ups. She finds SJW calming, so sometimes she switches to that for a few days instead if her symptoms call for it. In other words, she takes what she needs as she needs them, not on a continuous basis.
At a SJW forum, people find that when their 5htp seems to plateua, poopout, or fade, the addition of tyrosine fixes it. They also find that when that happens, it means now they have too much serotonin, so they stop for a couple days until they can feel their stores are running on empty and then take some more. While it may have taken higher doses and continuous dosing in the early stages of recovery, maintenance stage only required small or intermittent doses.
In this way I think supplements are different than meds. We may not need the same dose or the same ones from one day to the next, one week to the next. We need to know how they make us feel, and then use that depending on where we are. Body chemistry is continuously changing day to day, bouncing around, being influenced by food choices, light, daily events, stress, sleep, etc. Supplements can be molded to fit the ever-moving target, where meds can't.
Too stimulated? Bipolar? I don't know. All I can say is it is probably one of these two things:
1. The dose was too high.
2. The dose needed to be matched with a counterpoint agent...either 5htp, magnesium, gaba, glycine. View tyrosine or SAMe as the accelerator pedal in your car...but you need a brake pedal too. And we need to learn how to navigate with both.
Posted by g_g_g_unit on October 27, 2009, at 21:43:53
In reply to Re: hypomania or overstimulation? SAM-e / tyrosine, posted by bleauberry on October 27, 2009, at 18:31:49
thanks for your helpful post. it's strange because when i supplement with b6, folic acid and methyl-b12 (which supposedly converts into S-AMe?) i don't get the same reaction as supplementing with pure S-AMe; like i say, the former provokes a calm, but near-schizoid state in me, where as pure S-AMe is far more pleasantly stimulating.
if i repeat the experiment (depending on where my Parnate trial goes), i may try a lower dose, like 200mg of S-AMe every second day (i assume you can't cut the enteric tablets?).
likewise, i only dabbled with N-acetyl-tyrosine. 300mg (the dosage it comes in) was way too much (i felt really tense and dysphoric), but 75mg was pleasant. i imagine since NALT is more potent than tyrosine, i could get away with a tiny dose.
i also have inhibiting substances on board - my (admittedly roughshod) plan for OCD w/ executive function difficulties was to try and combine something stimulating like S-AMe with a modestly therapeutic dose of inositol.
Posted by bleauberry on October 28, 2009, at 17:45:14
In reply to Re: hypomania or overstimulation? SAM-e / tyrosine » bleauberry, posted by g_g_g_unit on October 27, 2009, at 21:43:53
> thanks for your helpful post. it's strange because when i supplement with b6, folic acid and methyl-b12 (which supposedly converts into S-AMe?) i don't get the same reaction as supplementing with pure S-AMe; like i say, the former provokes a calm, but near-schizoid state in me, where as pure S-AMe is far more pleasantly stimulating.
Maybe a roadblock in the B metabolism somewhere? SAMe is like a short-cut bridging the roadblock?
>
> if i repeat the experiment (depending on where my Parnate trial goes), i may try a lower dose, like 200mg of S-AMe every second day (i assume you can't cut the enteric tablets?).You can cut the enterics. They lose a tiny bit of potency, but not much. You can dismiss the internet claims that it must be taken whole. My own experiments and others have confirmed that SAMe can definitely be felt even when the enteric tabs are cut into quarters or halves. Theory is trounced by actual experience.
>
> likewise, i only dabbled with N-acetyl-tyrosine. 300mg (the dosage it comes in) was way too much (i felt really tense and dysphoric), but 75mg was pleasant. i imagine since NALT is more potent than tyrosine, i could get away with a tiny dose.I wouldn't pay attention to the dose. Pay attention to the feel. If it is 10mg that fixes your chemical imbalance, then so be it. If someone else's chemical imbalance requires 1000mg, so be it. You have to find your own dose, which may be dramatically higher or lower than your best predictions.
>
> i also have inhibiting substances on board - my (admittedly roughshod) plan for OCD w/ executive function difficulties was to try and combine something stimulating like S-AMe with a modestly therapeutic dose of inositol.
>
I seriously doubt you will find inositol helpful for that purpose. The other agents I mentioned are much better, faster, and more direct.
Posted by g_g_g_unit on October 28, 2009, at 21:01:14
In reply to Re: hypomania or overstimulation? SAM-e / tyrosine, posted by bleauberry on October 28, 2009, at 17:45:14
>
> I seriously doubt you will find inositol helpful for that purpose. The other agents I mentioned are much better, faster, and more direct.
>i have magnesium on hand, which i take anyway and always find helpful. gylcine leaves me a little spacey though. why the thumbs down on inositol? granted, i don't find it effective as an instant anti-anxiety agent, but its clinical efficacy in OCD trials makes it worth experimenting worth IMO. i've used lower doses with some success in the past, so want to see what 10-18g might do.
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