I keep hearing that these two products 'should not be taken together'
"without consultation with your doctor," - which is totally un-useful. My doctor usually hasn't got a clue, I can't find any doctors who do and no one ever has time to look it up. I can't find a proper detailed scientific answer on the Web either.
Do any of you know?
I mean REALLY KNOW...

Thanks.

J.

J_9

I am looking in 2007 Mosby's Nursing Drug Reference, 20th Anniversary Edition and I will quote what it says:

"! Do not use together; increased risk of serotonin syndrome: St. John's wort and SAM-e"

According to Psychiatriac Nursing Fifth Edition Serotonin Syndrome symptoms include (most frequent to least frequent)

* Mental status changes, including confusion or hypomania (hypomania is a mild degree of mania characterized by optimism; excitability; energetic, productive behavior; marked hyperactivity and talkativeness; heightened sexual interest; quick anger and irrability; and a decreased need for sleep. It may be observed before a full blown manic episode)

* Restlessness or agitation

* Myoclonus, which is a spasm of a muscle or a group of muscles

* Hyperreflexia which is increased reflex reactions

* Diaphoresis (sweating)

* Shivering (or shaking chills)

* Tremor

* Diarrhea, abdominal cramps, nausea

* Ataxia (an impaired ability to coordinate movement. A staggering gait and postural imbalance) or incoordination

* Headaches

I hope this helps. If not, let me know and I will see if I can find out more for you.

jonmark222

I appreciate the info.
If you can find more information, I would be grateful.
I have taken both (Prozac for 12 years) SAM-e for about 1 year and, up to now, I have felt fine. I recently went on to weight-watchers and lost about 16 lb. in 3 months. I am currently experiencing some strange symptoms: anxiety, nervousness, inablility to focus, restlessness, slight ataxia - which seems reflected in your explanation; but not really the other symptoms. BTW ( I also take Lotrel for HBP, but my pressure is now lower naturally because I have lost weight.) I have completely lost confidence in 'doctors' whose best diagnosis is an educated guess and often appears to me to be an uneducated guess.
I have decided to try and phase out the Prozac - slowly; the Lotrel too, and see what happens. What do you think? I am aware your opinion is just that and don't worry I won't sue you for the take I am asking you to give me. I don't believe in that sort of thing.
Thanks.
J.

J_9

Well, apparently the Lotrel does not interact with either the Prozac or the SAM-e, so I would venture to guess (yes medicine is a PRACTICE) that the symptoms you are experiencing are due to the Prozac and SAM-e.

You may have been taking them for up to a year, but it sometimes takes a while for meds to reach a level where they are considered toxic. Now, understand toxic does not always mean deadly, but can mean that is when adverse reactions begin to happen.

If you feel it necessary to wean of the meds slowly, let me advise you that you should only do one at a time. Don't go off the Prozac and the Lotrel at the same time. I would guess you should go off the Prozac first, since withdrawal symptoms can increase BP, so you will have your Lotrel to back you up during the weaning process.

If you have not, it may benefit you to talk directly to a pharmacist/chemist about these drugs rather than a physician. The pharmacist is much more knowledgable about the effects of meds and withdrawals than most doctors.

jonmark222

Janine....I am MOST GRATEFUL to you for your answers.

By the way, my 31 year old daughter has just begin a three year training course to be a nurse at the University of Applied Sciences of Western Switzerland. It is run by the Red Cross. She was accepted there after having passed the preliminary exams successfully. From the age of 19 to the present she was a legal secretary; so I believe there are a few similarities with your own story. Just another example of synchronicity.

I would like to count myself as an on-line 'friend' if that is OK with you?

J.

J_9

Wow, J, that is amazing, you have got to be proud of your daughter!!!!

Yes, talk about synchronicity!!!!

Please J, add me as a friend. I would really like that!!!!!

Another funny thing is you are J and I am J!