Yes there are both side effects and reactions possible when taking Sam E. alone and with other drugs. Sam-e has some neurotransmitter effects and can stimulate some people and make them anxious when taken all by itself. Combining it with antidepressants may be a big no-no unless you consult with your doctor. Sam-e may interact with other drugs that work on the same neurotransmitters, and could cause serotonin syndrome. Symptoms of serotonin syndrom include hallucinations, fever, muscle spasm, difficulty walking, and diarrhea. Some drugs that may interact with SAM-e include SSRIs, SNRIs, tramadol, St. John's wort, monoamine oxidase inhibitors, meperidine, and Deprenyl. You should always check with a medical provider before adding a supplement to your current drug regimen.