A case of serotonin syndrome was associated with the concurrent use of tricyclic antidepressants and SAM-e. Specifically, a 71-year-old female became increasingly anxious, agitated, and confused within 48 to 72 hours after ingesting a higher dose of clomipramine (75 mg/day) while she was taking SAM-e (100 mg/day IM). Parkinson’s disease patients should not take SAM-e with the drug levodopa, as SAM-e may interfere with the drug’s actions.