s-adenosylmethionine (SAM-e) supplements are being used for treating depression naturally. SAM-e is present naturally in all cells of the body and is produced from the amino acid,methionine. It plays an important role in the brain functions and neurotransmitters(brain chemicals) production. It is also involved in the methylation cycle in the brain.
It was in the 1970’s when for the first time the antidepressant properties of s-adenosylmethionine (SAM-e) were discovered by the Italian researchers. Researchers have found that the depressed people have low levels of SAM-e in their blood and the cerebral spinal fluid (fluid that surrounds the brain and the spinal cord), and supplementation raises its levels and the levels of other neurotransmitters in the brain (e.g dopamine and others).
Recent systemic reviews and metanalysis have shown that SAM-e is effective in the treatment of depression. A report from the US department of Health and Human services gave the conclusion that SAM-e is better than placebo and was equivalent to standard therapies for the treatment of depression. However further trials and data is needed before it can be declared as a standard alternative treatment.
Moreover research studies have found that patients who did not respond to selective serotonin reuptake inhibitors (SSRIs) showed better treatment response when SAM-e was added as an adjuvant therapy. Therefore SAM-e shows more promising results when used as add-on therapy although it has shown good results in monotherapy as well.
If used with other antidepressants you may need to decrease the dose of the standard antidepressants because it potentiates the antidepressant effects. It can be combined with the other antidepressants unlike St johns wort which poses a greater risk when combined with other antidepressants. However it is not beneficial for the depressive symptoms occurring in bipolar disorder.
SAM-e has been found useful in various conditions in different studies and they include:
2. ADHD (Attention deficit hyperactivity disorder)
3. Insomnia (Inability to sleep)
4. Cardiovascular diseases
6. Rheumatoid arthritis
8. Liver disease
SAM-e can be taken in the oral form in the range from 400-1600mg per day in divided doses. In some studies dose of 800mg twice per day was used. It can also be given through the intravenous route in the route of 150- 1600 mg per day. It is still not clear about the optimum dose of SAM-e for the treatment of depression.
1. It may potentiate the effect of other anti depressants ( MAO inhibitors, TCAs and SSRIs)
2. SAM-e given through the intravenous route can enhance the effects of oral hypoglycemic agents (drugs used for diabetes).
3. It may augment the effects of ursodeoxycholic acid.
4. It may also enhance the antidepressant effects of St Johns wort, tryptophan and 5-HTP.
The common side effects of SAM e reported are nausea, dry mouth and restlessness.
It should be used with caution along with other antidepressants, 5-HTP and tryptophan.
It is should NOT be used in patients suffering from :
1. Peptic ulcer or stomach ulcer.(because it blocks the effect of platelets and increases the chances of bleeding)
2. Intracranial bleeding ( bleeding inside the brain)
3. Using blood thinning agents/anticoagulants like warfarin, aspirin and anti-platelet agents like clopidogrel and others.
Discontinue before surgery
It is advisable to discontinue SAM-e at least 14 days before undergoing any surgery.