Can SAM-e be used to treat depression?

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Anthony L. Komaroff, MD
Internal Medicine
The supplement known as SAM-e has been used for a variety of medical problems. These have included psychiatric illnesses, musculoskeletal problems and liver diseases. There have been studies of SAM-e showing that it can reduce pain from osteoarthritis. There is some work that suggests it might benefit adults with ADHD (attention deficit hyperactivity disorder).

Unfortunately, we don't have much good data on the effectiveness of SAM-e in treating depression. The clinical studies that have been done are either of poor quality or are inconclusive. The most commonly used dosages of SAM-e in trials of depression were 800 -- 1,600 milligrams daily for 6 weeks. It is not clear from the evidence whether or not SAM-e really has an effect on depression.

What about safety? It is important to remember that supplements like SAM-e have not undergone the same rigorous testing for safety and effectiveness as prescription medicines. The U.S. Food and Drug Administration (FDA) does not strictly regulate supplements as it does medicines. In addition, the purity of SAM-e sold in stores can vary from brand to brand, as this too is not regulated.

However, studies have shown that SAM-e appears to be fairly well tolerated. Frequent reported side effects include nausea, rashes and anxiety. SAM-e may lower blood sugar levels, which could be a problem in people who take insulin, for example. Also, there have been reports of insomnia, mood change, headache and hyperactivity. SAM-e has not been adequately studied in pregnant or breastfeeding women, the elderly or children.

If you are considering taking this supplement, you should first speak with your doctor to see if it would be a good choice for you.
Several studies suggest that the dietary supplement S-adenosylmethionine (SAM-e) may have beneficial effects on mood. SAM-e may alleviate symptoms of depression when used alone or as an adjunct to antidepressant medication. The compound is believed to achieve this effect by modulating the serotonin and dopamine systems in the brain. Potential side effects associated with use of SAM-e include arm soreness; hot, itchy ears and crawling sensation on the skin.

Medicinal use of SAM-e has not been approved by the FDA.
Marjorie Nolan Cohn
Nutrition & Dietetics

SAM-e is a substance that occurs naturally in the cells of plants, animals, and humans. Because the body produces less SAM-e with age, some people think that SAM-e may be a helpful supplement for certain diseases. Although current trials are inconclusive, an analysis of 28 different studies showed that SAM-e had a statistically significant improvement in the symptoms of depression when compared to a placebo. Some studies have shown that improvements were comparable to conventional antidepressants such as the class of medications called tricyclic antidepressants.

SAM-e is particularly helpful for those with a type of depression that produces low energy. The dosage is 400 to 800 milligrams daily, depending upon need or tolerance. The dose most often used for depression in clinical studies is 800 to 1,600 milligrams daily for up to six weeks. Although SAM-e usually causes few problems, you should use caution if you have diabetes, low blood sugar, or an anxiety or other type of psychiatric disorder. Gastrointestinal problems, headaches, fatigue, and skin rashes are the most common side effects.

Harris H. McIlwain, MD
Rheumatology
You might try SAM-e to treat depression. Most studies suggest that SAM-e works as well as pharmaceutical antidepressants yet it works quickly, giving results within one week. Pharmaceutical antidepressants may take as long as four weeks to show benefit. 
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.