In 2009 I wrote about my experience taking SAM-e (S-adenosyl-L-methionine) to treat my depression. SAM-e is a natural compound which can be taken in supplement form. This supplement has been used for many purposes including treating osteoarthritis, fibromyalgia, and depression. I have used SAM-e for years with no bad side effects. My experience taking SAM-e has been a very positive one as it has kept me from sinking to the extreme lows of a major depressive episode. Yet when I tell my doctors, or other people in general, that I take SAM-e I usually get a puzzled expression. It seems most people have never heard of SAM-e. This is surprising to me because there is much research to show that it is an effective supplement to treat some forms of depression. In recent years additional research has suggested that when SAM-e is paired with a traditional antidepressant, it can be a successful add-on for treating resistant Major Depressive Disorder. In this post we are going to take a look at some of these studies and I will be giving you some further resources so that you can read up on this supplement on your own.
Last year the New York Times ran a big story on a study (July 2010) conducted by researchers at Harvard Medical School and Massachusetts General Hospital in Boston. These researchers were specifically looking at whether or not SAM-e could be an effective treatment option for patients who did not respond to traditional antidepressants. Their report, which was published in The American Journal of Psychiatry, concluded that:
“These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and warrant replication.”
Here are some of the results of this study:
• Following six weeks of treatment 36% of the patients receiving both SAM-e and an antidepressant showed improvement in their depression symptoms. This is compared to 18% of those who took an antidepressant and a placebo.
• The study authors found that 26% of those study patients who took SAM-e experienced a complete remission of symptoms as compared to 12% in the placebo group.
The Depression Clinic of Chicago reported that there was a miscalculation of these results and that the actual response rates for the SAM-e group was much higher than indicated. The December issue of the American Journal of Psychiatry corrected the results which actually showed that 46% of the patients improved receiving both SAM-e and an antidepressant and that 36% of those patients in the SAM-e group experienced complete remission of their symptoms.
Despite the success of this study, some experts and doctors are cautious about recommending SAM-e to patients who are already taking an antidepressant. One reason is the increased risk for the patient to develop serotonin syndrome, a rare but potentially deadly complication of combining two antidepressants or combining either SAM-e or St. John’s wort with an antidepressant. One of the other drawbacks of using SAM-e is that it is not covered by insurance and can be expensive. I take a rather low dose (400 mg a day) as compared to some who may need 1600 mg daily and I spend about $65 a month for my dosage. SAM-e has not been proven to be effective for children or teens. It is also not recommended for those who have Bipolar Disorder as it can potentially cause a manic episode. SAM-e is not without side effects but the worst of these is usually stomach upset. It is recommended that you take SAM-e with vitamin B-12, B-6, and folic acid for it to be most effective.