My Experience Taking SAMe (S-adenosyl-L-methionine)

by Anne Windermere Patient Advocate

Okay so I can't pronounce the formal name of this over the counter supplement, nor do I totally understand the chemistry behind it, but it has been my experience that SAMe helps my depression. If you ever take a look at my profile page you will notice that I am not taking any prescribed anti-depressants. It isn't from a lack of trying. I have tried several antidepressants and found that the side effects were too much for me. I have also tried St. John's Wort which seemed to only increase my nap times. Then several years ago I heard about something through the on-line grapevine called SAMe (pronounced sameee). I am always skeptical of any treatment whether it is prescribed or not. So I researched this supplement...a lot. I looked at studies. I read first hand accounts from people who were taking it. And based upon what I found, I decided to try it myself.

What is SAMe exactly?

It is a little hard to explain. It is neither an herb nor hormone. It is a compound that our body produces naturally. In an article by Carol and Richard Eustice, SAMe is defined as: "...a compound produced by our bodies from methionine. Methionine is an amino acid found in protein-rich foods. How does SAM-e work? With additional help from vitamin B-12 and folic acid, SAM-e relinquishes a methyl group from its composition to surrounding tissues and organs. Through this action, SAM-e helps with the maintenance of cell membranes, removal of toxic substances from the body, and the production of mood-enhancing neurotransmitters." So it is recommended that you take B-12 and folic acid to help facilitate the effects of SAMe.

What is SAMe used for?

Among the most popular uses include treatment for liver cirrhosis, osteoarthritis, depression, and fibromyalgia. It is primarily used to improve joint function and decrease the inflammation of arthritis as well as a treatment for depression.

How do you get it?

In Europe you get it by prescription but here in the states it is not FDA approved and is sold as an over the counter supplement. I buy mine at the local health food store. You can also purchase it on-line. Why won't the FDA bother with it? Royane Real, in her article entitled, "Is S-adenosyl-L-methionine a Miracle Cure For Depression?"

offers a plausible reason: "It's very unlikely that S-adenosyl-L-methionine will ever undergo major clinical trials like those that are used to evaluate new drugs for the FDA in the United States. The reason is that S-adenosyl-L-methionine is a natural substance and it can never be patented. That means no drug company could make big profits from it." As we all know most things do come down to money.

How much do you take?

The literature says you should probably take the smallest dosage possible to start just to see how well your body responds to it. Most of the packages I have seen start at 200 mg. You might be able to cut the pill in half to start off at a lower dose. I did begin taking the 200mg in the morning, with an empty stomach. After taking this dosage daily for several weeks then I upped it to two pills at 200 mg each twice a day. I have heard of people taking as much as 1600 mg daily for their depression.

Usually the capsules are in foil covered packages and you should store your SAMe in a dry cool place.

What are the known side effects?

Here is the really good part. In a 1999 Newsweek article, "What is SAMe" authors Geoffrey Cowley and Anne Underwood state that: "SAMe doesn't seem to cause adverse effects, even at high doses." They go on to report that: "No one has found SAMe significantly more effective than a prescription antidepressant, but it's clearly less toxic. The drugs that predate Prozac (tricyclics and MAO inhibitors) can be deadly in overdose, or in combination with other medications. Newer antidepressants, such as Prozac, Zoloft and Paxil, are less dangerous, but their known side effects range from headaches and diarrhea to agitation, sleeplessness and sexual dysfunction. And SAMe? Studies suggest that like other antidepressants, it may trigger manic episodes in people with bipolar disorder. Aside from that, the most serious side effect is a mild stomach upset."

Mostly I have heard that it can bring about a manic episode for those who have bipolar disorder, it can cause insomnia, anxiety, and can upset your stomach.

The only side effect that I have ever experienced with SAMe is the upset stomach. I used to take it in the morning but now I take it at night and it doesn't ever upset my stomach now. Some people might not wish to take it at night as it may cause insomnia.

But surely these side effects are nothing compared to some I have experienced or heard about from many of the major antidepressants. But then again you are taking a substance which is not FDA regulated. You are kind of on your own with taking it or trusting that there aren't any weird fillers in them. It is therefore good to purchase such supplements with a company you trust and know.

One side effect will be on your pocketbook. SAMe is not cheap. I buy 60 enteric coated tablets from my local health food store for over $60. They are about a buck a pill. If you decide you need a higher dosage, well you do the math.

What about effectiveness? Have any studies to show us?

I do indeed.

Cowley and Underwood (1999 Newsweek article, "What is SAMe?") state the results from one small study: "In one of several small U.S. studies, researchers at the University of California, Irvine, gave 17 severely depressed patients a four-week course of SAMe (1,600 mg daily) or desipramine, a well-established antidepressant. The SAMe recipients enjoyed a slightly higher response rate (62 percent) than the folks on desipramine (50 percent)."

Royane Real, in her e-zine article entitled, "Is S-adenosyl-L-methionine a Miracle Cure For Depression?" reports that: "Studies of S-adenosyl-L-methionine done in Europe show that S-adenosyl-L-methionine can relieve depression in about 70% of cases. This 70% success rate in treating depression is better than a placebo, and it equals the rate of cure of prescription antidepressants."

Look through the literature and you will find that the studies are fairly positive for the use of SAMe for treating depression. It doesn't seem to be so good for manic depression, however, because it may cause a manic episode. Whether or not SAMe is effective for severe and entrenched depression, I do not know. But then again there are many cases where regular antidepressants do not help in some cases either.

I did read about some danger in people going off their antidepressants which are working well, in order to try SAMe. If something is working well for you keep with it

Also I do not know about the dangers of combining SAMe with prescribed antidepressants. I have read that you can experience dangerous levels of serotonin if you combine SAMe with some antidepressants. Always ask your doctor about possible drug interactions and especially with supplements.

So what has been your personal experience taking SAMe?

I have taken SAMe off and on for about three years now. The first time I took it, I noticed it taking effect within a week as opposed to prescribed antidepressants or St. John's Wort which all took more than several weeks to kick in. It did not make me sleepy and mostly it made me feel very productive and even keeled. My testament to SAMe are my closets. All of a sudden I got up one day and tackled my closets which I was unable to deal with organizing for years. I felt like getting up and doing things. It doesn't make me feel happy so much as motivated. It did lessen my depression and feelings of despair and hopelessness. But I have to tell you that the effects did seem to diminish over time. After about five months or so I began to feel the familiar signs of depression looming. I thought that the SAMe had run its course and was no longer effective. So I stopped it abruptly. This was a huge mistake.

Any time you are taking anything for your mood whether it is a prescribed antidepressant or a supplement such as SAMe, you need to taper off from it should you decide to quit taking it. I had such an abrupt mood change that I was left spiraling out of control and ended up having to call a suicide hotline. After my mood leveled out I took a break from SAMe and tried Prozac which I had to stop due to severe medical side effects. I then tried St. John's Wort for a second time only to find it made me nap all the time.

So after some months I decided to try my beloved SAMe again. I started with 200mg and then upped it to taking a 400mg tablet at night. This has been the most effective dose and way for me to take it. I have been taking it this way for more than several months now and so far so good. There are times when I think I am lapsing back into depression but it soon passes. The SAMe seems to take the edge off of things and helps me to keep an even keel. It has no bad effects on my libido nor does it make me feel tired or like a zombie.

If it stops working again, I will taper off from it and go to Plan B. Not sure what Plan B would be yet but I will cross that bridge when I get to it. This is the way of life for we who suffer from depression, always looking for the right combination of methods and treatments to help us to stay afloat.

Is SAMe a miracle cure? No. It is just another tool in my arsenal to help keep depression from destroying my life. It is helping for now. Good enough for me.

I hope this was helpful! Please tell us if any natural supplements help you and your depression. Share your experience.

We want to hear about it!

Anne Windermere
Meet Our Writer
Anne Windermere

These articles were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Merely Me."