SAM-e May Increase the Effectiveness of Your Antidepressant

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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:

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.

Caution: Do not start taking SAM-e in addition to any antidepressants you may be presently taking without asking your doctor first. Always tell your doctor about any supplements, vitamins, or herbal remedies you wish to take along with your prescription medications.

Here are some of the other studies and reports on SAM-e:

  • In 2002 the U.S. Department of Health and Human Services conducted a comprehensive literature review on SAM-e and concluded that: "These data indicate that SAMe is more effective than placebo for relief of symptoms of depression" and that "treatment with SAMe was equivalent to standard therapy for depression."

  • A 2005 review of studies on the effectiveness of SAM-e in the treatment of depression, published in Clinical and Investigative Medicine, concluded that: "There appears to be a role for SAMe in the treatment of major depression in adults."

  • In 2010 Consumer Reports listed SAM-e as being "likely effective" for reducing the symptoms of major depression and osteoarthritis.

My advice to you if you are considering to use SAM-e is to read as much as possible about this supplement and to also ask your doctor for his or her expertise.

Here are some further resources with information about the use of SAM-e to treat depression:

In addition you may also find these Health Central articles on SAM-e and natural supplements to be helpful: