HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mischoulon, D. Articles by Fava, M. Search for Related Content PubMed PubMed Citation Articles by Mischoulon, D. Articles by Fava, M. Agricola Articles by Mischoulon, D. Articles by Fava, M.

Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence^1,2,3,4

¹ From the Harvard Medical School, Depression Clinical and Research Program, Massachusetts General Hospital, Boston.

Major depression remains difficult to treat, despite the wide array of registered antidepressants available. In recent years there has been a surge in the popularity of natural or alternative medications. Despite this growing popularity, there is limited evidence for the effectiveness of many of these natural treatments. S-adenosyl-L-methionine (SAMe) is one of the better studied of the natural remedies. SAMe is a methyl donor and is involved in the synthesis of various neurotransmitters in the brain. Derived from the amino acid L-methionine through a metabolic pathway called the one-carbon cycle, SAMe has been postulated to have antidepressant properties. A small number of clinical trials with parenteral or oral SAMe have shown that, at doses of 200–1600 mg/d, SAMe is superior to placebo and is as effective as tricyclic antidepressants in alleviating depression, although some individuals may require higher doses. SAMe may have a faster onset of action than do conventional antidepressants and may potentiate the effect of tricyclic antidepressants. SAMe may also protect against the deleterious effects of Alzheimer disease. SAMe is well tolerated and relatively free of adverse effects, although some cases of mania have been reported in bipolar patients. Overall, SAMe appears to be safe and effective in the treatment of depression, but more research is needed to determine optimal doses. Head-to-head comparisons with newer antidepressants should help to clarify SAMe’s place in the psychopharmacologic armamentarium.

Key Words: SAMe • S-adenosyl-L-methionine • depression • antidepressants • alternative treatments • natural treatments

This article has been cited by other articles:

				U. WERNEKE, T. TURNER, and S. PRIEBE Complementary medicines in psychiatry: Review of effectiveness and safety The British Journal of Psychiatry, February 1, 2006; 188(2): 109 - 121. [Abstract] [Full Text] [PDF]

				M. I Ramos, L. H Allen, D. M Mungas, W. J Jagust, M. N Haan, R. Green, and J. W Miller Low folate status is associated with impaired cognitive function and dementia in the Sacramento Area Latino Study on Aging Am. J. Clinical Nutrition, December 1, 2005; 82(6): 1346 - 1352. [Abstract] [Full Text] [PDF]

				A. A. Nierenberg, P. Eidelman, Y. Wu, and M. Joseph Depression: An Update for the Clinician Focus, January 1, 2005; 3(1): 3 - 12. [Full Text] [PDF]

				A. Coppen and C. Bolander-Gouaille Treatment of depression: time to consider folic acid and vitamin B12 J Psychopharmacol, January 1, 2005; 19(1): 59 - 65. [Abstract] [PDF]

				M. I Ramos, L. H Allen, M. N Haan, R. Green, and J. W Miller Plasma folate concentrations are associated with depressive symptoms in elderly Latina women despite folic acid fortification Am. J. Clinical Nutrition, October 1, 2004; 80(4): 1024 - 1028. [Abstract] [Full Text] [PDF]

				C. S Lieber and L. Packer S-Adenosylmethionine: molecular, biological, and clinical aspects--an introduction Am. J. Clinical Nutrition, November 1, 2002; 76 (5): 1148S - 1150S. [Abstract] [Full Text] [PDF]