What Is SAMe?
SAMe (prounounced "sammy") is an abbreviation for S-adenosylmethionine.
SAMe is manufactured in the human body from the essential amino acid methionine and the energy-producing compound adenosine triphosphate (ATP).
It can also be synthesized in a laboratory and it is this form which is sold as a dietary supplement.
How Does It Work?
SAMe molecules play a very important role in the body. They are able to donate a four-atom appendage - called a methyl group - to other nearby molecules. This process, called methylation, has many important functions in the body, including the regulation of neurotransmitters, such as serotonin, norepinephrine and dopamine. Shortages of these neurotransmitters have been associated with depression, so a shortage of a molecule like SAMe, which regulates these neurotransmitters, could play a role in depression.
Is It an Effective Treatment for Depression?
Overall, clinical trials involving SAMe indicate that it works as least as well as tricyclic antidepressants, an older class of antidepressants including such drugs as amitriptyline (Elavil, Endep), imipramine (Tofranil) and nortriptyline (Pamelor, Aventyl). Thus far, no studies have been published comparing SAMe with SSRIs, although it has been investigated as an add-on treatment for partial and non-responders to these medications, with promising results.
Some studies indicate that SAMe may be superior to conventional antidepressants in at least one area: It appears to relieve depression more quickly, sometimes taking effect within a matter of days, rather weeks, which is typical of conventional antidepressants. When combined with a low-dose tricylic antidepressant, faster results were also seen.
Is It Safe and Well-Tolerated?
SAMe is well-tolerated and does not appear to cause any serious adverse effects. Among the reported side effects of SAMe are: mild insomnia, lack of appetite, constipation, nausea, dry mouth, sweating, dizziness and nervousness.
Those with bipolar depression are advised to not use SAMe unless they are also taking a mood stabilizer, due to reports of increased anxiety, mania and hypomania in patients with bipolar disorder.
Thus far, no significant drug-drug interactions have been reported with SAMe, although a potential does exist for a dangerous build up of serotonin called serotonin syndrome to occur if it is used concurrently with other drugs which increase serotonin, such as other antidepressants.
Can It Be Used During Pregnancy and Breastfeeding?
Although SAMe is a substance already produced in the human body and appears to be fairly safe to use as a supplement, there is limited data about its safety during pregnancy and breastfeeding. Given this lack of information and the fact that there is considerably more data available for conventional antidepressants, it is probably wise for women to avoid SAMe during pregnancy and breastfeeding.
Source:
Michoulon, David, MD, Phd. "Update and Critique of Natural Remedies as Antidepressant Treatments." Obstetrics & Gynecology Clinics of North America 36 (2009): 789-807.
