S-adenosylmethionine (SAMe) for depression, to enhance the effectiveness of conventional anti-depressants and as a possible neuro-protectant

S-adenosyl-L-methionine (SAMe) is a natural metabolite essential to the function of all of our cells. It has been used extensively for treating depression in Europe and other countries for over three decades. Based on its record of few side effects, it was approved by the US FDA as a neutraceutical. SAMe is a “first line CAM treatment” for moderate to severe depression. It has fewer side effects than other antidepressants, works more rapidly, can augment the effects of other anti-depressnats, and does not cause weight gain, sexual dysfunction, sedation, or cognitive interference. It is also better tolerated by the elderly, and by people with compromised liver function. It is particualrly useful in people whose depression is secondary to medical conditions. For example, SAMe improves arthritis and joint pain. In Europe SAMe has been shown to be safe for treatment of cholestasis of pregnanacy without adverse effects on mother or child. Three small recent studies of the use of SAM-e in combination with other nutrients show promising results for treatment and prevention of dementia. There are no reported adverse drug or herb interactions, and SAM-e protects the liver from the adverse effects of other medications. SAM-e is activating and can exacerbate anxiety or induce mania in people with bipolar disorder, as do other antidepressants. Because physicians are not familiar with the benefits of SAMe (partly because it is not a prescription medication in the US), public education is needed to raise awareness and provide accurate information on this underutilized, valuable treatment.