S-adenosyl-L-methionine (SAMe) is a naturally occurring chemical in the human body, produced largely by the liver. It is also manufactured synthetically as a supplement.
(See also Overview of Dietary Supplements Overview of Dietary Supplements Dietary supplements are the most common therapies among integrative medicine and health (IMH) and complementary and alternative medicine (CAM), which include healing approaches and therapies... read more .)
Claims for SAMe
SAMe is said to be effective in treating depression Depression Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to interfere with functioning. It may follow a recent... read more , osteoarthritis Osteoarthritis (OA) Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function. Arthritis due to damage of joint... read more , and gallbladder and liver disorders. It may help people who have osteoarthritis function better. Some people also claim that SAMe may help treat attention-deficit/hyperactivity disorder Attention-Deficit/Hyperactivity Disorder (ADHD) Attention-deficit/hyperactivity disorder (ADHD) is poor or short attention span and/or excessive activity and impulsiveness inappropriate for the child’s age that interferes with functioning... read more (ADHD) and fibromyalgia Fibromyalgia Fibromyalgia is characterized by poor sleep, fatigue, mental cloudiness, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments. Poor sleep, stress, strains... read more .
Evidence for SAMe
Scientific studies so far do not clearly confirm that SAMe has most of its claimed benefits and more research is needed.
However, in 2 studies reviewed in a 2002 analysis SAMe was shown to be as effective as nonsteroidal anti-inflammatory drugs (NSAIDs) in treating functional limitations (but not pain) in people with osteoarthritis, and without the side effects common with NSAID use.
In some studies, SAMe used in combination with an antidepressant was useful for people who had depression that did not abate with treatment using a selective serotonin reuptake inhibitor Selective serotonin reuptake inhibitors (SSRIs) Several types of medications can be used to treat depression: Selective serotonin reuptake inhibitors (SSRIs) Norepinephrine-dopamine reuptake inhibitors, serotonin modulators, and serotonin-norepinephrine... read more (SSRI), but this benefit was not confirmed in later studies.
Side Effects of SAMe
No serious side effects have been reported. People with a bipolar disorder should not use SAMe, because it can cause manic episodes.
Side effects of SAMe are uncommon, and when they do occur, they are usually minor problems such as nausea, gas, diarrhea, constipation, dry mouth, or headache.
Drug Interactions with SAMe
Combining certain antidepressant medications, such as clomipramine, with SAMe may increase serotonin levels, which may cause serotonin syndrome Serotonin Syndrome Serotonin syndrome is a potentially life-threatening drug reaction that tends to cause high body temperature, muscle spasms, and anxiety or delirium. Serotonin is a chemical that transmits impulses... read more , a serious disorder characterized by fever, confusion, rapid heart rate, anxiety, tremors, and other symptoms. SAMe may also decrease levodopa levels (deficient in people who have Parkinson disease Parkinson Disease (PD) Parkinson disease is a slowly progressive degenerative disorder of specific areas of the brain. It is characterized by tremor when muscles are at rest (resting tremor), increased muscle tone... read more ) and thus decrease the effectiveness of medications that aim to treat Parkinson disease by increasing levodopa levels.
Recommendations for SAMe
People who plan to take SAMe with certain antidepressants such as clomipramine should talk to their doctor about the risks, because serotonin levels may increase and result in serotonin syndrome. People with Parkinson disease should avoid SAMe because it may decrease the benefit of certain medications used to treat Parkinson disease. Overall, SAMe appears to be safe for most people.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
National Institutes of Health's National Center for Complementary and Integrative Health: S-Adenosyl-L-Methionine (SAMe): In Depth