What SAM-e is: SAM-e (S-adenosylmethionine), the activated form of the amino acid methionine, is produced in the body, primarily the liver. It is essential to a great number of chemical processes, including maintaining cells, manufacturing substances used by the nerves and influencing emotions and moods. SAM-e supplements, big sellers in recent years, can cost as much as many drugs, and you have to take them long term.
Claims, purported benefits: Treats depression, arthritis and liver disease, among other things. Sold in Europe as a prescription drug for some of these disorders. Said to be as effective for pain relief as aspirin, but without aspirin’s potential to cause stomach bleeding and ulcers.
SAM-e: the latest research
Depression. Some studies suggest that SAM-e might be an effective treatment for depression, with fewer side effects than antidepressant drugs. Though the evidence is still unclear, areview article in the Canadian Journal of Psychiatry in 2012 concluded that SAM-e, along withfolate, appears to be effective and well-tolerated and “may represent a usefuladdition to the antidepressant armamentarium.” In 2013, a systemic review of complementaryand alternative therapies as adjuncts to antidepressants, published in the Journal of AffectiveDisorders, concluded that the evidence of benefit for SAM-e is limited and preliminary.
Osteoarthritis. Early studies suggested that SAM-e is at least as effective as NSAID pain relievers such as ibuprofen and aspirin. A 2009 review by the Cochrane Collaboration, which lookedat four clinical trials, concluded that SAM-e may help reduce pain and improve function in peoplewith osteoarthritis, though the effects are probably small. Until larger studies are done, however, it advised against routine use of SAM-e. In 2013, a systemic review of complementaryand alternative therapies for osteoarthritis, published in Rheumatology, concluded that SAM-eis as effective as NSAIDs and less likely to cause adverse effects.
Side effects: People taking high doses have reported nausea, restlessness, insomnia, headaches and diarrhea. It may bring on manic episodes in people with bipolar disorder. Animalstudies suggest it may be risky for those with Parkinson’s disease.
Bottom line: The overall consensus among researchers is that SAM-e deserves furtherinvestigation. So far, however, the possible benefits and long-term risks remain unclear. Even ifSAM-e were effective, you can’t count on getting a reliable product with a standardized dose,and in any case nobody yet knows what the right dose would be for various disorders. Peoplewith depression or arthritis should seek medical advice before taking SAM-e.