About Mind/Body Consultant Services & Protocols

Protocols: S-adenosyl-l-methionine (SAMe)

Depression

Description: S-adenosyl-l-methionine (SAMe) is a naturally occurring substance produced in mammals from l-methionine and adenosine triphosphate. SAMe takes part in numerous metabolic pathways and is a major source of methyl groups in the brain.

Method of Action: Unknown. Administration of SAMe results in the conversion of phosphatidylethanolamine to phosphatidylcholine, increasing the fluidity of cell membranes and possibly facilitating neurotransmission by increasing the density of available receptors or heightening the efficiency of receptor-effector coupling. Significantly increases CSF levels of homovanillic acid and 5-hydroxyindoleacetic acid, the metabolites of dopamine and serotonin respectively and lowers prolactin levels. No changes in the concentrations of norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol have been reported, but SAMe does appear to inhibit the reuptake of norepinephrine in a temperature-dependent fashion and blunt peripheral noradrenergic responsivity after chronic administration. SAMe increases the central turnover of (particularly) dopamine and also serotonin. SAMe administration also causes reduction in the response of both prolactin and thyrotropin to thyrotropin-releasing-hormone stimulation in male but not female subjects. This may be indirect evidence of increase dopaminergic activity. SAMe is also linked to folate and B-12 metabolism.

Indications and Usage: Oral administration of SAMe has been shown to be as or more effective in the treatment of depressive disorders than standard tricyclic drugs. May be effective in the treatment of panic disorder, treatment refractory depression, agoraphobia, bulimia, chronic pain syndromes including fibromyalgia, suicidal ideation, hypochondriasis, posttraumatic stress disorder, menopausal depression and attention deficit disorder. SAMe has been used with varying success in other disorders related to methyl group deficiency, nerve demylination and especially those in which both a mood disturbance and impairment of cognitive abilities are present including: dementia, Multiple Sclerosis, Alzheimer's Disease, Epilepsy, Parkinson's Disease, AIDS-related and congenital myelopathy.

Contraindications: Do not use this product if you are pregnant or lactating without first seeking advice from your physician. Do not use this product if you or a blood relative suffer from a Biopolar Disorder (manic depression).

Dosage and Administration: Use enteric-coated product only. Standard dose for mild to moderate depression is 400-1200 mg in divided doses to a maximum dose of 1600 mg. Ideally endogenous SAMe levels should be measured to determine deficiency before SAMe administration. Product should also contain Vitamins B12 and B6 and folate and also have enteric coating.

Clinical Effect In: Three to seven days with some improvement still continuing over 21 days.

Adverse Reactions: No long-term laboratory studies have been undertaken to determine physiologic effects of SAMe supplementation over treatment periods longer than 6 months. During treatment periods less than 6 months no deleterious changes in laboratory values or other significant physiologic functions, hepatoxic, anticholinergic effects have been reported. Short-term and reversible side effects reported during SAMe studies have been: Mild nausea, increase in urinary frequency, thirst, headache, constipation, dry mouth, sweating, dizziness, diarrhea and moderate increases in anxiety. It was not clear, however, if these effects were treatment-related. Discontinue use if agitation, irritability, insomnia, excitability or hyperkinesis occurs. Some rat studies have suggested that excess methylation can contribute to the development of Parkinson's Disease symptoms (tremor, hypokinesia) related to a decrease in SN tyrosine hydroxylase (TH) immunoreactivity and degeneration of TH-containing fibers in the caudate nucleus. If you suspect that an herb or other supplement is making you sick, call the FDA's MedWatch hotline at 800-332-1088 or contact the agency via its website at http://www.fda.gov/medwatch.

Known Interactive Effects: None known.

Additional Considerations: May be preferable to traditional antidepressants where suicidal lethality is an issue due to extremely high levels needed for overdose. Most stable and reliable brands currently: Nature Made Hypericum Buyers Club, Better Health, Solgar, Now, Naturol.

Warnings: The information above is provided for educational purposes and may not be construed as a medical prescription or as a substitute for the advice of your physician. Do not use this product without first consulting your physician especially if your are pregnant or lactating. Be advised that some herbs and dietary supplements can cause severe allergic reactions in some individuals and may also have an adverse result in conjunction with other medications, or treatments. Your should regularly consult your physician in matters regarding your health and particularly in respect to symptoms and conditions which may require diagnosis or medical attention. Reevaluate use of this product after 6 months.

Back to Protocols >>