To Your Health

I would like to try SAMe for depression. What is good and what is bad about it, and is it safe?

Q. I would like to try SAMe for depression. What is good and what is bad about it, and is it safe?

A. S-Adenosyl Methionine (SAMe) comes with a lot of good news and only one bit of bad news: It is really expensive. The good news is that it appears to be entirely safe, with only a few minor side effects reported (increased anxiety, mild diarrhea, and nausea) when used in amounts as high as 3,600 mg/day ($10 worth per day). In other studies using 1,800 mg/day, no significant side effects were noted, and amounts in the range of 400 to 600 mg/day will usually provide noticeable benefits.

SAMe is one of the better-studied natural antidepressants, with more than 100 peer-reviewed studies. Clinical trials with injected or oral SAMe have shown that it is superior to a placebo and is as effective as many common antidepressants in alleviating depression, especially when people are depressed without any apparent cause. And it works comparatively fast. When given by injection, both with and without a prescription antidepressant, symptom relief may be noticeable in as little as seven days.

Biologically, SAMe is a methyl donor; in fact, it is the most essential methyl donor in the brain. It is involved in the synthesis of several neurotransmitters that are activated by attaching a methyl group. Moreover, it is also necessary in the process of attaching a methyl group to DNA, activating genes and allowing them to produce the proteins that are necessary for cells to function optimally.

While all this is indispensable, perhaps just as important is the role of SAMe in membrane function. Certain important membrane components such as phosphatidylcholine are rich in methyl groups, which are provided by SAMe. Phos-phatidylcholine makes cell membranes limber. Stiff membranes do not transmit neurotransmitter signals as well as pliant membranes because the receptors on the membranes are a little like parts of a jigsaw puzzle. The neurotransmitter can fit into the receptor easier if some wiggle room is provided by a supple membrane.

Depression often accompanies serious illness. In a two-year study involving 108 patients with osteoarthritis, 600 mg/day of SAMe was reported to provide significant alleviation of both pain and depression. The depression that may accompany Parkinson's disease and Alzheimer's disease also responds to SAMe. Ten of 11 Parkinson's patients experienced at least a 50% reduction in their score on the 17-point Hamilton Depression Scale, and Alzheimer's patients given SAMe were reported to improve in cognitive function as depression was reduced.

As with many nutrients, SAMe may provide benefits other than an expected antidepressant effect. Both animal and human research indicates that SAMe, when given along with alcohol, prevents the accumulation of fat in the liver that alcohol usually induces. Furthermore, within 15 days, SAMe supplements can dislodge fat that has already accumulated. SAMe supplements of 1,200 mg/day for two years reduced the need for liver transplantation in alcoholic liver cirrhosis patients by half.

When something is reported to have many different health and medical applications it may seem too good to be true. However, when you understand the mechanisms behind SAMe's actions within the body it is easier to understand how one substance could have so many achievements.

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