Five of the seven sources that address SAM-e agree that SAM-e can be as effective as
tricyclic anti-depressants and SSRIs and that it is better than placebo in treating
depression. Berkeley Wellness and the Mayo Clinic agree that SAM-e is a promising
treatment for depression but caution that long-term benefits and risks are unknown.
See below.
A 1994 meta-analysis by Bressa, G.M., assembled data from twenty-five double-blind
studies (fourteen against tricyclic antidepressants and eleven against passive placebo).
The anti-depressant response rate ranged from 17% to 38% better for SAM-e than for
placebo. SAM-e was significantly more effective than passive placebo and
“equivalently effective to and typically better tolerated than” tricyclic anti-
depressants in the treatment of depression.^1
Fugh-Berman and Cott concluded that use of SAM-e for depression and for some other
symptoms of mental disorder is supported by a basic neurobiological rationale and by
some clinical evidence. It functions as a methyl group donor, similar to folate, described
in another chapter of this outline.
A 2002 review by Brown et al. found SAM-e to be safe and effective for treatment of
major depression. They reviewed sixteen open trials, thirteen double-blind, placebo-
controlled studies and nineteen double-blind controlled trials in comparison to standard
anti-depressants.^2
According to Brown et al., SAM-e is as effective as traditional antidepressants for
depression. A history of a good response to tricyclic antidepressants would "weigh ...
heavily” in favor of using SAM-e by itself. Brown et al. consider SAM-e to be a “first line
CAM treatment” for mild, moderate or severe depression.^3
A 2002 review by NCCAM, published by the AHRQ, concluded that:
“Compared to placebo, treatment with SAM-e was associated with an
improvement of approximately 6 points in the score of the Hamilton Rating Scale
for Depression. (This degree of improvement is clinically significant and is
equivalent to a partial response to treatment.)