Consumer Reports lists SAM-e as one of eleven “supplements to consider,” stating that
it is, “likely effective in reducing symptoms of major depression.”
Berkeley Wellness and the Mayo Clinic take a more conservative position, stating that
the real risks and benefits are still not established. Berkeley does add that: “Some
studies show that SAM-e might be an effective treatment for depression, with fewer
side effects than anti-depressant drugs.”
The Mayo Clinic gives SAM-e a green light of approval but states equivocally that:
“SAM-e has promise as an effective treatment for depression..., but the long-term
benefits and risks are still unknown....[I]t’s best to consult your doctor before trying
SAM-e. Two drawbacks are the inconsistent quality and high price....” “...[M]ost of the
studies were poorly designed. Large-scale, controlled studies are needed....”
Weil cites with approval the 2010 Papacostas, Mischoulon, Shyu, Alpert & Fava study
cited below under adjunctive use and states generally that SAM-e “works quickly, often
lifting mood within days rather than weeks [as is often the case with prescription
antidepressants.]”^7 He says unequivocally that: “You can use SAM-e with prescribed
antidepressants (and other medications).”^8
The Berger et al. study, with over 20,000 participants, is a larger scale validation of
safety [not efficacy, since the focus of the study was on arthritis] than can be obtained
for most nutriceuticals.^9
- ADJUNCTIVE USE FOR DEPRESSION
Brown et al. suggest that SAM-e is also “quite useful” in augmenting the effect of
other antidepressants, including MAOIs, SSRIs, SNRIs, and tricyclics. Brown et al. do
not specify a recommended dose for augmentation, but rather suggest starting with
200 - 400 mg per day and increasing the dose every 3-7 days as tolerated until a response
is achieved. They point out that there is a wide range in dose requirements for response
depending on the medication being augmented and the characteristics of the people
receiving treatment.
