Confirming this suggestion, a 2010 clinical trial by Papacostas, Mischoulon, Shyu,
Alpert & Fava found that SSRI non-responders improved significantly when SAM-e was
added to the SSRI dose. The trial had 73 subjects, selected because their HAM-D
scores had failed to improve on SSRIs alone. Subjects were given oral dosages of SAM-
e 1,600 mg per day (a severe depression monotherapy dose) split into two doses of
800 mg each, to supplement a long list of SSRIs, including fluoxetine, citalopram,
paroxetine, escitalopram, sertraline, duloxetine and venlafaxine, at manufacturer-
specified minimum dosages. HAM-D response and remission rates for the SAM-e
group were 36.1% and 25.8% respectively, compared to 17.6% and 11.7% for the
placebo group. Translating that into people, six people treated with placebo
responded and four remitted; in contrast, of the people receiving SAM-e
supplementation, 18 responded and 14 remitted.^10
Additional studies should help in determining optimal doses, safety for long-term use,
effectiveness in preventing relapses, and appropriate protocols for complementary use
with other anti-depressant drugs.
Thus, use of SAM-e as an adjunctive treatment to tricyclics, SSRIs and MAOIs appears
to hold promise. Doses will vary depending on the dose and effect of the antidepressant
and the individual’s characteristics Larger and longer term studies are needed to
confirm and extend the evidence of efficacy and absence of significant adverse drug
interactions. Other potential drugs with which SAM-e might be used adjunctively remain
to be tested. As with any combination treatment, adjunctive SAM-e therapy should be
tried under close supervision with the prescribing physician.
- NEUROPROTECTION
Recent U.S. studies have shown promising evidence of effectiveness of SAM-e in
protecting the aging brain.
Brown and Gerbarg cite three small but promising recent studies of the use of SAM-e
for treatment and prevention of dementia, using a complex nutriceutical formulation
including folate (vitamin B9) (400 micrograms), vitamin B12 (6 micrograms), vitamin E
