SAM-e has not been studied in children or in pregnant or breast-feeding women.
Accordingly, although there are no contraindications, it cannot be recommended.
- DOSAGE
Fava et al.’s 1995 study used 400 mg per day of injected SAM-e, but there is no
standard IV or IM dose, and oral medication is now the dominant form, with a stomach-
acid-resistant covering to slow damage through the digestion process.
Brown et al. recommend an oral dosage of 400 to 600 mg per day for mild depression,
600 to 1,200 mg per day for moderate depression, 1,200 to 1,600 mg per day for
severe depression, and 1,600 to 2,400 mg per day for very severe treatment-resistant
depression. Weil concurs. However, they all caution that consumers who are elderly or
frail, or have significant medication sensitivities, significant anxiety, serious
gastrointestinal problems, or other serious medical conditions, should work up to these
dosages. Starting with a dose as low as 200 mg. per day, Brown et al. recommend
increasing the dose to the recommended range as long as the medication is well
tolerated, over a period of days or weeks. Brown et al. note that dosages above 1,600
mg. per day have not been tested in clinical trials, but are sometimes necessary for
response.
In Brown et al. II, Bottiglieri states that his review of the clinical trials suggests that the
lowest effective oral dose is 800 mg per day for mild to moderate depression and 1600
mg per day for severe depression.
For dementia, the three cited trials used 400 mg per day as part of the nutriceutical
tonic. In Brown et al. II, Bottiglieri states that 400 mg of SAM-e alone, 3 times a day for
3 - 5 months, can, “improve measures of cognitive function as well as mood and speed of
mental processing.”^26
All SAM-e products must list the amount of SAM-e in each tablet. Pharmaceutical grade
SAM-e is available without a prescription. The two pharmaceutical grade brands are
Donamet and SAMYR. They are well regulated by the European equivalent of the FDA.
Also, ConsumerLab.com posts reviews of other SAM-e brands including analysis of the
