number of milligrams of active product in each brand. Consumers should be wary of
purchasing “bargain brands,” because they are often of poor quality with less active
ingredients.
Brown, Gerbarg and Bottiglieri stress that because SAM-e is easily oxidized, oral doses
should be purchased only in blister packs that isolate each pill. They should not be
stored in the refrigerator to avoid condensation within the blister pack.- RESEARCH: Long-term studies with tracking of side effects are needed to confirm and
extend the positive findings of SAM-e research, particularly in the areas of medication
augmentation and neuroprotection. Since many doctors are not yet familiar with SAM-e,
dissemination of information about its safety and efficacy is needed. SAM-e has been used
by hundreds of thousands of people and many of these have taken it for 10 years, some for
20 years. No long-term adverse effects have appeared. If anything, it has long-term health
benefits. The fact that there was a well-done, closely monitored for side effects, 3-year
study of SAM-e in 20,000 people should be considered a sufficiently long-term trial.
1
Bressa, G.M., “SAM-e as Anti-depressant: Meta-analysis of Clinical Studies,” Acta Neurol Scandinavica Suppl.
154:7- 14 (1994). http://www.ncbi.nlm.nih.gov/pubmed/7941964
(^2) Brown, R.P., Gerbarg, P.L., & Bottiglieri, T., “S-adenosylmethionine (SAM-e) for Depression: Biochemical and
Clinical Evidence,” Psychiatric Annals 32(1):29-44 (2002).
(^3) How to Use Herbs, Nutrients & Yoga in Mental Health Care, by Richard P. Brown, M.D. (of Columbia University
College of Physicians and Surgeons), Patricia L. Gerbarg, M.D. (of New York Medical College), and Philip R. Muskin,
M.D. (of Columbia as well) (W. W. Norton & Company, New York 2009), at 23.
(^4) http://archive.ahrq.gov/clinic/tp/sametp.htm
(^5) Fava, M., Rosenbaum, J.F., Birnbaum, R., et al., “The Thyrotropin Response to TRH as a Predictor of Response to
Treatment in Depressed Outpatients,” Acta Psych. Scandinavica 86:42-45 (1992).
(^6) Lake, J.A. and Spiegel, D., Complementary and Alternative Treatments in Mental Health Care, American
Psychiatric Publishing, Inc., Washington (2007) at 118-119.
(^7) Weil, A., Spontaneous Happiness (Little, Brown and Company, New York 2011), at 116.
(^8) Id.