S

SAMe A chemical that occurs naturally in the
BRAIN. SAMe, which is short for S-adenosylme-
thionine, participates in the brain’s synthesis of
DOPAMINE and serotonin, neurotransmitters that
have key functions in brain communication
regarding emotions and mood. SAMe is available
in the United States as a dietary supplement and
as a prescription medication in most European
countries. People commonly take SAMe to relieve
symptoms of DEPRESSION, OSTEOARTHRITIS, chronic
BACK PAIN, and CHRONIC FATIGUE SYNDROME (CFS).
Clinical studies support SAMe’s effectiveness in
treating depression and osteoarthritis, though are
not entirely conclusive. So far research findings
have failed to support a conclusive benefit from
SAMe for chronic back pain and CFS.

Depression

In a number of clinical studies SAMe appears as
effective as prescription tricyclic ANTIDEPRESSANT
MEDICATIONSfor treating mild to moderate depres-
sion and without the side effects, such as drowsi-
ness and dry mouth, common to them. However,
depression can be a serious medical condition.
Doctors worry that people who use over-the-
counter remedies to self-treat depression may put
themselves at risk. Conventional medical
approaches to treating depression may incorporate
antidepressant medications with PSYCHOTHERAPYto
resolve the underlying causes of the depression.
As well, any substance that alters the produc-
tion and ratio of brain neurotransmitters has the
potential to create imbalances in those vital brain
chemicals that cause further problems. One such
consequence is serotonin syndrome, a serious and
potentially fatal accumulation of serotonin in the
brain. SAMe appears to suppress monoamine oxi-
dase, the same NEUROTRANSMITTER that tricyclic

antidepressants target. While doctors monitor peo-

ple taking tricyclics for evidence of serotonin syn-

drome, a person who is self-medicating with

SAMe may not recognize the symptoms of sero-

tonin toxicity (HEADACHE, dizziness, vomiting, dis-

orientation and confusion, unconsciousness) as

related to SAMe. Also because of SAMe’s

monoamine oxidase inhibition ability, people who

are taking monoamine oxidase inhibitor (MAOI)

antidepressants should not take SAMe.

Serotonin syndrome is a serious and

potentially fatal SIDE EFFECT of ANTIDE-

PRESSANT MEDICATIONS. It requires imme-

diate medical attention.

Osteoarthritis

A number of clinical research studies show that

osteoarthritis improves after taking SAMe for four

to six weeks. However, researchers have yet to

identify the actions of SAMe responsible for this

improvement. The METABOLISM of endogenous

(naturally occurring) SAMe produces various

chemical substances (notably amino acids) that

the body can use to repair JOINTtissues and pro-

duce the synovial fluid that lubricates joints. Some

researchers believe SAMe as a supplement pro-

vides more of these amino acids. Because of the

length of time it takes to see improvement, how-

ever, other researchers question whether it is

the SAMe supplement or the natural processes of

the body that result in reduced PAINand INFLAMMA-

TION.

Chronic Back Pain and CFS

Chronic back pain and CFS can be debilitating

conditions that defy attempts to improve symp-

toms. The mechanisms of both are poorly under-

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