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Expert Panel Finds SAMe Promising
Oct. 10, 2002 -- It's not a miracle drug. But the supplement SAMe is showing great promise in treating a number of seemingly unrelated disorders -- depression, osteoarthritis, and chronic liver conditions.
In a just-released government report, a group of 16 researchers published the results of a three-year review of human clinical studies of SAMe, including 47 studies for depression, 14 studies for osteoarthritis, and 41 studies for liver disease.
The analysis of SAMe was sponsored by the U.S. Agency for Healthcare Research and Quality (AHRQ), a division of the Department of Health and Human Services.
In their analysis, researchers found that:
- As a treatment for depression, SAMe was shown to be as effective as antidepressants, and more effective than placebo. SAMe also had fewer side effects when compared with standard antidepressants.
- As a treatment for osteoarthritis, SAMe had fewer digestive side effects than anti-inflammatory drugs like ibuprofen, yet was effective in relieving pain.
- SAMe also showed significant effects on cholestasis, a condition where flow of bile in the liver is obstructed. Causes include oral contraceptives, estrogen, pregnancy, and birth defects. Currently, there is no effective treatment other than getting rid of the cause.
Although the majority of SAMe studies involved small numbers of patients, "the [AHRQ] report indicates that that this is a compound worthy of further investigation," says Maurizio Fava, MD, director of the depression clinic and research program at Massachusetts General Hospital in Boston.
"True, these are very small studies, but they consistently suggest the efficacy of this compound in depression," Fava tells WebMD. "We've never had a large double-blind study [in which neither the researchers nor the patients knew if they were taking SAMe or placebo] in the U.S. It's time for researchers to look at this more closely."
The acronym SAMe refers to S-adenosyl-L-methionine, a nutritional supplement that has been available for the past 30 years.
"SAMe is not an amino acid; it's a derivative of an amino acid that's found in every single cell in the body," says Teodoro Bottiglieri, PhD, a neuropharmacologist with Baylor University Medical Center in Dallas. "It plays an essential role in activating other molecules in the cells."
The substance affects many metabolic processes -- more than 100, Bottiglieri says. When a disorder causes a deficiency of SAMe in the body's cells, taking a SAMe supplement could be a way of restoring those levels. "SAMe is a natural substance for the body, it's not a designer drug, and therefore can be carried in, absorbed into pathways," he explains.
"But I don't want to make it sound like a panacea for everything," he tells WebMD. "It begins to fall into the category of snake oil."
An NIH study under way is looking at SAMe as a treatment for depression in people with Parkinson's disease. "Patients with Parkinson's have a high incidence of depression -- a massive loss of dopamine in the brain, which can impact mood," says Bottiglieri. The L-dopa medication that patients take for Parkinson's makes them unusually SAMe-deficient "because L-dopa consumes vast quantities of SAMe, like a sponge, it mops up all the SAMe in the body."
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