SAM-e (S-adenosylmethionine, SAMe)

Medically Reviewed by Christine Mikstas, RD, LD on April 21, 2023
3 min read

SAM-e is a compound that's made naturally in the body and plays an important role in normal bodily function. A synthesized form of SAM-e is considered a supplement in the U.S., but SAM-e has been sold as a prescription drug in parts of Europe for decades. Its scientific name is S-adenosylmethionine. SAM-e is also known as ademetionine and SAMe.

SAM-e has some evidence as a treatment for osteoarthritis pain. Some studies have found that oral SAM-e is as effective as NSAID painkillers, such as ibuprofen and Celebrex. SAM-e takes longer to act than drugs do, but it also has fewer side effects than NSAIDs.

SAM-e has also been used to treat depression for many years. Some studies have found that SAM-e might work as well as tricyclic antidepressants in relieving symptoms. However, many of these studies were flawed or too small to be conclusive.

Other uses of SAM-e have not been studied as thoroughly. There's some evidence that SAM-e might help ease the pain of fibromyalgia and spinal cord damage caused by HIV. SAM-e may also help control cholestasis -- a buildup of bile in the liver -- particularly in pregnant women during the third trimester. One trial suggested that SAM-e might be helpful for adults with ADHD. However, more research needs to be done.

Some people use SAM-e as a treatment for other conditions, such as liver disease, Alzheimer's disease, pain, migraine, and bursitis. We don't know the potential risks or benefits of these uses.

There is no established ideal dose of SAM-e. For depression, many studies have started patients at 400 to 600 milligrams daily. For osteoarthritis, 600-1,200 milligrams daily of SAM-e divided into three doses is common. Ask your doctor for advice. Sometimes, the dose of SAM-e is increased gradually over a few weeks. This can help reduce side effects such as restlessness or anxiety.

There are no food sources of SAM-e.

  • Side effects. SAM-e seems to be a relatively safe drug. High doses of oral SAM-e can cause symptoms like gas, upset stomach, diarrhea, constipation, dry mouth, headache, dizziness, anxiety, and skin rashes. SAM-e can also trigger an allergic reaction in some people.
  • Risks. If you have any medical issues, check with a doctor before you start using SAM-e supplements. SAM-e might not be safe for people with conditions such as bipolar disorder, Parkinson's disease, and diabetes. Because SAM-e can affect the blood vessels, stop using SAM-e two weeks before getting surgery.
  • Interactions. If you take any medicines regularly, talk to your doctor before you start using SAM-e supplements. SAM-e could be dangerous when combined with antidepressants or supplements that treat depression, like St. John's wort. SAM-e could also interact with some prescription painkillers, cough medicines, and treatments for diabetes and Parkinson's disease. Patients taking MAOIs should not use SAM-e without discussing it with their doctor.

Given the lack of evidence about safety, SAM-e is not recommended for children or for women who are breastfeeding. Although SAM-e has been studied as a treatment for liver problems during pregnancy, pregnant women should only use SAM-e if a doctor recommends it.