Depression is a common mental health disorder and even though medications are available for treatment, the majority of patients develop either disturbing side effects or resistance. In most cases, the antidepressant fails to work over the long term. Now finally there is a study that shows that use of S-adenosyl methionine (SAMe) with an SSRI can help improve outcome in chronically depressed patients. SAMe has been around for more than 30 years and is well known for its long term anti depressant effects. However, its short-term benefits were known until recently.
In the last decade, many isolated reports have suggested that SAMe may be effective as monotherapy for depression but this is the first controlled study showing that SAMe can be used as adjunctive therapy. How SAMe works is not known but there is speculation that it affects certain brain neurotransmitters.
A few patients with depression have been found to have low levels of SAMe in the cerebrospinal fluid, but this is not a universal finding and bears no correlation to severity of depression. However, some researchers have shown that an increase in SAMe correlates well with depression. SAMe concentrations also appear to increase in some patients who do respond to the tricyclic antidepressant, desipramine.
SAMe is well tolerated and the labels in health food stores do carry a warning that it may induce mania in bipolar patients. Even though SAMe is readily available as a dietary supplement, its synthesis is not easy. The majority of formulations of SAMe tested in the last decade have shown that many products contain less than the stated amount of the supplement.
Additionally SAMe is also prohibitively expensive.