Written by Jessica Patella, ND. Research shows safety and effectiveness of SAMe as additional therapy to antidepressants for treatment of major depressive disorders.
Major depressive disorder affects 14.8 million American adults each year and is the leading cause of disability in the U.S. for ages 15-44 (1). Major depressive disorder also remains difficult to treat, with many patients who are unresponsive to antidepressant medications (2). The natural supplement S-adenosyl methionine (SAMe) has been available in Europe since the late 1970s in the treatment of depression and became available in the United States in 1999. Recent research suggests that SAMe can be an effective adjunctive treatment option for individuals that do not respond to serotonin reuptake inhibitor (SRI) medications (2). Research suggests that 50% of all patients treated with a single antidepressant drug will not respond to the treatment (2). These patients are either partial responders or non-responders to the antidepressant therapy.
The current research evaluated non-responders to SRI medications to determine if SAMe could help these individuals (2). The research included 55 participants that had been on a SRI for at least 6 weeks and their dosage remained constant during the 6-week study. The participants were divided into two groups:
- Group one: received placebo pills twice daily, after two weeks 2 pills twice daily; 24 participants
- Group two: received 400mg SAMe twice daily (800 mg SAMe total), after two weeks the dosage doubled totaling 1,600 mg SAMe; 31 participants
The Hamilton Depression Rating Scale (HAM-D), a test to determine the severity of depression was given before and after the 6-week administration of SAMe or placebo. Overall, according to the HAM-D ratings, 6 participants taking placebo responded and 4 remitted (were not experiencing symptoms). In the SAMe group, 18 participants responded (p=0.01) and 14 remitted (p=0.02), showing significant benefit to taking SAMe with antidepressant drugs versus placebo (2). Response rates for participants taking SAMe was 36.1% versus 17.6% in the placebo group. Remission rates for participants taking SAMe was 25.8% versus 11.7% in the placebo group (2).
There were no adverse side effects from combining SAMe with the participants’ antidepressant medication (2). Although a slight increase in systolic blood pressure (average increase of 3.1mmHg) was observed in the SAMe group (2).
In conclusion, SAMe was shown to be a safe and effective additional therapy to antidepressants for major depressive disorder. This study was the first randomized, double-blind, placebo-controlled trial evaluating the effects of SAMe as adjunctive therapy for patients with major depressive disorder that do not respond to SRI medications. This study has set the groundwork for future studies on this topic.
Source: Papakostas, George I., et al. “S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial.” American Journal of Psychiatry 167.8 (2010): 942-948.
Posted September 8, 2010.
References:
- National Institute of Mental Health. The Numbers Count: Mental Disorders in America. See the National Institute of Mental Health website.
- Papakostas, et al. S-Adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders with Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial. Am J Psychiatry 2010; 167:942-948.
