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No studies been done comparing oral SAMe to SSRIs

Posted by 3 Beer Effect on April 28, 2002, at 11:01:06

In reply to SAME VS SSRI, posted by Geno on April 27, 2002, at 16:52:48

I searched Pubmed, & found no reputable scientific double-blind studies that have compare ORAL SamE to SSRIs like Zoloft or Prozac, which kind of makes you wonder if SAMe is really as effective as the media makes it out to be. Most of the studies compared IV Sam E with Old Tricyclic Antidepressants. (Almost any drug is much more powerful & effective when given intraveneously, so that kind of skews the results).

You have to watch out when buying supplements like SAMe/Herbs/weight lifting supplements because most of the sites/information about them on the internet are created and/or funded by the companies that sell those supplements or herbs.

There is a good book you should read that they have in most Barnes & Nobel bookstores in the Medical Reference section called the PDR guide to nutritional Supplements, which doesn't sugarcoat anything or misrepresent facts or make dramatic unproven statements- it just gives you the real information. But it is about $60, so you might just want to sit in one of those chairs they have their in the bookstore & read it for a few hours and then leave- then you get all the info you want for free.

Here's the info I found from what appears to a reputable source on herbs & supplements called supplementalmed.com(although the dose given seems kind of high- most people start off with 200mg/day and titrate to 400 mg or more depending on response)-
http://www.supplementalmed.com/supplementalmed_023.htm

"SAMe (S-Adenosyl-Methionine) General: S-Adenosyl-Mehtionine is a naturally occurring physiological substance present throughout the body, including the central nervous system, whose primary role appears to be that of a methyl donor (Janicak, 1989). It contributes to the activation, production, and metabolism of enzymes, hormones, neurotransmitters, nucleic acids, proteins, phospholipids and certain drugs (Frezza, 1993).

Reported Effects: It has been used in Europe since the 1970's for the treatment of depression and arthritis. It may also play a therapeutic role in liver disorders.

Dose: 1200-1400 mg

Half Life: unspecified in the studies reviewed.

Depression: A review of 20 studies using intravenous SAMe for the treatment of depression showed a statistically significant improvement in mood symptoms (Janek, 1989). This review included 6 open label studies without a placebo, and 14 randomized controlled studies comparing SAMe to either placebo or to a tricyclic antidepressant. Sixty-one percent of the 100 patients in open labeled trials responded to the supplement. Three of the controlled studies reported a 74% response rate (29 of 37 SAMe patients and 1 of 25 placebo patients). The 8 studies comparing SAMe to tricyclic antidepressants (TCAs) revealed a 77% response rate for SAMe (109 of 142 patients) and 65% for TCAs (80 of 124 patients). This 12% difference was statistically significant (p<.01). Response to IV SAMe is reported to be quite rapid (within a few days). and to have few side effects.

Two small studies showed similar responses to oral SAMe (Rosenbaum, 1990)(Salmaggi, 1993), though definitive placebo controled trials have yet to be done.

Adverse Effects: Reported side effects inclued mania or hypomania (a few reports with IV preparations), thirst, salivation, nausea, urinary frequency, diarrhea, and headache. All occur in low incidence in available studies.

Pharmacology and possible mechanisms: SAMe appears to increase serotonin turnover, inhibit the reuptake of Norepinephrine in a temperature-dependent fashion, and to augment dopaminergic activity. SAMe also increases folate levels and donates a methyl group to catecholeamines (Baldessarini, 1987).

Discussion: There is reasonable preliminary evidence to support to benefit of SAM-e for patients with Depression. Many of the above studies were conducted with intravenous SAM-e rather than oral SAM-e which makes generalizing the findings difficult. There is data to suggest that is may be helpful with arthritis, and certain forms of liver disease, though data is scant. Nevertheless, SAM-e is a vital, naturally occuring substance which may prove to be useful in multiple medical conditions and warrants further study. The broad statements made in some recent magazine articles are a bit dramatic and not yet justified. Interactions with other drugs have not been studied so people should use this substance with caution and in coordination with their health care provider".


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poster:3 Beer Effect thread:104324
URL: http://www.dr-bob.org/babble/20020425/msgs/104359.html