SAM-e (S-Adenosylmethionine): an anti-depressant with added benefits

We’ve reported on the NIH-funded trial of antidepressants SAM-e (a dietary supplement) and Lexapro (a prescription drug) currently underway at Massachusetts General Hospital and Butler Hospital (see under “SAM-e” on this Blog).

Recently one of our NYBC associates drew our attention to an interview from a few years back with Richard Brown, M.D., clinical psychiatry professor at Columbia University with a long-time interest in depression treatments. Dr. Brown has had experience using SAM-e to treat depression in people with HIV, and notes that the added benefits of this dietary supplement for joint and liver health may make it a very good option for treatment over the longer term.

See also the NYBC entry on SAM-e.

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Used in tandem with conventional antidepressants, SAM-e also enhances their effectiveness. A study published in Psychiatry Research comparing 40 depression sufferers taking imipramine, half of whom were also given 400 mg of SAM-e a day, found a significant difference between the two treatments. “The SAM-e group was much better in four days,” says Brown. And compared with other pharmaceutical antidepressants, SAM-e also has fewer nasty side effects.

Despite its benefits, SAM-e is not entirely foolproof. Bipolar disorder sufferers should avoid SAM-e as it can induce mania, and some people experience mild gastrointestinal problems, occasional headaches or heart palpitations. Still, SAM-e doesn’t cause the weight gain or sexual dysfunction associated with prescription antidepressants—a huge plus, says Brown, since about 30% of patients stop taking standard antidepressants before improvements can occur. “More people will get better on SAM-e because they won’t drop out because of the side effects,” he explains.

And SAM-e has other unusual bonuses. For starters, research suggests it alleviates arthritis and may even regenerate lost cartilage, and animal studies have found that it restores memory—a promising discovery for Alzheimer’s patients. SAM-e may even benefit the liver: Brown’s own study of 20 HIV patients with depression found that both their mood and liver function improved tremendously—a connection he attributes to SAM-e’s ability to boost levels of glutathione. An antioxidant, glutathione is generated in the liver, and is crucial for immune function and often lacking in HIV patients.

With so much going for it, Brown believes there’s no reason not to use SAM-e. “Eighty percent of people with depression have to be on medication for a lot of their adult lives,” says Brown. “I’d rather give them something that does good things in their bodies as they get older.”
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Citation: Psychology Today Magazine, Mar/Apr 2001 – Last Reviewed 14 Dec 2006

New England Journal of Medicine article: Pharmaceutical companies don’t publish studies that show antidepressants less effective

The New York Times – January 17, 2008
Antidepressant Studies Unpublished
By BENEDICT CAREY
The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.

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Pharmaceutical companies mislead the public about the effectiveness of their prescription antidepressants.

That’s the bottom line of this New York Times story, which reports on an investigation published in the New England Journal of Medicine this week.
Well, not surprising. We knew that the FDA drug approval process, which ideally should represent a gold standard in evaluating the effectiveness and safety of medicines, has been seriously compromised by its dependence on pharmaceutical company-funded research.
And, we think we know why there’s comparatively little public attention given to some very substantial research showing that such dietary supplements as DHEA, SAM-e, St. Johns Wort may be useful for depression. These are supplements, not patentable drugs, so the pharmaceutical companies can’t establish exclusive rights to them and charge enormous sums for their distribution.
If you’d like to take a look at some of the evidence about dietary supplements for depression, look under the “Depression” category of this blog, or refer to the information sheet on depression from the New York Buyers’ Club.