SAMe (S-Adenosylmethionine) was discovered in the early 1950s and has been found to be useful in the treatment of depression, osteoarthritis, fibromyalgia, migraines, and liver disease. Most of the early work on SAMe was done in Europe and involved the use of intravenous or intramuscular injections of stable forms of the compound. SAMe occurs naturally in the body, particularly in the brain and liver, and its synthesis depends on an adequate supply of folic acid and vitamin B12. It is now available in North America as an enteric-coated oral supplement and several studies have been done to evaluate its effectiveness. Oral supplementation with initial doses up to 1600 mg/day has been found to ease depression and is more effective than a placebo and similar in effect to moderate doses of tricyclic antidepressants. Clinical trials evaluating SAMe in osteoarthritis therapy conclude that oral supplementation with 400-1600 mg/day improve symptoms in as little as two weeks. In double-blind studies SAMe was found to be comparable in its beneficial effects to naproxen (750 mg/day), piroxicam (20 mg/day), indomethacin (150 mg/day), and ibuprofen (1200 mg/day). A six-week trial involving 44 fibromyalgia patients found that 800 mg/day of SAMe improved pain, mood, and morning stiffness. It has also been found beneficial in the treatment of chronic liver disorders and intravenous infusions of the compound have been found useful in preventing migraine headaches. SAMe is non-toxic, has no known drug interactions, and is generally well tolerated. Its safety in children and during pregnancy has not been established. There have been a few reported cases of manic reactions in patients with bipolar disorder possibly involving SAMe so it is not recommended for this condition nor for self-diagnosed depression.
Chavez, Mary. SAMe: S-Adenosylmethionine. American Journal of Health-System Pharmacy, Vol. 57, January 1, 2000, pp. 119-23