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SAMe (SAM-e) is the common abbreviation for a substance called S-adenosylmethionine, which occurs naturally throughout the human body. This substance plays a vital role in a number of internal processes essential to continuing health and wellbeing. In its man-made, supplemental form, SAMe is widely considered beneficial as a form of complementary and alternative medicine, or CAM.

SAMe Basics

The vast majority of the body’s fluids and tissues contain at least some amount of SAMe. The substance is required for such basic tasks as the production and decomposition of chemicals in the brain called neurotransmitters, maintenance of normal immune system function, and ongoing support of the membranes that hold the body’s cells together. SAMe performs most of these tasks in combination with vitamin B9 (also known as folate) and vitamin B12 (also known as cobalamin), and deficiencies of either of these vitamins can significantly impair human health by contributing to a shortage of SAMe.  Supplemental SAMe comes in forms that include capsules, tablets, and doctor-administered injections.

Complementary and Alternative Medicine Basics

Complementary and alternative medicine is a term used to describe health-supporting or disease-treating techniques that fall outside of the normal scope of standard medical treatment. As the term suggests, some of these techniques work with and complement standard treatment approaches, while others function as alternatives to standard treatment approaches. Generally speaking, most people who use a CAM-based treatment seek out complementary techniques, not strictly alternative techniques. In addition to SAMe, substances used in complementary and alternative medicine include a wide range of vitamins, minerals, plants and herbs, and beneficial species of bacteria and yeasts known collectively as probiotics. Other non-substance-based practices used in various forms of CAM include meditation, yoga, tai chi, massage therapy, chiropracty (chiropractics) and acupuncture.

To a large degree, complementary and alternative medicine has its roots in traditional practices that predate the modern scientific approach to medical practice. In many cases, popular remedies have been passed down through the generations without ever receiving any type of systematic scientific scrutiny. For this reason, many forms of CAM have an unsupported or highly disputed status in the mainstream medical and scientific communities. However, some forms of CAM have received significant scientific scrutiny under the same types of research guidelines used for the review of mainstream medications. Doctors and researchers refer to CAM treatments that meet modern testing standards as evidence-based complementary and alternative medicine.

Usefulness in Depression Treatment

A range of modern studies support the inclusion of properly monitored SAMe use as an evidence-based approach for the treatment of major depression (formally known as major depressive disorder). For instance, in a report published in 2005 in the journal Clinical and Investigative Medicine, researchers from the Yale Prevention Research Center analyzed the results of 11 previous studies, reviews and clinical trials that examined the usefulness of SAMe in depression treatment. The authors of this report concluded that there is considerable evidence to support the use of injectable forms of SAMe, and some evidence to support the use of oral doses of the substance.

In a review published in 2013 in Psychiatric Times, a team of researchers noted that SAMe can provide as much treatment benefit as standard antidepressant medications, while simultaneously presenting significantly lower risks for the onset of major side effects. The authors of this review also noted that SAMe works much more quickly than antidepressants, which can take as long as two months to produce their beneficial effects. The National Institutes of Health’s US National Library of Medicine generally supports these conclusions, and notes specifically that SAMe appears to provide as much benefit as popular antidepressant medications called tricyclic antidepressants.

Considerations

While there is substantial evidence for the effectiveness of SAMe in depression treatment, not all studies support this point of view. Known potential side effects of SAMe use include headaches, nausea, insomnia, diarrhea, intestinal gas buildup, sleeplessness, restlessness and an unusually high level of anxiousness. People who receive high doses of the supplement may also develop symptoms of the hyperaroused state called mania; for this reason, SAMe use is inappropriate for individuals diagnosed with bipolar disorder. No one should take SAMe or any other treatment for depression without the explicit advice and consent of a trained mental health professional. This directive holds true for people already taking an antidepressant, as well as for people not currently taking an antidepressant. Use of the supplement is especially dangerous in combination with any medication that raises the body’s supply of a chemical called serotonin.

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