S-adenosyl-L-methionine (SAMe) is a methionine derivative and involved as a cofactor in several synthetic steps, especially as a donor of the methyl group. It is produced naturally in the body, mainly by the liver, and synthetically manufactured as supplements.

(See also nutritional supplements Overview.) S-adenosyl-L-methionine (SAMe) is a methionine derivative and participates as a cofactor in several synthetic steps, particularly as a donor of methyl group. It is produced naturally in the body, mainly by the liver, and synthetically manufactured as supplements. SAMe claims should in depression (1, 2), osteoarthritis (3-5), cholestasis (6) and liver disease (7) to be effective. In addition, mechanistic SAMe has been shown as a platelet inhibitor (8). Documents Clinical studies that have evaluated the health benefits of SAMe either very small, without proper methodology or arising conflicting results between different studies. However shows a meta-analysis of 2002 from osteoarthritis patients (5) that SAMe was more effective in the reduction of functional impairment associated with osteoarthritis than the placebo. More importantly, that in two studies that were evaluated in this analysis, SAMe (1200 mg / day, for. example, at 600 mg orally twice daily) was as effective as non-steroidal anti-inflammatory drugs (NSAIDs), but without the common side effects associated with NSAID. More high-quality studies with standardized supplements are needed before recommendations for supplementing SAMe to treat depression, liver disease and osteoarthritis can be made. Undesirable effects serious side effects at doses between 200 and 1200 mg / day has not been reported. SAMe is contraindicated in patients with bipolar disorder, because it could trigger manic episodes. Drug interactions Some care should be taken to end the day with antidepressants in combination with SAMe, as both increase serotonin levels, which may possibly lead to adverse effects such as rapid heart rate, and anxiety. S -Adenosyl- l -Methionine References Papakostas GI.Evidence for S-adenosyl-L-methionine (SAM-e) for the treatment of major depressive disorder. J Clin Psychiatry 70 (Suppl 5): 18-22, 2009. Turner P, Kantaria R, Young AH. A systematic review and meta-analysis of the evidence base for add-on treatment for patients with major depressive disorder who have not Responded to antidepressant treatment: A European perspective. J Psychopharmacol 28 (2): 85-98, 2014. Rutjes AW, Nüesch E, Reichenbach S, et al. S-adenosylmethionine for osteoarthritis of the knee or hip. Cochrane Database Syst Rev (4) CD007321, 2009. De Silva V, El-Metwally A, Ernst E, et al; Arthritis Research UK Working Group on Complementary and Alternative Medicines.Evidence for the efficacy of complementary and alternative medicines in the management of osteoarthritis: a systematic review. Rheumatology (Oxford) 50 (5): 911-920, 2011. Soeken KL, Lee WL, Bausell RB, et al. Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis. J Fam Pract 51 (5): 425-430, 2002. Gurung V, Middleton P, Milan SJ, et al. nterventions for Treating cholestasis in pregnancy. Cochrane Database Syst Rev 6: CD000493, 2013. Rambaldi A, Gluud C. S-adenosyl-L-methionine for alcoholic liver diseases. Cochrane Database Syst Rev (2): CD002235, 2006. De la Cruz JP, Mérida M, Gonzalez-Correa JA, et al. Effects of S-adenosyl-L-methionine on blood platelet activation. Gen Pharmacol 29 (4): 651-655., 1997

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