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SAMe Info

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SAMe is a molecule that is formed naturally in the body. It can also be made in the laboratory. SAMe is involved in the formation, activation, and breakdown of other chemicals in the body, including hormones, proteins, and certain drugs.

SAMe has been available as a dietary supplement in the US since 1999, but it has been used as a prescription drug in Italy, Spain, and Germany for many decades.

People most commonly take SAMe by mouth for depression and osteoarthritis. SAMe is also tried for anxiety, back pain, fibromyalgia, and many other conditions, but there is no good scientific evidence to support these uses.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
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  • Osteoarthritis.  Multiple studies show that oral SAMe can decrease symptoms and improve function in patients with osteoarthritis similarly to non-steroidal anti-inflammatory drugs (NSAIDs), although with a slower onset of action.
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  • Cholestasis.  Clinical research suggests that oral or intravenous SAMe is similarly effective to ursodeoxycholic acid (ursodiol) for treatment of cholestasis.
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  • Depression.  The available clinical research suggests that oral SAMe has a role in the treatment of depression when used as a second-line agent or in combination with conventional medications.
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Info

The body uses SAMe to make certain chemicals in the body that play a role in pain, depression, liver disease, and other conditions.

When taken by mouth: SAMe is LIKELY SAFE It can sometimes cause gas, diarrhea, constipation, dry mouth, headache, insomnia, anorexia, sweating, dizziness, and nervousness, especially at higher doses. It can also make some people with depression feel anxious.

When given by IV: SAMe is LIKELY SAFE in appropriate doses given by a healthcare professional.

When given as a shot: SAMe is LIKELY SAFE in appropriate doses given by a healthcare professional.

Special Precautions & Warnings:

Pregnancy: SAMe is POSSIBLY SAFE when given intravenously (by IV) in the short-term during the third trimester of pregnancy. There isn't enough reliable information to know if taking higher doses of SAMe for longer periods of time is safe to use, or if SAMe is safe to use during the earlier trimesters of pregnancy. Stay on the safe side and avoid use.

Breast-feeding: There isn't enough reliable information to know if SAMe is safe to use when breast feeding. Stay on the safe side and avoid use.

Bipolar disorder: Use of SAMe can cause people with bipolar disorder to convert from depression to mania.

Inherited disorder called Lesch-Nyhan syndrome: SAMe might make symptoms of Lesch-Nyhan syndrome worse.

Parkinson disease: SAMe might make symptoms of Parkinson disease worse.

Surgery: SAMe might affect the central nervous system. This could interfere with surgery. Stop taking SAMe at least 2 weeks before a scheduled surgery.

Dextromethorphan (Robitussin DM, and others)

Interaction Rating=Moderate Be cautious with this combination.

SAMe can affect a brain chemical called serotonin. Dextromethorphan (Robitussin DM, others) can also affect serotonin. Taking SAMe along with dextromethorphan (Robitussin DM, others) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking dextromethorphan (Robitussin DM, and others).

Levodopa

Interaction Rating=Moderate Be cautious with this combination.

Levodopa is used for Parkinson's disease. SAMe can chemically change levodopa in the body and decrease the effectiveness of levodopa. Taking SAMe along with levodopa might make Parkinson's disease symptoms worse. Do not take SAMe if you are taking levodopa.

Medications for depression (Antidepressant drugs)

Interaction Rating=Major Do not take this combination.

SAMe increases a brain chemical called serotonin. Some medications for depression also increase the brain chemical serotonin. Taking SAMe along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking medications for depression.

Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.

Medications for depression (MAOIs)

Interaction Rating=Major Do not take this combination.

SAMe increases a chemical in the brain. This chemical is called serotonin. Some medications used for depression also increase serotonin. Taking SAMe along with these medications used for depression might cause too much serotonin in the body, and serious side effects including heart problems, shivering, and anxiety.Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Meperidine (Demerol)

Interaction Rating=Moderate Be cautious with this combination.

SAMe increases a chemical in the brain called serotonin. Meperidine (Demerol) can also increase serotonin in the brain. Taking SAMe along with meperidine (Demerol) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety.

Pentazocine (Talwin)

Interaction Rating=Moderate Be cautious with this combination.

SAMe increases a brain chemical called serotonin. Pentazocine (Talwin) also increases serotonin. Taking SAMe along with pentazocine (Talwin) might cause serious side effects including heart problems, shivering, and anxiety. Do not take SAMe if you are taking pentazocine (Talwin).

Tramadol (Ultram)

Interaction Rating=Moderate Be cautious with this combination.

Tramadol (Ultram) can affect a chemical in the brain called serotonin. SAMe can also affect serotonin. Taking SAMe along with tramadol (Ultram) might cause too much serotonin in the brain and side effects including confusion, shivering, stiff muscles, and other side effects.

Herbs and supplements with serotonergic properties: SAMe increases a chemical in the brain called serotonin. Taking SAMe along with other herbs and supplements that increase serotonin might lead to too much serotonin and cause serious side effects including heart problems, shivering and anxiety, Herbs and supplements that increase serotonin levels include 5-HTP, Hawaiian baby woodrose, L-tryptophan, and St. John's wort.

There are no known interactions with foods.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For depression: 800-1600 mg of SAMe daily in divided doses for 4-12 weeks is most commonly used.
  • For osteoarthritis: 600-1200 mg of SAMe daily in up to three divided doses for up to 84 days has been used.
  • For reduced or blocked flow of bile from the liver (cholestasis): 500 mg of SAMe taken twice daily or 1600 mg taken daily in two divided doses for 2-8 weeks has been used.
BY INJECTION:
  • For depression: Most often, 200-400 mg of SAMe has been given daily as a shot or intravenously (by IV) for 1-4 weeks
  • For reduced or blocked flow of bile from the liver (cholestasis): 800 mg daily or 500 mg twice daily for 14-20 days has been used.

Ademetionine, Adenosylmethionine, Adénosylméthionine, S-Adenosyl Methionine, S-Adénosyl Méthionine, S-Adenosyl-L-Methionine, S-Adénosyl-L-Méthionine, S-Adenosylmethionine, S-Adénosylméthionine, S-Adenosylmethionine Butanedisulfonate, S-Adenosylmethionine Tosylate, S-Adenosylmethionine Tosylate Disulfate, SAM, SAM-e, Sammy, Samyr.

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