SAMe exhibited direct antioxidant activity in vitro (Caro & Cederbaum 2004). CLINICAL USE

Although SAMe is administered as an oral supplement in Australia, it is also used in injectable dose forms in Europe. This discussion will mainly focus on oral use. OSTEOARTHRITIS

A 2004 meta-analysis of 11 RCTs involving almost 1500 patients, comparing SAMe with either placebo or NSAIDs, concluded that SAMe is as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA of the knee. In addition, SAMe-treated patients were 58% less likely to experience adverse effects than those treated with NSAIDs (Soeken 2004).

The longest clinical trial to date was conducted over 2 years and found that a loading dose of oral SAMe 600 mg/day taken over the first 2 weeks, followed by a maintenance dose of 400 mg, produced an improvement in symptoms within the first month and no serious adverse effects (K├Ânig 1987).

Comparative studies Comparative studies in humans have found that oral SAMe (1200 mg) produces similar symptom-relieving effects as piroxicam (20 mg), ibuprofen (1200 mg), indomethacin (150 mg) or naproxen (750 mg) (Caruso & S-Adenosyl-L-Methionine (SAMe) 1056

Pietrogrande 1987, Glorioso et al 1985, Maccagno et al 1987, Muller-Fassbender 1987, Vetter 1987).

More recently, a 16-week randomised, double-blind crossover study of 61 individuals with OA of the knee compared the efficacy of SAMe (1200 mg/day) with celecoxib (200 mg/day). At this dose SAMe was as effective as celecoxib in providing significant symptom relief; however, it had a slower onset of action, requiring 1 month of continuous use before benefits were felt (Najm et al 2004). The same study was unable to detect an antidepressant effect for SAMe.

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