SAMe (S-adenosylmethionine; also known as Sammy) is a supplement claimed to be an effective treatment for multiple medical conditions. SAMe is a naturally occurring compound involved in fundamental biochemical reactions called methylation reactions. These reactions also involve vitamin B12 and folic acid. SAMe has been commercially available for years in European countries, including Germany, Italy, and Spain. SAMe became available as a dietary supplement in the United States in the spring of 1999.
Multiple therapeutic effects have been attributed to SAMe. Multiple studies indicate that SAMe reduces depression, which is relevant because depression may occur with MS. The mechanism by which SAMe may produce its antidepressant effect is not known. SAMe also may be effective for liver disease, fibromyalgia, a form of arthritis known as osteoarthritis, and a spinal cord condition that occurs in people with AIDS.
It has been claimed that SAMe may be a treatment for MS. This claim is based on several observations of uncertain significance. First, a small subgroup of people with MS have vitamin B^ deficiency. Because SAMe and vitamin B^ are involved in similar chemical reactions, it is proposed that SAMe is beneficial for MS. In addition, SAMe sometimes is used to treat some rare genetic diseases that produce injury to the nerve cells in a manner somewhat similar to the nerve damage produced by MS. However, these arguments for SAMe treatment of MS are not well grounded. There is no evidence that abnormalities in vitamin B^ or SAMe play a major role in MS, and levels of SAMe are normal in the spinal fluid of people with MS.
SAMe is claimed to be a potential treatment for other neurologic disorders, including Parkinson's disease, Alzheimer's disease, and epilepsy. Current research does not support the use of SAMe for these conditions.
In general, SAMe appears to be well tolerated. In clinical studies, no major toxicity has been reported in 22,000 people treated with SAMe. Minor side effects are nausea, vomiting, diarrhea, constipation, dry mouth, mild insomnia, dizziness, and anxiety. SAMe should not be used with antidepressant medications. SAMe may increase the adverse as well as therapeutic effects of steroids. SAMe may decrease the effectiveness of the Parkinson's disease medication levodopa.
Depression is a serious condition, and anyone who feels that he or she is depressed should be evaluated by a physician. Treatment with SAMe—or any other antidepressant compound—should be done in conjunction with a physician. In clinical studies of depression, the daily dose of SAMe has been 400 to 1,600 milligrams.
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