SAM-e — Supplements
S-Adenosylmethionine: universal methyl donor with antidepressant, hepatoprotective, and joint-supportive properties.
Overview
S-Adenosylmethionine (SAM-e) is the principal methyl donor in the body, participating in over 100 methyltransferase reactions essential for neurotransmitter synthesis, DNA methylation, phospholipid metabolism, and cartilage proteoglycan production. Clinical trials demonstrate antidepressant efficacy comparable to tricyclic antidepressants and NSAIDs for osteoarthritis pain. SAM-e also has hepatoprotective properties, promoting glutathione synthesis and bile flow. It is a prescription drug in several European countries for depression and liver disease.
Indications
- Major depressive disorder (adjunctive or monotherapy)
- Osteoarthritis pain management
- Hepatoprotection and liver health
- Fibromyalgia symptom management
Mechanism of Action
SAM-e donates methyl groups to neurotransmitters (serotonin, dopamine, norepinephrine), phospholipids, and DNA
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| SAM-e | 400 mg | 1-3 times daily | Start 200 mg BID; titrate to 400-800 mg BID; cycle 6-12 weeks |
Safety & Contraindications
- May trigger mania in bipolar disorder; avoid without psychiatric supervision
- Can cause GI upset, anxiety, and insomnia
- Avoid combining with serotonergic medications (SSRIs, MAOIs) without medical guidance
- Enteric-coated, stabilized formulations are essential (SAM-e degrades rapidly)