SAMe is often used for depression – but many marketed products are much lower in potency than their label claims, according to a recent report. Counsel patients about these concerns.
SAMe seems to increase serotonin turnover as well as dopamine and norepinephrine levels, and neuroimaging studies show that SAMe affects the brain similarly to conventional antidepressants. Several clinical studies in patients with depression show that taking SAMe 800-1600 mg by mouth daily for 4-12 weeks is more effective than placebo and about as effective as tricyclic antidepressants. Plus, it’s likely safe for most people and generally well-tolerated in typical doses.
But SAMe is difficult to formulate as a stable oral salt. In fact, the FDA halted trials of an investigational prescription product in 1993 due to concerns about tablet dissolution – supplement products may have the same problems. The ongoing quality concerns about SAMe are reinforced by a recent report showing that of 24 tested products, 16 contained less than 20% of the labeled potency – and 6 products contained no SAMe at all. On top of this, a 30-day supply can cost upwards of $100.
If patients decide to try a SAMe product, make sure they’re aware of the quality concerns. Also, explain that there are several forms of SAMe available – suggest looking for third party certified products of the butanedisulfonate salt. It’s the most bioavailable and seems to be the most stable.
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