BOSTON—S-adenosyl methionine (SAMe) may enhance the efficacy of serotonin reuptake inhibitors (SRIs) in adults with major depression who do not respond to SSRIs alone (Am J Psychiatry. 2010;167:942-48. DOI: 10.1176/appi.ajp.2009.09081198). SAMe is a naturally occurring molecule that serves as a methyl donor in cellular metabolism. Formed from the essential amino acid methionine and adenosine triphosphate (ATP), studies suggest SAMe may increase the availability of certain neurotransmitters including dopamine and serotonin.
Researchers from Harvard Medical School and Massachusetts General Hospital recruited 73 adults with major depressive disorder who were SRI nonresponders for a six-week, double blind, randomized trial. Patients received a placebo or 1,600 mg/d of SAMe along with prescribed SRI treatment at a stable dose. The primary outcome measure was response rates on the 17-item Hamilton Depression Rating Scale (HAM-D).
Patients treated with adjunctive SAMe had higher HAM-D response and remission rates (36.1 percent and 25.8 percent, respectively), compared to the placebo group (17.6 percent response and 11.7 percent remission). There was no statistically significant difference in the proportion of SAMe-treated patients versus subjects on placebo who discontinued the trial for any reason, or due to adverse events or inefficacy.
