Saturday, October 25, 2008

SAM-e can be Dangerous

SAM-e is being widely promoted as a "natural antidepressant". Quite by accident I recently stumbled upon some data which indicated that sustained use of SAM-e is potentially very dangerous.

SAM-e is S-adenosylmethionine. Part of its known actions is to act as a methyl donor. If you are using SAM-e you must make sure your vitamin B levels are adequate. The use of SAM-e has been associated with hyperhomocysteinemia, excess SAM-e is associated with Parkinson's Disease like disorders, excess methyl donation is a risk factor for some cancers, and the hyperhomocysteinemia that can arise from unwise use of SAM-e can induce atherosclerosis. It has also been found that in the brains of schizophrenic patients there is an over expression of SAM-e. Excessive SAM-e also induces oxidative stress and lipid peroxidation.

If you are taking S-adenosylmethionine be absolutely certain you have a very good intake of the B vitamin group, particularly folate, and you have a good antioxidant intake as well.

NEVER take SAM-e in conjunction with any antidepressants, "natural" or otherwise. It is probably advisable that before taking SAM-e you should have your homocysteine levels checked. If these levels are high then do not take it and immediately boost your intake of B vitamins and folate.

If you are using SAM-e for depression you might want to consider an "unnatural antidepressant" prescribed by your doctor. Antidepressant drugs are amongst the most widely prescribed drugs and have been subject to extensive trials and analysis. They have an excellent safety profile but it can take quite some experimentation to find the antidepressant that works for you. As recent studies have indicated the efficacy of antidepressants appears contingent on the induction of neurogenesis. This is probably a downstream effect from antidepressant use. At present I am taking an antidepressant. No, I'm not depressed, I just prefer the occasional dosing of an antidepressant because the one I am using has a number of favourable qualities.

Ideally if you are suffering from depression you should first try strategies that do not require taking anything. Check your diet, get some regular exercise, spend time with positive people, stabilise your sleep patterns if need be, get out in the sun occasionally(yes, sunshine, probably via circadian regulation and vitamin D, can give a slight boost to serotonin levels), and find ways to reduce your stress levels.

A brief overview of SAM-e is available at Wikipedia.

10 comments:

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Anonymous said...

I take SAM-E daily: 400mg with folic acid and pycnogenol (expensive I will say). I have noticed a very high rise in clarity and focus, while not so much of the dangers expressed here on this page. I believe it is important to know what you are pre-disposed to before taking such a supplement, but will also note that it has been used for a quarter century in Europe now with great success. There are dangers to every supplement out there. And there are also dangers to every diet out there. It should be viewed as a safe supplement in the hands of the educated, not an over the counter fixer upper. If you don't have time to learn the chemistry and take the proper precautions, make sure to do so before taking SAM-E. I highly recommend it to those who experience ADD, and are not bi-polar.

Anonymous said...

and obviously Schizophrenics should stay away from this supplement as well, as it cause a rapid mis-firing, that will make there episodes and symptoms worse.

xlpharmacy said...

I have met a lot of people that drink stuff like this, i just call them weak minds.. I mean world and life in here is hard doesn't matter where you are.

Medical Alert said...

Thank you for posting this informative article. I agree with your statement that prescription anti-depressants are extremely common and are subjected to many trials. That seems safer to me than this "natural" alternative.

Anonymous said...

What if arteriosclerosis has already begun? Can something be done (besides stopping the SAM-e)?

John said...

Atherosclerosis does appear reversible. It can take a long time and careful planning but it does appear to happen. The Heart Scan Blog might be able to help you in that regard.

Anonymous said...

I DECIDED TO TAKE SAM-e (400MG) AFTER STOPPING ZOLOFT. WITHIN A FEW DAYS, I FELT PRETTY POWERFUL STOMACH PAINS. I DIDN'T WANT TO CONNECT BOTH BECAUSE I WAS SO HOPEFUL THAT I COULD BE ON A "NATURAL" ANTIDEPRESSANT (FEELING THAT IT CARRIED NO STIGMA OF "WEAKNESS" AND OTHER SUCH WEIRD CULTURAL PREJUDICES). BUT THEN I NOTICED THAT I WAS EXPERIENCING OTHER PROBLEMS. INCREDIBLE NAUSEA VERY SOON AFTER INGESTION. WATER ON THE KNEE WITH ACCOMPANYING BLACK AND BLUE ON THE CALF (NOT CAUSED BY ANY FALL OR STRESS ON THE KNEE). FINALLY MY DOCTOR PUT TWO AND TWO TOGETHER AND MADE ME STOP. HONESTLY, WITHIN TWO DAYS, MY SYMPTOMS WENT AWAY (THE KNEE IS STILL SWOLLEN, BUT IT'S ONLY BEEN A WEEK). I DO ADMIT THAT SAM-E DID SEEM TO WORK ON MY DEPRESSION, BUT AT A PRETTY HUGE COST. I AGREE THAT IT IS BETTER TO GO ON SOMETHING TRIED AND TESTED. AND I NEED TO GET RID OF THIS ARTIFICIAL DIVIDE: "REAL" VS. "NATURAL" ANTI-DEPRESSANT. WHATEVER IS BEST FOR THE BODY AND SOUL IS WHAT I NEED TO TAKE. THANKS FOR LISTENING TO THIS WEIRD RANT AND I THANK THE PERSON WHO POSTED THIS FIRST.

John said...

Hey Anonymous,

The symptoms you describe suggest to me that the SAMe you purchased was not just SAMe. Many studies have found extremely worrying contaminants in supplements and all too often the active ingredient was at very low levels. I'm not against supplements, use some myself, but I go to considerable lengths to purchase reputable brands.

Don't be concerned, many people have gone down the "natural" route and found it wanting. I reject the natural vs artificial dichotomy, I think that is a ridiculous way to think about therapy.

Prescription antidepressants have problems but can be very effective. Often the patient needs to try a few types to find which works for them. If Zoloft works you then keep using it.

Anonymous said...

SAM-e caused liver damage in my child, given for depression by a naturopath...