- Indications with possible efficacy:
- Indications with possible, but poorly documented efficacy:
- Other indications with no proof of efficacy:
Dementia and Alzheimer's disease
Enhancement of intellectual performances
To delay aging
- Risk of Drug Interactions: Moderate
- Adverse Effects: Not frequent
SAM-e is a naturally occurring molecule found in almost all tissues. It plays an essential role in the production and activation of proteins, hormones and neurotransmitters. SAM-e administration is associated with increased CNS serotonine, dopamine and norepinephrine levels. It appears to have analgesic and anti-inflammatory properties and seems to stimulate cartilage growth and repair. Oral SAM-e is weakly absorbed. Peak levels are reached 3 to 5 hours after ingestion of an enteric-coated tablet.
Direction of use
Its action on neurotransmitters may be responsible for its antidepressant activity.
Between 400 and 1600 mg daily in 2 or 3 doses.
Usual doses: 800 mg daily
Because of its analgesic and anti-inflammatory effects as well as its capacity to stimulate cartilage growth and repair, SAM-e efficiency seems comparable to NSAIDs in the treatment of osteoarthritis.
Loading dose of 600 to 1200 mg daily (in 3 doses) for 2 to 3 weeks followed by 200 mg twice daily.
- Intrahepatic cholestasis:
SAM-e may decrease pruritus, fatigue, alkaline phosphatase levels and bilirubin.
Usual doses: 800 mg twice daily
There is insufficient reliable information to conclude that SAM-e is effective in any other indication.
- Side effects
SAM-e is not associated with any specific toxicity. SAM-e may cause mild digestive troubles, dry mouth, insomnia and dizziness.
People with bipolar disorder or Parkinson's disease should avoid SAM-e.
It may modify the effects of antidepressants and levodopa. Before taking SAM-e, check with your pharmacist to make sure that there are no drug interactions with your regular medication
- Pregnancy and breastfeeding
It should only be considered when benefits clearly outweigh the risks. Since there is no safety data available concerning its use during breast-feeding, lactating women should not take SAM-e.
- SAM-e is an interesting molecule but its therapeutic value remains to be clearly established. It does not appear to be associated with any severe toxicity.
In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.
Medicinal plant contents vary naturally from plant to plant - just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.
For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.
- Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2010
- Natural Therapeutics Pocket Guide 2000-2001 (Lexicomp)
- Passeportsanté.net. SAM-e. www.passeportsante.net
- Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002
- The Review of Natural Products, 6th Edition, 2010
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.