SAMe for depression?

Consumer Reports News: September 17, 2010 11:38 AM

Our September article on Dangerous Supplements identified S-Adenosyl Methionine (SAMe) as one of 11 supplements that's worth considering for certain conditions, including major depression. Now a small but rigorous clinical trial in the August issue of the American Journal of Psychiatry adds to that support, suggesting that when antidepressant drugs alone don't work, adding SAMe under your doctor's supervision might help.

It was the first randomized, double-blind, placebo-controlled trial of its kind, according to the research team at Massachusetts General Hospital's Center for Treatment-Resistant Depression. The 6-week study, funded by the National Institute of Mental Health, included 73 people with major depression who hadn't responded to common antidepressant drugs, including fluoxetine (Prozac and generic), paroxetine (Paxil and generic), and sertraline (Zoloft and generic). Thirty-nine got SAMe plus their antidepressant, and 34 got a placebo along with their medication.

Overall, 18 patients treated with SAMe showed moderate improvement compared with 6 who took placebo. And 14 who got SAMe experienced substantial relief compared with 4 who were given placebo. No serious adverse events were reported in the study, though people who took SAMe appeared to have a slight increase in blood pressure.

The researchers called the results "preliminary," and said that follow-up studies need to confirm their findings before SAMe is added to the "antidepressant treatment armamentarium." And the therapy can be expensive: A month's supply of the doses used in the trial—800 milligrams twice a day—could cost about $145, and it's unlikely to be covered by insurance. Finally, SAMe has been linked to a number of side effects and drug interactions, including with certain antidepressants. So talk to your doctor or pharmacist before starting SAMe—or any other supplement.

If you're depressed, also talk with your doctor to make sure that you get the right care. While nearly 15 million American adults have major depression, more than half of all patients treated with just drugs fail to get substantially better. And our recent survey of 1,500 Consumer Reports subscribers seeking treatment, found that older, often less expensive antidepressants work just as well, and with fewer side effects, than newer, more costly drugs. For information on the effectiveness, safety, and price of those drugs, see Consumer Reports Best Buy Drugs report on antidepressants.

—Douglas Podolsky, senior editor

Read about some things that may increase your risk for depression and find out which treatments worked best for our readers who've experienced depression.

—Aaron Bailey