SAMe is a compound that our body makes naturally from certain amino acids in high-protein foods like fish and meat. The production of SAMe is closely linked with folate and vitamin B12. As you may have read above, deficiencies in these nutri-
ents can lead to depressed levels of SAMe in the brain and nervous system. In the body, SAMe donates a part of itself, a methyl group, to surrounding body tissues, especially the brain. SAMe’s role as a methyl donor is what has scientists interested.
SAMe is approved as a prescription drug in 14 countries, and it is available as a dietary supplement in the United States and Canada. European physicians use SAMe to treat patients with depression, and it seems to work. The results of recent well-controlled studies show that SAMe is significantly better than a placebo in treating depression, and it may even be more effective than tricyclic antidepressant medication. These studies show that SAMe works quickly—symptoms improve in as few as four to five days.
Exactly how SAMe works to treat depressive symptoms is not entirely clear. It is associated with higher levels of brain neurotransmitters. But it may also work by favorably changing the composition of cell membranes in the brain, enabling neurotransmitters and cell receptors to work more efficiently.
To treat depression, studies use 800 to 2400 milligrams per day in divided doses. Start with one 400-milligram tablet twice daily, then work up to two tablets three times daily. SAMe is not a very stable molecule; to help it withstand the acidity of your stomach, make sure you buy an enteric-coated product.
The supplement is very well tolerated at the recommended doses, but it may cause nausea and gastrointestinal upset in doses higher than 1600 milligrams. European studies have not found any long-term problems associated with taking SAMe.
If you are currently taking medication for depression and you are thinking about trying SAMe, do not discontinue your medication without first speaking to your doctor. When taken with antidepressant drugs, SAMe may have an addictive effect, causing potentially dangerous side effects.
The Bottom Line…
Leslie’s recommendations for managing depression
1. Eat three meals each day plus a mid-day snack to avoid wide fluctuations in blood sugar and neurotransmitter levels.
2. Eat between 5 and 12 servings of grain foods, and 5 to 10 fruits and vegetables each day to ensure you get enough carbohydrates in your diet.
3. Get more omega-3 fats in your diet. If you decide to try fish oil capsules, buy a product that offers both EPA and DHA, and that has added vitamin E to increase its stability.
4. Eliminate alcoholic beverages, which can worsen feelings of depression.
5. Make sure you’re getting enough vitamin B6 in your diet.
6. If you suffer from mild depression and you’re already taking a multivitamin and mineral pill, try a 50- or 100-milligram B6 supplement every day. If you’re not taking a multivitamin and mineral, take a B complex supplement every day (check the ingredients to make sure it gives you 50 to 100 milligrams of B6).
7. Make sure your diet has plenty of folate and vitamin B12.
8. If extra B vitamins do not help your depression, try a standardized extract of St. John’s wort. Take 300 milligrams three times a day. Buy a product that is standardized for 0.3 percent hypericin, and that contains a high amount of hyperforin.
9. If you are taking an SSRI drug (Prozac®, Effexor®, Paxil®, Zoloft®, Serzone®) and suffering sexual dysfunction as a side effect, try taking 60 milligrams of ginkgo biloba leaf extract twice daily. Look for an extract that contains 24 percent ginkgo flavone glycosides.
10. Consider taking 800 to 1600 milligrams of SAMe, a dietary supplement that is used to treat depression. Buy an enteric-coated product and take on an empty stomach.
11. If your mood swings do not improve with dietary changes or the recommended supplements, consult your doctor. Serious emotional problems may require medication.