S-adenosyl-L-methionine (commonly called "SAM-e") is a naturally-occurring chemical component present in all cells of the body, essential in more than 200 metabolic pathways. SAM-e has been approved as a prescription drug for depression in Germany, Italy, Spain, and Russia, and has been in use in Europe for over three decades. It is available without a prescription in the United States and some other countries.
SAM-e appears to be an effective treatment for depression where it can be used alone or with antidepressants. Since its side effects are less than those of many antidepressants, SAM-e might be tolerated better by many people. It works more rapidly and does not cause weight gain, sexual dysfunction, sedation, or cognitive interference.
Recent studies have shown promise for treatment of dementia. Experts have suggested that SAM-e may also help address ADHD.
SAM-e has not been studied in children or in pregnant or breast-feeding women.
There are no known drug interactions with SAM-e.
SAM-e may help prevent other drugs from interacting with the liver.
Mild nausea is the most common side effect and can be reduced by taking SAM-e with food.
SAM-e can worsen underlying agitation, panic, or anxiety. Accompanying use of a mood stabilizer is essential if there is any indication of mania or bipolar disorder. In the absence of bipolar symptoms, a calming agent can deal with any undesirable activating effects of SAM-e.