The over-the-counter dietary supplement SAM-e ("SAMMY") shows promise as an alternative treatment to prescription drugs for depression and osteoarthritis and may help some chronic liver conditions, according to an Evidence Report Summary on the supplement released this week.
The Evidence Report on SAM-e, introduced to the US in 1998, was sponsored by the US Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ).
"The Department of Health and Human Services hired an impeccable group of researchers to examine 102 clinical studies to determine whether or not SAM-e works ... their results are quite compelling," said Dr Hyla Cass, a Los Angeles-based clinical psychiatrist and UCLA assistant professor.
The report on SAM-e, or S-adenosyl-L-methionine, a natural compound found in every human cell and involved in over 35 biochemical processes in the body, was prepared for the HHS by Rand Corporation, a Southern California-based think tank. A team of medical professionals worked for more than three years on a literature review and synthesis of evidence on 102 different human clinical studies of SAM-e to determine its efficacy for treatment of depression, osteoarthritis and cholestasis of pregnancy and intrahepatic cholestasis associated with liver disease.
The key findings include evidence that SAM-e is as effective as prescription antidepressants, fights osteoarthritis pain as well as non-steroidal anti-inflammatory drugs (NSAIDS) and helps some liver conditions.
The report summary also refers to the high annual costs - $43.7 to $52.9 billion - associated with treatment and lost wages for depression. It also states that an estimated 15 per cent of Americans suffer from arthritis and the annual cost to society is estimated at $95 billion. Osteoarthritis is the most common form of arthritis.
Among the findings culled from 47 studies on the treatment of depression, the summary concludes that "compared to the use of conventional antidepressant pharmacology, treatment with SAM-e was not associated with a statistically significant difference in outcomes."
"These new findings suggest that SAM-e works as effectively as prescription drugs and it does it without the side effects," added Dr Cass. "This is big news for patients who suffer side effects from prescription antidepressants such as headaches, weight gain and the most significant - sexual dysfunction."
The team also examined 14 studies of osteoarthritis, which causes pain in the joints. They conclude that SAM-e appears to work as effectively as non-steroidal anti-inflammatory drugs (NSAIDS) in treating osteoarthritis.
The summary also finds promise that SAM-e may have an effect on intrahepatic cholestasis of pregnancy. This condition, caused by elevated levels of bilirubin in the liver, occurs in 1 in 500 to 1,000 pregnancies.
The team recommended more studies on SAM-e in the area of liver disease as well as depression and osteoarthritis to understand "the risk benefit ratio of SAM-e compared to conventional therapy, especially for depression and osteoarthritis."
The SAM-e Evidence Report Summary is available from the Department of Health and Human Services' Agency for Healthcare Research Quality website.