S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial
Papakostas GI, et al
Published in American Journal of Psychiatry
Methodology
Six-week double-blind randomised trial of adjunctive oral SAMe (target 800 mg twice daily) versus placebo in SRI nonresponders continuing a stable antidepressant dose; primary outcome 17-item HAM-D response rate.
Key Findings
73 patients with major depressive disorder who had not responded to a serotonin reuptake inhibitor were randomised to adjunctive SAMe (target 800 mg twice daily) or placebo for 6 weeks while continuing their antidepressant. HAM-D response was 36.1% with SAMe versus 17.6% with placebo, and remission 25.8% versus 11.7%, giving a number needed to treat of about 1 in 6 for response and 1 in 7 for remission. Discontinuation for any reason (20.6% vs 29.5%), for adverse events (5.1% vs 8.8%) and for inefficacy (5.1% vs 11.7%) did not differ significantly.
Conclusions
These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and warrant replication.
Limitations
Preliminary trial of 73 patients over only 6 weeks; the authors themselves call for replication, and the sample was too small to characterise durability or rarer adverse effects.
Supplements Studied
These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and warrant replication.
These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe adjunctive treatment strategy for SRI nonresponders with major depressive disorder and warrant replication.
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