SAM-e for Cognitive Function
Cognitive benefits of SAM-e are largely inferred from its mood effects rather than directly demonstrated.
Overview
Verdict
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- Studied at 400-1,600 mg/day; cognitive benefit has not been demonstrated outside depression
- Expected timeframe
- Not established
Protocol
- form
- Enteric-coated S-adenosyl-L-methionine, butanedisulfonate or tosylate salt, taken on an empty stomach in the morning
- duration
- Trials with cognitive measures ran 6-8 weeks
- co factor
- Evidence is insufficient. SAM-e is central to methylation reactions involved in neurotransmitter synthesis and myelin maintenance, and low central SAM-e has been reported in Alzheimer disease and in B12 deficiency, which is the mechanistic rationale. Clinically, cognitive measures have appeared as secondary outcomes in depression trials with inconsistent results, and small uncontrolled studies in Alzheimer disease have not been followed by adequately powered randomised trials. No trial has shown cognitive benefit in healthy adults or in mild cognitive impairment. Cognitive improvement seen in depression trials plausibly reflects mood improvement rather than a direct nootropic effect.
- titration
- Not applicable - no cognitive dose-response has been established
- starting dose
- Not established for this outcome. Depression trials used 400-1,600 mg/day of enteric-coated SAM-e
Evidence
What the studies say
No studies are yet linked to both SAM-e and Cognitive Function.
Safety
Caveats
Depression is one of the most common reversible causes of apparent cognitive impairment, so cognitive change in that setting is best addressed by treating the depression. Progressive memory or thinking change needs medical assessment, because B12 deficiency, hypothyroidism, sleep apnoea, depression, alcohol and anticholinergic medication burden are treatable contributors. For long-term cognitive health, the evidence sits with physical exercise, treating hearing loss, controlling blood pressure and diabetes in midlife, not smoking, limiting alcohol, sleep and social engagement. Safety of SAM-e: it can precipitate hypomania or mania and must be avoided in bipolar disorder. It is serotonergic and should not be combined with SSRIs, SNRIs, MAO inhibitors, tramadol, triptans or St John wort without medical advice, given serotonin syndrome risk. Nausea, insomnia, anxiety, headache and gastrointestinal upset are common, particularly at higher doses - take it in the morning to limit insomnia. It raises homocysteine, so adequate B12, folate and B6 intake matters, and B12 deficiency should be excluded before use in anyone with cognitive symptoms. Safety in pregnancy and breastfeeding is not established.
Less likely to help if
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Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.