Opinions - Why so little about Sam-E

[CorySpaceCowboy]

I am curious as to why there is so little on Sam-e in these forums? There is far more on SJW, 5-HTP, DHEA, etc. SWIM has tried all of these for a more positive mood and none compare to Sam-e in his opinion. Has SWIY's just not tried it or does it just not work for them?

[Potter]

Well describe the above experiments, length of time, dose, qualitative effects, don't forget the subjects vitals and pertinent personal history. What about it made it superior to the others? Make it convincing.

[psyche]

SWIM has read very good things about sam-e but somehow never got around ordering it. Would be interesting to hear DF'rs experiences about it.


psyche added 9 Minutes and 29 Seconds later...

Ok, I'll throw the first rock. Here's an article about Sam-e:

Source: NEWSWEEK
Date: July 1999

What Is SAMe

Proponents claim that this hot new over-the-counter dietary supplement can ease depression, restore arthritic joints and combat chronic liver disease. Here's what we know about it—and what we don't.
By
Geoffrey Cowley and Anne Underwood

She was making lunch for herself and a friend one Saturday this spring when an unfamiliar feeling swept over her. The 50-year-old social worker had fallen deep into depression two years earlier, and had given up on prescription antidepressants when the first one she tried left her sluggish, sexually dormant and numb to her own emotions. Then, in mid-March, she heard about a naturally occurring substance called SAMe (pronounced "Sammy"). She had been taking it for just a few days when she began setting the table that Saturday morning. A ginger-miso sauce was chilling in the fridge, and she was garnishing her finest plates with fresh anemones. Suddenly, there it was: a sense of undiluted pleasure. This woman (who asked not to be named) has taken SAMe ever since, and her mood isn't the only thing that has changed. Until this spring she took prescription-strength anti-inflammatories for her arthritis, and still had trouble bending her knees. She's now off those drugs—and feeling more nimble than she has in 20 years.
Could an over-the-counter tonic really do all this? Pills purporting to cure everything from hemorrhoids to hangnails are usually worthless and sometimes dangerous. And because SAMe has not been studied extensively in the United States, many doctors are leery. Beware, says Dr. Gilbert Ross of the American Council on Science and Health, a conservative watchdog group. Supplement dealers are once again trying to "flimflam the public into using untested remedies instead of FDA-approved pharmaceuticals."
The Food and Drug Administration has not rigorously evaluated SAMe, let alone approved it. (Federal law permits the unregulated sale of naturally occurring substances as long as marketers avoid therapeutic claims.) And the studies that researchers have conducted are not of the magnitude the FDA would require for a drug approval. But that doesn't mean SAMe is "untested." In dozens of European trials involving thousands of patients, it has performed as well as traditional treatments for arthritis and major depression. Research suggests it can also ease normally intractable liver conditions. SAMe doesn't seem to cause adverse effects, even at high doses. And doctors have prescribed it successfully for two decades in the 14 countries where it has been approved as a drug.
Until recently, few Americans had heard of the stuff. An Italian firm developed it as a pharmaceutical in the early 1970s but lacked the will or the resources to make a run at a drug approval in the United States. Then, this spring, two U.S. vitamin companies, GNC and Pharmavite, started importing large quantities of SAMe to sell as a supplement. The product took off quickly—Pharmavite's Nature Made brand now ranks 25th among the 13,000 supplements sold in grocery and drugstores—and the impact is still growing. When you consider that some 50 million Americans suffer from arthritis or depression, the implications are staggering.
SAMe (known formally as S-adenosylmethionine) is not an herb or a hormone. It's a molecule that all living cells, including our own, produce constantly. To appreciate its importance, you need to understand a process called methylation (chart). It's a simple transaction in which one molecule donates a four-atom appendage—a so-called methyl group—to a neighboring molecule. Both the donor and the recipient change shape in the process, and the transformations can have far-reaching effects. Methylation occurs a billion times a second throughout the body, affecting everything from fetal development to brain function. It regulates the expression of genes. It preserves the fatty membranes that insulate our cells. And it helps regulate the action of various hormones and neurotransmitters, including serotonin, melatonin, dopamine and adrenaline. As biochemist Craig Cooney observes in his new book, "Methyl Magic," "Without methylation there could be no life as we know it."
And without SAMe, there could be no methylation as we know it. Though various molecules can pass methyl groups to their neighbors, SAMe is the most active of all methyl donors. Our bodies make SAMe from methionine, an amino acid found in protein-rich foods, then continually recycle it. Once a SAMe molecule loses its methyl group, it breaks down to form homocysteine. Homocysteine is extremely toxic if it builds up within cells. But with the help of several B vitamins (B6, B12 and folic acid), our bodies convert homocysteine into glutathione, a valuable antioxidant, or "remethylate" it back into methionine.
SAMe and homocysteine are essentially two versions of the same molecule—one benign and one dangerous. When our cells are well stocked with B vitamins, the brisk pace of methylation keeps homocysteine levels low. But when we're low on those vitamins, homocysteine can build up quickly, stalling the production of SAMe and causing countless health problems. High homocysteine is a major risk factor for heart attack and stroke. During pregnancy, it raises the risk of spina bifida and other birth defects. And many studies have implicated it in depression.
How, exactly, might taking extra SAMe improve a person's mood? Researchers have identified several possibilities. Normal brain function involves the passage of chemical messengers between cells. SAMe may enhance the impact of mood-boosting messengers such as serotonin and dopamine—either by regulating their breakdown or by speeding production of the receptor molecules they latch on to. SAMe may also make existing receptors more responsive. These molecules float in the outer membranes of brain cells like swimmers treading water in a pool. If the membranes get thick and glutinous, due to age or other assaults, the receptors lose their ability to move and change in response to chemical signals. By methylating fats called phospholipids, SAMe keeps the membranes fluid and the receptors mobile.
Whatever the mechanism, there is little question that SAMe can help fight depression. Since the 1970s, researchers have published 40 clinical studies involving roughly 1,400 patients. And though the studies are small by FDA standards, the findings are remarkably consistent. In 1994 Dr. Giorgio Bressa, a psychiatrist at the University Cattolica Sacro Cuore in Rome, pooled results from a dozen controlled trials and found that "the efficacy of SAMe in treating depressive syndromes... is superior [to] that of placebo and comparable to that of standard... antidepressants."
This isn't the first natural substance to show promise as a mood booster. Small studies suggest that St. John's wort can ease low-grade melancholy, but SAMe has been tested against far more serious disorders. In one of several small U.S. studies, researchers at the University of California, Irvine, gave 17 severely depressed patients a four-week course of SAMe (1,600 mg daily) or desipramine, a well-established antidepressant. The SAMe recipients enjoyed a slightly higher response rate (62 percent) than the folks on desipramine (50 percent).
No one has found SAMe significantly more effective than a prescription antidepressant, but it's clearly less toxic. The drugs that predate Prozac (tricyclics and MAO inhibitors) can be deadly in overdose, or in combination with other medications. Newer antidepressants, such as Prozac, Zoloft and Paxil, are less dangerous, but their known side effects range from headaches and diarrhea to agitation, sleeplessness and sexual dysfunction. And SAMe? Studies suggest that like other antidepressants, it may trigger manic episodes in people with bipolar disorder. Aside from that, the most serious side effect is a mild stomach upset.
Until large U.S. studies confirm these findings, few American doctors will recommend SAMe to severely depressed people. "The evidence looks promising," says Harvard psychiatrist Maurizio Fava, "but it's not definitive. In some European countries they have different marketing standards than we do." UCLA biochemist Steven Clarke echoes that concern, saying the nation is embarking on a large, uncontrolled experiment in which consumers are the guinea pigs. A key concern is that depressed patients will drop other treatments to try SAMe, and end up suicidal. Columbia University psychiatrist Richard Brown warns of that hazard in "Stop Depression Now," a new book coauthored with Baylor University neuropharmacologist Teodoro Bottiglieri. Yet Brown himself has treated several hundred patients with SAMe in recent years, sometimes combining it with other drugs, and he has never had a bad experience. "It's the best antidepressant I've ever prescribed," he says flatly. "I've seen only benefits."
If the world needs a better antidepressant, it could also use a better arthritis remedy. Nearly a third of the 40 million Americans with chronic joint pain use drugs like aspirin and ibuprofen. In arthritis-strength doses, these so-called NSAIDs, or nonsteroidal anti-inflammatory drugs, can have devastating gastric side effects. Some 103,000 Americans are hospitalized annually for NSAID- induced ulcers, and 16,500 die. Even when NSAIDs don't destroy the digestive tract, they may ultimately worsen people's joint problems, for they slow the production of collagen and proteoglycans, the tissues that make cartilage an effective shock absorber.
Could SAMe provide an alternative? In a dozen clinical trials involving more than 22,000 patients, researchers have found SAMe as effective as pharmaceutical treatments for pain and inflammation. But unlike the NSAIDs, SAMe shows no sign of damaging the digestive tract. And instead of speeding the breakdown of cartilage, SAMe may help restore it. You'll recall that after giving up its methyl group, SAMe becomes homocysteine, which can be broken down to form glutathione (the antioxidant) or remethylated to form methionine (the precursor to SAMe). As luck would have it, the reactions that produce glutathione also yield molecules called sulfate groups, which help generate those joint-sparing proteoglycans.
What does this mean for patients? The Arthritis Foundation, a mainstream advocacy group, recently said its medical experts were satisfied that SAMe "provides pain relief" but not that it "contributes to joint health." The evidence that SAMe can repair cartilage is admittedly preliminary, but it's intriguing. When German researchers gave 21 patients either SAMe or a placebo for three months, using MRI scans to monitor the cartilage in their hands, the SAMe recipients showed measurable improvements. That wouldn't surprise Inge Kracke of Cologne. She was an active 48-year-old when a 1996 auto accident mangled her left knee and left her hobbling on a cane. Dr. Peter Billigmann of the University of Landau prescribed a regimen that combined SAMe (1,200 mg a day for three months) with injections of hyaluronic acid, a cartilage component. Cartilage injuries don't normally heal, but a year later Kracke's knee looked better on X-rays. She now plays golf three times a week.
SAMe may have other benefits as well. Studies suggest it can help normalize liver function in patients with cirrhosis, hepatitis and cholestasis (blockage of the bile ducts). SAMe has also been found to prevent or reverse liver damage caused by certain drugs. As patients hear more about this supplement, they may try treating themselves for all these conditions and others. But many of them will be disappointed—either because they expect miracles that SAMe can't deliver, or because they take the wrong dose or form.
The first challenge is to buy full-strength SAMe. "Some companies are very reliable manufacturers," says Dr. Paul Packman of Washington University in St. Louis. "But some aren't. You can't always tell from the label on the bottle how much active ingredient is actually in it." Pharmaceutical-grade SAMe comes in two forms, one called tosylate and a newer, more stable form called butanedisulfonate. Only Nature Made and GNC sell the new butanedisulfonate version, but several U.S. retailers import reliable tosylate products. And because SAMe is absorbed mainly through the intestine, it's best taken in "enteric coated" tablets that pass through the stomach intact. None of the products comes cheap. The price of a 400-mg dose ranges from $2.50 (Nature Made) up to $18.56 for an uncoated Natrol product called SAM sulfate.
Assuming you buy full-strength SAMe, the second challenge is to use it effectively. Experts advise taking it twice a day on an empty stomach, but different people may require different amounts. Though studies suggest that 400 mg a day is an effective dose for arthritis, the daily doses used in depression trials have ranged as high as 1,600 mg. Clinicians generally start people with mood problems at 400 and ratchet up as necessary.
Unfortunately, there is no convincing evidence that SAMe can make healthy people happier or more mobile than they already are. But there are lessons here for everyone. We now know that methylation is vital to our well-being. It's equally clear that the modern Western diet—rich in protein, light on the plant foods that supply folate—is a prescription for stalling that vital process. "SAMe works as a medication to treat certain diseases," says Paul Frankel, a biostatistician at the City of Hope National Medical Center in Duarte, Calif. "But for most people the problem is undermethylation of homocysteine." In other words, many of us could arm ourselves against low moods, bad joints and weak hearts simply by upping our intake of B vitamins. That may sound less exciting than taking a miracle supplement. But with luck, it could keep you from ever needing one.

http://www.biopsychiatry.com/sameart.html

[CorySpaceCowboy]

My apologies. I suppose it should have gone without saying that since there is so little on the effects of Sam-e I should have made this more about SWIMS experiences than just a general question. But anyways...

SWIM has been taking 400mgs of sam-e once daily for the past 3 weeks.

SWIMS STATS
Age-22
Weight- 155lbs/70.5kgs
Dose- 400mgs (once daily, first thing in the morning)

Prior to starting SAM-e SWIM felt he has been suffering, from about the age of 16, from what he can best describe as "comfortably numb." Which he thinks was caused by the belief that because one day he will die that nothing really mattered.

OPTIMISTIC MOOD
By the end of the first day he realized he was in a positive mood for the entire last half of that day, which he found odd since his mood is almost exclusively neutral, and to his surprise the positive feelings have not disappeared nor diminished since then. The easiest way for SWIM to describe the feelings is to say that they remind him of how he felt as a child, before taking Sam-e a lot of things just seemed pointless to SWIM, but now he seems to just naturally and happily go with life's flow. He has become slower to anger. And has found he enjoys socializing and even work much more now. He has more mental energy and more patients than he did before.

SWIM would also like to stress that these effects are in no way, what he would call "intense." Which he actually prefers, it simply makes him feel better, it doesn't change who he is and it's a very natural feeling expieriance.

He has also realized that his pessimistic beliefs that caused him to be depressed seem to have vanished, his outlook on the world is different than it used to be. This makes him curious as to wheather or not Sam-e could be a type of therapy to snap one out of emotionaly unhealthy beliefs. He has went without it on 2 seperate occasions and expieriance no decrease in his positive mood. After he has finished his supply he will discontinue use to see if that is the case.

HEALTHIER FEELING
After the first few days of taking the product SWIM realized he had begun to feel much better physicaly than he had previously. His body gets wore out far less easily, and he just simply feels healthier and less fragile than he did before.

COMPARE AND CONTRAST
SWIM has tried other things to improve his mood including St. Johns Wort, DHEA, and 5-HTP. Here is how these substances compared to Sam-e for him.

St. Johns Wort really had no noticible effects for SWIM, even at mega doses he really can't say he felt a thing from it. So that's all on that.

DHEA also did not really make SWIM feel more positive, it did at times, but the feelings were not consistant and short lived.

5-HTP did make SWIM feel more laid back, relaxed, and care free. However, it also made him feel tired, which he did not enjoy. Nor did it make SWIM feel more positive about life, it just helped him not care about anything really.

And then there is Sam-e, which simply makes swim feel optimistic.

CorySpaceCowboy added 98 Minutes and 4 Seconds later...

Oh forgot something. Make sure to take a B-Complex vitamin including B6, B12 and folic acid while taking SAM-e, it will ensure that you get the benefits of SAM-e and prevent your homocysteine levels from becoming too high. High levels of homocysteine can cause atherosclerosis, heart attacks, strokes, liver damage, and possibly Alzheimer's disease.

More detailed information on this can be found on the Wikipedia page for SAM-e. Sorry, but post count is not high enough to link to it.

[Gradient]

Found a website that hosts a bunch of abstracts from Medline on SAMe (S-Adenosyl-L-Methionine). Here are some relevant snippets:
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"The antidepressant effect of SAMe may be due, at least in part, to a normalization of putrescine levels in the nucleus accumbens septi."

"All the chronic treatments showed antidepressant effects and up-regulated the hippocampus 5-HT(1A) receptors. SAM prevents the 5-HT(1A) receptor up-regulation induced by acute imipramine in the frontal cortex. This mechanism may contribute to imipramine's antidepressant effect."

"Although there exists significant potential for therapeutic application of SAMe, its uncertain risk profile precludes definitive recommendation at this time. Healthcare providers and consumers should likely temper their enthusiasm for this dietary supplement until sufficient information becomes available."

"Several reviews and at least two meta-analyses have examined the available evidence surrounding SAMe in the therapy of depression for trials completed prior to 1994 and concluded that SAMe was superior to placebo in treating depressive disorders and approximately as effective as standard tricyclic antidepressants"

"Overall, SAMe appears to be safe and effective in the treatment of depression, but more research is needed to determine optimal doses. Head-to-head comparisons with newer antidepressants should help to clarify SAMe's place in the psychopharmacologic armamentarium"

"EEG-ERP mapping identified SAMe as an antidepressant."

"Consumers should be instructed to avoid unmonitored consumption of this dietary supplement until sufficient discussion has taken place with their primary healthcare provider. Although there exists significant potential for therapeutic application of SAMe, its uncertain risk profile precludes definitive recommendation at this time. Healthcare providers and consumers should likely temper their enthusiasm for this dietary supplement until sufficient information becomes available."

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Looks like there is the potential for some more interesting research comparing SAMe to some of the modern anti-depressants. Certainly an interesting compound - not the norm for depression treatment. Cool topic!

[seeingred]

Had some positive effects from Sam E. It is hard to find and expensive. Yep but deff felt the optimism and comfort.

[onzero]

very effective for swim, but also strong side effects inluding insomnia, anxiety, and gut issues.

occasionally seemed hypomanic.

[Durd1e]

SWIM found SamE unparalleled in terms of an all round improvement in his life. The increasein liver function meant he had more energy, slept better, his sweat actually smelt better, he generally felt more alive. The increase in serotonin resulting from the samE meant his mood was substantially better.

I think there is probably not a lot on here about it as it is generally considered more liver support than nootropic. Most of its effects on the mind are indirect.

Its also worth noting that it potentiated the effects of any other serotoninergenic drugs swim took.

[supermil]

i like sam-e
i take 400 mg daily
200 in the morning.
i will try it with PS , and other noos

[bluntshell]

My buddy tried 200 mg morning and 200 at night for about 90 days.

No noticeable effects.

[supermil]

you can try the injectable form

[RoboCop]

Bump. Would love to hear more about Sam-e.

Would this be dangerous to take daily with 5-htp?
Any safety tips on its use?
Couldn't Sam-e be used post rolling mdma/methylone/etc to help recovery.

Swim is taking this for mild deppression, I wish there was more information on this site about it.

[Durd1e]

It can be dangerous to take daily with 5htp as the both raise the serotonin level in your brain. Now people will undoubtedly tell you that there is a risk of serotonin syndrome from this but tbh the risk is minute.

The real danger is that long term raised serotonin will cause the brain to downregulate and 5htp has been linked to fibrosis of the endocardium and valves of the heart. Now this has not been categorically proven but evidence does point to this.

5htp is best taken intermittently. SAMe, I think is safer but still not daily forever.

5htp only really becomes dangerous if mixed with an SSRI like prozac or st john's wort.


I'll post a little more info when I get the time.