SAM-e (S-adenosylmethionine)
Mental Health · Methyl donor
Tier C+
What this is
Enteric coating and proper storage (cool, dry) are essential — SAM-e degrades readily. Papakostas 2010 trial showed SSRI augmentation benefit in MDD nonresponders. Expensive relative to other antidepressant augmentation options. Bipolar screening important (has triggered hypomania/mania case reports).
Mechanism
Endogenous methyl donor; essential cofactor for methylation reactions including neurotransmitter synthesis and phospholipid production; influences homocysteine and folate cycle
Dose & route
400-1600 mg/day PO divided, enteric-coated, empty stomach
Citations
- https://pubmed.ncbi.nlm.nih.gov/20595412/
- https://pubmed.ncbi.nlm.nih.gov/12056580/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3833570/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.