S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine.

Jonathan E Alpert, George Papakostas, David Mischoulon, John J Worthington, Timothy Petersen, Yasmin Mahal, Alana Burns, Teodoro Bottiglieri, Andrew A Nierenberg, Maurizio Fava

Journal: Journal of clinical psychopharmacology 2005;24(6):661-4

PMID: 15538131

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Abstract

BACKGROUND

The purpose of this open trial was to evaluate the safety, tolerability, and efficacy of oral S-adenosyl-L-methionine as an antidepressant adjunct among partial and nonresponders to serotonin reuptake inhibitors or venlafaxine.

METHOD

Thirty antidepressant-treated adult outpatients with persisting major depressive disorder received 800 to 1600 mg of S-adenosyl-L-methionine tosylate over a 6-week trial.

RESULTS

Intent-to-treat analyses based on the Hamilton Depression Rating Scale revealed a response rate of 50% and a remission rate of 43% following augmentation with S-adenosyl-L-methionine. Gastrointestinal symptoms and headaches were the most common side effects.

CONCLUSION

Augmentation of selective serotonin reuptake inhibitors or venlafaxine with S-adenosyl-L-methionine warrants a placebo-controlled trial in resistant depression.

Address: Depression Clinical and Research Program, Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA. [email protected]

DOI: 10.1097/01.jcp.0000145339.45794.cd

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MeSH Terms: Adult, Cyclohexanols, Depressive Disorder, Major, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, S-Adenosylmethionine, Selective Serotonin Reuptake Inhibitors, Venlafaxine Hydrochloride