Generalized anxiety disorder can affect anyone at any stage of life. It is characterized by symptoms such as uncontrollable worry, disproportionate and debilitating preoccupation about the future, difficulty concentrating, restlessness, insomnia, fatigue, irritability, muscle tension and heart palpitations. According to the University of Maryland Medical Center, anxiety disorders are often found alongside gastrointestinal disorders and depression. S-adenosyl methionine, or SAM-e, known in Europe as the pharmaceutical drug Ademetionine, has been used to treat depression for 20 years. There is no substantive research, however, that it may be effective as a treatment for anxiety disorders.
SAM-e
MayoClinic.com has given SAM-e a C rating for its safety and efficacy in the treatment of depression, although it gets a B rating for the treatment of arthritis pain. Despite its long history of use, the mechanism by which it works in the brain is not known. Found naturally in the human body, SAM-e is known to play a necessary role in four important metabolic pathways. Taken together, these may be responsible for its therapeutic action. Through its promotion of the methylation pathway, SAM-e may increase serum levels of the neurotransmitters serotonin, dopamine and norepinephrine.
Depression and Anxiety
Nearly all pharmaceutical treatments for depression are believed to work by increasing serum or synaptic levels of serotonin in the brain. According to MayoClinic.com, anxiety disorders respond well to treatment with selective serotonin re-uptake inhibiting drugs. Like these drugs, SAM-e is believed to promote feelings of well-being by increasing synaptic serotonin levels. Unlike SSRIs, however, SAM-e also increases synaptic levels of dopamine and norepinephrine.
Dopamine and Norepinephrine
In addition to increasing synaptic serotonin, most new-generation antidepressants also increase dopamine and norepinephrine levels. It is hoped that this will help treat the fatigue and anheodonia, or lack of pleasure, that serotonin-specific drugs have historically been unable to treat. Unfortunately, according to the University of Maryland Medical Center, the feelings of increased energy and motivation this may provide in depressed patients can intensify rather than treat symptoms when used to treat anxiety.
Epinephrine and Anxiety
The role of norepinephrine in anxiety disorders is not well-understood. While the use of trycyclic antidepressants is considered to be a risk factor for the development of anxiety disorders, these drugs are also used to treat anxiety disorders that are unresponsive to traditional anti-anxiety drugs. SAM-e, which also increases serum norepinephrine levels, has similarly been used to treat anxiety and implicated as a cause. Due to its complex pharmacological activity, SAM-e may interact with conventional anti-anxiety and anti-depressant medications. For this reason, you should talk to your doctor before taking SAM-e.
References
- Mayo Clinic; SAMe: Safety; April 2011
- Sloan-Kettering; SAMe; August 2010
- University of Maryland Medical Center; Possible Interactions with: S-Adenosylmethionine (SAMe); August 2007
- Mayo Clinic; Anxiety: Treatments and Drugs; January 2011
- University of Maryland Medical Center; Generalized Anxiety Disorder: All Information; January 2009
- University of Maryland Medical Center; Stress and Anxiety - Overview; January 2009
