S-adenosylmethionine, or SAMe, exists abundantly throughout your body. Purported uses for supplement form include treating depression, arthritis, fibromyalgia and liver disease. Research supports some of these suggested uses but some studies failed to find benefit. In several instances, using this supplement could cause adverse effects. If you believe taking SAMe will address a particular health concern, talk to your doctor about the appropriateness of using this supplement. He can offer guidance on safe use and monitor your treatment.
SAMe and Serotonin Syndrome
Combining antidepressants and supplements with demonstrated antidepressant activity can result in a condition called serotonin syndrome, which results from excess production of this brain chemical heavily involved in mood. Symptoms include but are not limited to agitation, hallucinations, increased body temperature, loss of coordination , uncontrolled muscle spasms, rapid fluctuations in blood pressure and even death.Examples include tricyclics, selective serontonin reuptake inhibitors and monoamine oxidase inhibitors. The University of Maryland Medical Center notes serotonin syndrome might also result from using this supplement at the same time as cough syrups containing dextromethorphan and the narcotic medications meperidine, pentazocine and tramadol. If you take any of these medications, do not use SAMe without talking to your doctor first.
Side Effects
The Beth Israel Deaconess Medical Center notes SAMe appears generally safe with the most common side effect being mild stomach upset. Other side effects associated with SAMe include nausea, vomiting, flatulence and headache. If taking SAMe to treat symptoms of depression, taking too large a dose at first could result in symptoms of mania, characterized by extreme states of happiness, increased energy, agitation and aggression. The Memorial Sloan Kettering Cancer Center recommends working up to the recommended full dosage of this supplement slowly over one to two weeks. Your doctor can suggest a graduated dosing schedule to avoid this potential problem. If you have bipolar disorder, you should not use SAMe. Drugs.com notes case reports of increased mania and anxiety in bipolar individuals using it.
Medication Interactions
Besides the potential to interact with medications that affect serotonin levels, SAMe has other potential interactions. It can lower blood sugar levels and using it at the same time as insulin or other medications to control glucose levels could result in hypoglycemia. You might require dosage adjustments in your medications to compensate for the effects of SAMe. Beth Israel reports the use of the Parkinson's drug levodopa depletes SAMe levels in the brain, which might account for the depression seen in this patient population as well as certain side effects of the drug. It notes one study which found supplementation relieved symptoms without interfering with the effectiveness of the drug. Some concern exists, however, that using it long-term might interfere with the actions of the medication levodopa.
Other Safety Concerns
Drugs.com notes that studies have found SAMe does not cause any harmful effects in pregnant women but safe use in this population has not been firmly established. Talk to your doctor before using any supplement if you are pregnant or breast-feeding. If you have liver or kidney disease, always clear the use of supplements with your doctor as these organs -- especially when functioning in a diseased state -- have a particular sensitivity to what you put in your body.
Dosing Guidelines
Staying within the suggested dosage guidelines will minimize negative reactions, particularly if taking it to treat depression. The University of Maryland Medical Center notes the following dosage guidelines: depression 800 mg to 1,600 mg in two doses; arthritis: 600 mg to 1,200 mg daily in two or three doses; fibromyalgia: 400 mg twice a day for six weeks; liver disease: 600 to 1,200 mg daily in divided doses for six months. Do not exceed recommended doses.
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