Wednesday, May 18, 2005

Give Yourself a Boost

Major depression remains difficult to treat. Despite the wide array of antidepressant medications available today, finding the right medication is very much a hit-or-miss proposition. For a variety of reasons, some people never achieve total symptom relief with single-drug treatment and end up taking two or more drugs for long periods of time. Enter the dietary supplement SAMe (S-adenosyl-L-methionine, or "Sammy," for short). Researchers at Massachusetts General Hospital in Boston recently reported that the effectiveness of antidepressive medications are often enhanced with the addition of SAMe. In a recent uncontrolled study of 30 people who struggled with depressive symptoms even while on antidepressants, half reported significant symptom improvement when they were given SAMe with their regular medication. Of these, 43% reported no depressive symptoms at all after six weeks of taking SAMe along with their prescribed antidepressant. Jonathan E. Alpert, MD, PhD, lead researcher of the study, says that symptom improvement was determined by looking at composite scores of three measures: The Hamilton Depression Rating Scale... the Montgomery Asberg Depression Rating Scale... and Clinical Global Impressions. Although no qualitative symptom-by-symptom analysis was performed, Dr. Alpert's own clinical impression was that the greatest improvements were in patient motivation, interest and energy level. The 30 patients in the trial were knowingly given 800 mg to 1,600 mg of SAMe daily along with their current antidepressant medication. Study participants were taking either venlafaxine (Effexor) or one of the class of drugs known as selective serotonin reuptake inhibitors (SSRIs), including Prozac, Zoloft and Lexapro. SAMe is not an herb or a hormone. It is a molecule that the human body manufactures from methionine, an amino acid found in protein-rich foods. How does SAMe improve mood? It is not known for sure, but researchers believe that SAMe enhances the action of various "mood-boosters" in the brain, such as serotonin and dopamine. Future research is required to learn more about the specific how's and why's of SAMe's impact. Dr. Alpert is currently conducting two more trials involving SAMe. One is a placebo-controlled study with 80 participants. Subjects will not know if they are receiving SAMe or a placebo with their antidepressant. The larger number of participants and the creation of a control group will allow a better examination of symptom-by-symptom results with both the antidepressant and the antidepressant-plus-SAMe groups, he said. The second trial will examine SAMe as a single-agent treatment compared directly with an SSRI antidepressant and with a placebo. This trial elevates SAMe from adjunct status to a possible equal alternative to antidepressants. Both ongoing SAMe studies are sponsored by the National Institutes of Health. Can you try using SAMe today? There appear to be no risks associated with using SAMe in conjunction with antidepressants. People who take blood thinners should not take SAMe. Talk to your doctor about whether or not it might be helpful for you... and take it only under his/her supervision. SAMe has been reported effective with restoring arthritic joints and with chronic liver disease as well. However, the FDA has not extensively evaluated SAMe or, of course, approved it.


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