SAMe for Depression

SAMe (pronounced 'sammy') is a relatively new supplement being used for depression. It is a naturally occuring coenzyme that is mostly produced and utilized mostly in the liver. There is not enough evidence yet to say whether SAMe outperforms placebo in treating depression because the studies that have been done have not had large enough numbers of participants.

There is some evidence that a Vitamin B12 deficiency would lead to a deficiency in SAMe and that people who have not had sufficient amounts of B12 would respond well to SAMe. B12 has been shown to have active antidepressant properties.

Research

Hardy, M. et al. (2002). S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease. U.S. Department of Health and Human Services; Rockville, MD.

Meta-analysis of SAMe vs. placebo showed that no trial has yet reached statistical significance. Each of the studies is limited by the small number of subjects included. The studies ranged in size from about six patients in the SAMe and placebo groups respectively, to nine patients in each group. The risk ranged from about 25 percent to 75 percent across the two outcomes and across studies in the SAMe group. If we assume that the risk ratio is 0.4, which is about the average risk ratio observed, then the risk in the placebo group ranges from 10 percent to 30 percent. The power to detect differences in risk between the two groups for this range (25 percent versus 10 percent; 50 percent versus 20 percent; and 75 percent versus 30 percent) is extremely low for comparison groups of sizes six and nine. In fact, the power does not exceed 30 percent in any case. Even if the risk ratio is as low as the minimum observed (0.12) and assuming the sample sizes in that study (seven and five in each group respectively), the power is only 34 percent. Therefore, these studies are so limited in statistical power that no definitive conclusion can be drawn.

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copyright © 2007 Tim Desmond, MA. Last updated 31Jul2008.
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