SAMe was not different from placebo and established antidepressants .
The exception was that compared to imipramine , fewer participants experienced troublesome adverse effects when treated with parenteral SAMe .
BACKGROUND Depression is a recurrent illness with high rates of chronicity , treatment-resistance and significant economic impact .
There is evidence in the literature that S-adenosyl methionine ( SAMe ) , a naturally occurring compound in the human body , has antidepressant efficacy .
This product may be an important addition to the armamentarium of antidepressant agents .
OBJECTIVES To assess the effects of SAMe in comparison with placebo or antidepressants for the treatment of depression in adults .
S-adenosyl methionine (SAMe) versus escitalopram and placebo in major depression RCT: efficacy and effects of histamine and carnitine as moderators of response.
OBJECTIVE To assess the antidepressant efficacy of S-adenosyl methionine ( SAMe ) , a naturally occurring methyl donor , versus the selective serotonin reuptake inhibitor ( SSRI ) escitalopram and a placebo control ; and to determine whether serum histamine or carnitine levels modified treatment response . METHODS We examined a sub sample ( n=144 ) from one site of a two-site study of adults with diagnosed Major Depressive Disorder ( MDD ) , recruited from 4/13/05 to 12/22/09 , who consented to the additional blood draw for serum histamine and carnitine levels . After washout , eligible subjects were r and omized to SAMe ( 1600 - 3200mg/daily ) , escitalopram ( 10 - 20mg/daily ) , or matching placebo for 12 weeks of double-blind treatment ( titration at week 6 in non-response ) . RESULTS On the primary outcome of the Hamilton Depression Rating Scale ( HAMD-17 ) , a significant difference in improvement was observed between groups from baseline to week 12 ( p=0.039 ) . The effect size from baseline to endpoint was moderate to large for SAMe versus placebo ( d=0.74 ) . SAMe was superior to placebo from week 1 , and to escitalopram during weeks 2 , 4 , and 6 . No significant effect was found between escitalopram and placebo or SAMe  . Response rates ( HAMD-17≥50 % reduction ) at endpoint were 45 % , 31 % , and 26 % for SAMe , escitalopram , and placebo , respectively ; while remission rates ( HAM-D≤7 ) were 34 % for SAMe ( p=0.003 ) , 23 % for escitalopram ( p=0.023 ) , and 6 % for placebo . No correlation between baseline histamine level and reduction of HAMD-17 score was found for either the SAMe or escitalopram  groups . Baseline carnitine levels were also not found to moderate response to either treatment . LIMITATIONS While SAMe appears to be an effective antidepressant agent , the overall findings from the parent study ( which showed no significant difference between groups due to site differences ) must be taken into consideration . CONCLUSIONS These preliminary results provide encouraging evidence for the use of SAMe in the treatment of MDD . Histamine and carnitine serum level may not necessarily moderate response to SAMe
SAMe was not different from placebo and established antidepressants .
The exception was that compared to imipramine , fewer participants experienced troublesome adverse effects when treated with parenteral SAMe .
BACKGROUND Depression is a recurrent illness with high rates of chronicity , treatment-resistance and significant economic impact .
There is evidence in the literature that S-adenosyl methionine ( SAMe ) , a naturally occurring compound in the human body , has antidepressant efficacy .
This product may be an important addition to the armamentarium of antidepressant agents .
OBJECTIVES To assess the effects of SAMe in comparison with placebo or antidepressants for the treatment of depression in adults .