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 .
A double-blind, randomized parallel-group, efficacy and safety study of intramuscular S-adenosyl-L-methionine 1,4-butanedisulphonate (SAMe) versus imipramine in patients with major depressive disorder.
S-adenosyl-L-methionine ( SAMe ) is a natural substance which constitutes the most important methyl donor in transmethylation reactions in the central nervous system . Several clinical trials have shown that SAMe possesses an antidepressant activity . This multicentre study was carried out to confirm both efficacy and safety of SAMe in the treatment of major depression .  SAMe was given intramuscularly ( i.m . ) at a dose of 400 mg/d , double-blind , vs. 150 mg/d oral Imipramine ( IMI ) in patients with a diagnosis of major depressive episode , with a baseline score on the 21-item Hamilton Depression Rating Scale ( HAMD ) of > or=18 . A total of 146 patients received SAMe whereas 147 received IMI  for a period of 4 wk . The two main efficacy measures were endpoint HAMD score and percentage of responders to Clinical Global Impression ( CGI ) at week 4 . Secondary efficacy measures were the final Montgomery-Asberg Depression Rating Scale ( MADRS ) scores and the response rate intended as a fall in HAMD scores of at least 50 % with respect to baseline . The analysis of safety and tolerability was conducted in all treated patients . SAMe and IMI did not differ significantly on any efficacy measure , either main or secondary . Adverse events were significantly less in patients treated with SAMe compared to those treated with IMI . These data show 400 mg/d i.m . SAMe to be comparable to 150 mg/d oral IMI in terms of antidepressive efficacy , but significantly better tolerated . These findings suggest interesting perspectives for the use of SAMe in depression
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 .