SAM-e can be used alone or in conjunction with other antidepressants. Since its side effects are less than those of many antidepressants, SAM-e is better tolerated by many people: It works more rapidly and does not cause weight gain, sexual dysfunction, sedation, or cognitive interference. Contraindicated when taking MAOI antidepressant medications. Contraindicated in cases of bipolar disorder unless under close medical supervision as it may promote the manic phase. Contraindicated in Parkinson’s disease as it may aggravate some symptoms. Possible side effects include gastrointestinal upsets: nausea, vomiting, diarrhoea, indigestion. Anxiety, headache, insomnia, and allergies may also be experienced.