S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine.
BACKGROUND
The purpose of this open trial was to evaluate the safety, tolerability, and efficacy of oral S-adenosyl-L-methionine as an antidepressant adjunct among partial and nonresponders to serotonin reuptake inhibitors or venlafaxine.


METHODS
Thirty antidepressant-treated adult outpatients with persisting major depressive disorder received 800 to 1600 mg of S-adenosyl-L-methionine tosylate over a 6-week trial.


RESULTS
Intent-to-treat analyses based on the Hamilton Depression Rating Scale revealed a response rate of 50% and a remission rate of 43% following augmentation with S-adenosyl-L-methionine. Gastrointestinal symptoms and headaches were the most common side effects.


CONCLUSIONS
Augmentation of selective serotonin reuptake inhibitors or venlafaxine with S-adenosyl-L-methionine warrants a placebo-controlled trial in resistant depression.
Alpert
Jonathan E
JE
Depression Clinical and Research Program, Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA. jalpert@partners.org
Papakostas
George
G
Mischoulon
David
D
Worthington
John J
JJ
Petersen
Timothy
T
Mahal
Yasmin
Y
Burns
Alana
A
Bottiglieri
Teodoro
T
Nierenberg
Andrew A
AA
Fava
Maurizio
M
D000328:Adult; D003511:Cyclohexanols / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012436:S-Adenosylmethionine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D000069470:Venlafaxine Hydrochloride
D003511:Cyclohexanols; D012436:S-Adenosylmethionine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride; C468227:adenosyl-methionine 1,4-butanedisulfonate