title: A comprehensive review on the efficacy of S-Adenosyl-L-methionine in Major Depressive Disorder.
abstract: OBJECTIVE
  To review the antidepressant efficacy of S-Adenosyl-L-Methionine (SAMe) both in monotherapy and/or in augmentation with antidepressants to better understand its potential role in the treatment of patients with Major Depressive Disorder (MDD) and Treatment-Resistant Depression (TRD).
  
  
  METHODS
  A MEDLINE/PubMed search was carried out by using the following set of keywords: ((SAMe OR SAdenosyl- L-Methionine) AND (major depressive disorder OR depression)). Data Selection and Data Extraction: No language or time restrictions were placed on the electronic searches. Randomized controlled trials and open trials involving humans were here included and analyzed. The references of published articles identified in the initial search process were also examined for any additional studies appropriate for the review.
  
  
  RESULTS
  SAMe is an important physiologic compound, playing a central role as precursor molecule in several biochemical reactions. Numerous studies have shown that SAMe may affect the regulation of various critical components of monoaminergic neurotransmission involved in the pathophysiology of MDD. Some findings have suggested its antidepressant efficacy in treating MDD. Several randomized controlled trials have supported that the antidepressant efficacy of SAMe in monotherapy is superior to placebo and tricyclic antidepressants. Recent findings have also demonstrated its efficacy in patients nonresponsive to selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.
  
  
  CONCLUSIONS
  Overall, SAMe is a well-tolerated medication, which may offer considerable advantages as an alternative to antidepressant drugs or as an add-on therapy in the treatment of MDD and TRD. More large-scale controlled trials are needed to gain a better understanding of the relative efficacy of this drug.
authors: National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, p.zza Italia 1, 64100 Teramo, Italy. dodebera@aliceposta.it.
authors: Domenico
authors: D
authors: De Berardis
authors: Laura
authors: L
authors: Orsolini
authors: Nicola
authors: N
authors: Serroni
authors: Gabriella
authors: G
authors: Girinelli
authors: Felice
authors: F
authors: Iasevoli
authors: Carmine
authors: C
authors: Tomasetti
authors: Andrea
authors: A
authors: de Bartolomeis
authors: Monica
authors: M
authors: Mazza
authors: Alessandro
authors: A
authors: Valchera
authors: Michele
authors: M
authors: Fornaro
authors: Giampaolo
authors: G
authors: Perna
authors: Monica
authors: M
authors: Piersanti
authors: Marco
authors: M
authors: Di Nicola
authors: Marilde
authors: M
authors: Cavuto
authors: Giovanni
authors: G
authors: Martinotti
authors: Massimo
authors: M
authors: Di Giannantonio
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012436:S-Adenosylmethionine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D012436:S-Adenosylmethionine; D017367:Selective Serotonin Reuptake Inhibitors; C468227:adenosyl-methionine 1,4-butanedisulfonate