SAM-e MEDIA  

Below you will read the good and the ugly by our media reporting on SAM-e.  Be assured that all the ingredients in the CELLFOOD® products are from the finest quality sources and offer the highest efficacy, with no unnecessary fillers. This is why all the CELLFOOD® products offer such a high level of synergistic value and properties.

Antidepressant highly touted but untested

By Karen S. Peterson, USA TODAY

SAM-e is a funny name for a very serious product. Highly touted as a "natural" antidepressant, SAM-e (pronounced Sammy) is the nickname for S-adenosyl-methionine.  

A beacon for the depressed, SAM-e is coming to a nearby drug or discount store.

You can read all about it in the book Stop Depression Now (Putnam, $19.95), written by two credentialed researchers who tout it as "the breakthrough supplement that works as well as prescription drugs, in half the time with no side effects."

You can prescribe it for yourself and avoid what many folks call the stigma of getting professional help.

But if you are thinking about taking SAM-e to fight depression, you will want to know:

·         Many experts want large-scale, scientifically controlled studies in the USA to verify that SAM-e works as an antidepressant.

·         If you are self-treating quite serious depression with SAM-e - or the popular herb St. John's wort - you have a fool for a patient, as one expert puts it.

·         Some brands sold on the Internet or in smaller health-food stores contain more baby powder or similar substances than SAM-e.

Available in Europe mainly as a prescription drug, SAM-e was recently introduced as a dietary supplement in the USA . It is sold over the counter and is not regulated by the government. Product labels can make no overt health claims to treat anything.

Healthy reputation

SAM-e is not an herb like St. John's wort. The body already likes it: SAM-e is made naturally in the body and supports a variety of functions, from the upkeep of cell membranes to the production of brain chemicals that make us mellow.

Extensive research in Europe shows that it can be effective for a laundry list of complaints, such as liver and joint problems. In Italy , doctors commonly prescribe SAM-e as an antidepressant.

Such a positive pedigree brought SAM-e immediate attention when it went on sale for a hefty price here this spring. Costs mostly vary from $15 to $35 for 20 pills, but the price can go much higher, experts say.

An upbeat profile of SAM-e in Newsweek in May set off a flurry of requests for the product.

"Since the article hit, things have exploded," says Marshall Fong of Pharmavite, which sells the product under its Nature Made brand in drug and discount stores.

GNC markets its brand in its stores. Nature Made and GNC sell one of two forms of SAM-e that are sold in the USA .

GNC spokeswoman Roberta Gaffka says customer service representatives report a record number of inquiries about SAM-e. "It is one of the hottest products we've seen this year, and the calls continue to escalate. It is amazing."

Much of the media attention to SAM-e is the result of the boundless enthusiasm of Richard Brown, a lecturer, psychopharmacologist and psychiatrist at Columbia University in New York . Brown, co-author of Stop Depression Now, says he has treated several hundred patients in the past five years.

"It works so well and so fast, with minimal side effects," he says.

SAM-e can work in a matter of days; prescription antidepressants can take several weeks. The prescriptions can have side effects varying from dry mouth to sexual dysfunction; the biggest complaint about SAM-e is gastric distress, Brown says.

Brown is not paid to endorse SAM-e and says the major drug companies are not delighted with him.

"Most of what doctors do in the U.S. is determined by drug companies' advertising, and there is no big drug company behind this therapy," he says.

Brown's co-author is Teodoro Bottiglieri, director of neuropharmacology and senior research scientist at Baylor University 's Institute for Metabolic Diseases in Dallas .

He calls SAM-e a "starting point" for those who don't want to admit they are depressed or don't want to see a psychiatrist.

You can take SAM-e first, before getting professional help if needed, Bottiglieri says.

"SAM-e gets you over the initial hurdle, so you can get yourself motivated to do something else," he says.

The book presents SAM-e as part of a program that includes lifestyle changes and the elimination of negative thinking patterns that can contribute to depression.

Other experts say SAM-e is promising but lacks what it must have to be accepted by researchers in this country: a double-blind, placebo-controlled study, done in the USA, with results "published in English, so we can pick them apart," says Norman Rosenthal, a research psychiatrist at the National Institute for Mental Health (NIMH).

In a double-blind study, neither the patients nor the doctors know who gets the substance studied and who gets a placebo, or dummy pill.

Such a study is in progress for St. John's wort, comparing it with both an antidepressant and a placebo. Results won't be in for 18 months to two years, says Jonathan Davidson, a psychiatry professor at Duke University Medical Center in Durham , N.C. , and the principal investigator for the research sponsored by NIMH.

No such study is under way for SAM-e, although Marshall Fong of Pharmavite says he thinks one will be coming soon. "I get calls from researchers all the time, and I see a Harvard-type institution doing something very shortly."

Brian Doyle, a psychiatrist at Georgetown Medical School in Washington , D.C. , says U.S. doctors are just starting to learn about SAM-e and will require such research to work with it. "We feel much better when (such) studies have been done."

Whether you should choose SAM-e or St. John's wort to treat depression on your own depends, in part, on how depressed you are. And that can be difficult - and dangerous - for the confused layperson to figure out.

"Even physicians are not supposed to prescribe for themselves, and if they do, they have fools for patients," says Frederick Goodwin, former head of NIMH and now a psychiatrist at George Washington University in Washington , D.C. People tend not to be objective about analyzing their feelings and behaviors, he says.

He is impressed with SAM-e but says, "It is really important to separate what works from the concerns I have about self-medication."

Donald Brown, author of Herbal Prescriptions for Better Health (Prima, $16), specializes in alternative treatments. "I am extremely concerned if people think they have a problem and are not interacting with a qualified health care professional."

He says some people might think they are depressed when they actually are suffering from other conditions, such as anemia or a malfunctioning thyroid.

Unhealthy mix

Experts also caution against taking "natural" antidepressants along with prescription drugs without a doctor's guidance.

Fong says: "I don't want people self-medicating. That is not because I wouldn't do it; I am completely educated about what I put in my body. Most people don't have the access to the information I have, let alone the ability to interpret it."

Rosenthal says the difference between a very mild and a serious depression is the difference between "pneumonia and a cold. Pneumonia can kill you."

In his book, he writes, "It is clear that when we are dealing with depression, in all its forms, we are dealing with a continuum, with happy, normal mood at one end and serious depression at the other and all sorts of gradations in between."

Rosenthal identifies various levels of depression. Moderate to serious depression should be treated by a professional. But with milder forms, "it may be reasonable to try a home remedy before seeking medical help, at least for a limited period of time," he writes.

Bottiglieri cautions, "If someone is severely depressed, self-treatment is not an option."

Others voice different concerns. Psychiatrist David Burns worries that people taking SAM-e will succumb to the placebo effect no matter what research shows.

In drug trials, Burns says, 30% to 50% of those taking a placebo report themselves cured.

"If you give SAM-e to 100,000, about 50,000 will want to go on Oprah and talk about the new truth, and everybody will believe them," says Burns, author of The Feeling Good Handbook (Plume, $17.95).

A final reservation from experts: Because the federal government does not regulate dietary supplements, the ingredients in any given bottle, at what actual dosage, can be problematic. Fong says: "The market is getting cluttered with fraudulent product. ... Some smaller players who want to make a buck are putting labels on bottles of baby powder."

Don't expect SAM-e, or any pill, to pierce the darkness of depression for everyone. Says Bottiglieri: "There is no magic pill that is going to help everybody. There is no pill you can take and in three weeks all your problems will go away.  

Is SAMe for Real?

Online advice from TIME health columnist Christine Gorman

Although I take 250 mg of vitamin c each day, I'm pretty much a skeptic when it comes to dietary supplements. Most of the ones I've seen are basically patent medicines whose proponents, seizing on a few isolated facts about the body, tout a treatment plan that has more to do with magic than medicine. But occasionally a supplement like same (pronounced sam-me) comes along that piques even my interest. It's supposed to combat depression, ease aching joints and possibly revitalize the liver. I'm not convinced these claims are true, but I think they're worth a closer look.

First, a note of caution. If you're suicidal or severely depressed, get professional help. Don't try treating yourself with sam-e or any other compound on your own.

If supplements were movies, same would be the sleeper hit of the summer. Introduced in the U.S. in March, it is now the fourth most popular individual supplement in drugstore chains and general retail outlets. General Nutrition Centers reports that sam-e is surpassing even St. John's wort. in sales. Two breathless guidebooks have already been published, and three more are coming in the fall.

Biochemists have known about same for years, although they usually call it sam-e, which is short for S-adenosylmethionine, a compound made by every cell in the body. (I don't know why it was renamed. Maybe the dietary-supplements folks think Sammy sounds sexier than Sam.) Turns out that sam or same plays a pivotal role in hundreds of biochemical reactions in the body. It's a methyl donor, meaning that it can attach a molecule made of one carbon atom and three hydrogen atoms to various proteins, lipids and even snippets of dna. Such methylation reactions are important in the production of many critical substances, including neurotransmitters in the brain and enzymes that help repair joints and the liver.

Much of the evidence for same's effectiveness comes from Europe . Researchers in Italy documented its apparent anti-depressant qualities in several small studies in the 1970s. (A couple of more recent U.S. studies found similar results.) Doctors in Germany think it may re- verse some of the damage caused by osteoarthritis, the wear-and-tear form of arthritis.

The results, though not definitive, are intriguing enough so that several U.S. psychiatrists have started offering same, both in addition to more conventional treatments and by itself. Rheumatologists have been more wary. "It does seem to offer pain relief," says Dr. William Arnold, who is chief medical editor of a book on alternative medicines that the Arthritis Foundation is publishing in October. "But the arthritis experiments were very uncontrolled." He's more impressed by another natural compound, glucosamine, which is the subject of a study being funded by the National Institutes of Health.

Even if sam-e is not the wonder cure its proponents claim, it so far appears to be safe. Some minor side effects, such as hot, itchy ears, have been reported. As with any antidepressant, a few people who take it develop mania, an uncontrolled frenzy of emotion and activity. Who knows what else may turn up if millions of people start using it? Maybe that's one reason same is still a prescription drug in Europe . So, if you do decide to try it, it's not a bad idea to let your doctor know so that he or she can watch for anything unusual.  

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Last Modified 05/21/2005