Efficacy and acceptability of S-adenosyl-L-methionine (SAMe) for depressed patients: A systematic review and meta-analysis

Limveeraprajak N, Nakhawatchana S, Visukamol A, Siripakkaphant C, Suttajit S, Srisurapanont M · Progress in Neuro-Psychopharmacology and Biological Psychiatry

SAMe alone separated from placebo on depressive symptoms (SMD -0.58, 95% CI -0.93 to -0.23, I-squared 68%). Added to an antidepressant it did not separate from placebo plus the same antidepressant (SMD -0.22, 95% CI -0.63 to 0.19, I-squared 76%), and set against an antidepressant alone the difference was SMD 0.06 (95% CI -0.06 to 0.18, I-squared 49%). Dropout rates did not differ in any of the three comparisons. The authors rate the certainty moderate.

Population

Twenty-three randomised trials, 2,183 participants, in three groups: 11 trials of SAMe against placebo, 5 of SAMe added to antidepressants, and 7 of SAMe against antidepressants alone

Intervention

S-adenosyl-L-methionine, alone or added to an antidepressant

Comparator

Placebo or an antidepressant

Limitations

Depression, not a joint — carried here because it is the literature most people taking SAMe are actually relying on, and it is much stronger than the osteoarthritis literature. Heterogeneity is high in two of the three comparisons. Full text was not retrievable.