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SAM-e
The buzz is on about SAM-e, and it's not all hype. The remedy that has been prescribed in Europe for 20 years to treat mood disorders and a wide array of other ailments, from arthritis to liver disorders. Studies in Italy and the United States hold out hope that it really can ease depression. There's even reason to think the new kid on the block may be more effective than Saint-John's-wort, especially for severe depression, with fewer side effects.
In 1994 Giorgio M. Bressa, a psychiatrist at the Unversita Cattolica in Rome, looked at the five most carefully planned studies that pitted SAM-e against a placebo. Thirty-eight percent of patients felt completely well on the supplement, he found, compared to only 22 percent taking sugar pills.
However, the studies that Bressa analyzed were short, some no longer than six weeks, and all were small, averaging only 30 people. What's more, some of the glowing reports on SAM-e likely bear witness to the fact that even a dummy pill makes many people feel better. In one of the largest U.S. experiments using SAM-e, which involved 42 patients, the supplement performed no better than a dummy drug.
The bottom line:
Psychiatrist Maurizio Fava, director of the clinical depression and research program at Massachusetts General Hospital, is convinced SAM-e is safe and largely free of side effects. But until larger and longer studies are done, he says, it's impossible to know how well it works. "It's something to consider when standard antidepressants haven't helped," he says.
Fava suggests starting out with 1,200 mg a day and working up to 1,600 mg if necessary. Be forewarned: The pills aren't cheap. A month's supply costs $45 to $75 compared to as little as $10 for a prescription medication (covered by insurance) or $25 to $50 for Saint-John's-wort. SAM-e should never be used by manic-depressives, says Fava, because it can trigger mania.
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