31 Jan 2018 --- A recent review of S-Adenosyl-methionine (SAMe) has provided a broad perspective on the role, efficacy and safety of SAMe in the treatment of depression, neuropsychiatric disorders and co-morbid medical conditions. The authors conclude that SAMe supplementation holds promise for several neuropsychiatric conditions, which is significant because evidence supporting the safety and efficacy of SAMe in both psychiatric and medical illnesses could impact clinical decision making.
The study reviewed 115 clinical and 17 preclinical studies to provide evidence that oral doses of SAMe between 200mg and 3200mg have similar efficacy to Tricyclic Antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) and are superior to placebo in ameliorating depressive symptoms and Depression and Quality of Life rating scales.
SAMe may also be effective in combination with other antidepressants, both TCAs (Tricyclic antidepressants) and SSRIs (Selective Serotonin Reuptake Inhibitors), in case of inadequate response to drug therapy and patients with depression associated to other medical conditions, i.e., HIV, Parkinson’s disease, osteoarthritis and fibromyalgia. In these two latter diseases, SAMe exerts anti-inflammatory and analgesic activity by enhancing proteoglycan bioactivity, according to the review.
This supplement can also be used in addition to standard antipsychotic drugs to improve the quality of life and reduce aggressive behavior in a subset of schizophrenic patients with low-active Catechol-O-Methyltransferase (COMT) activity.
The highlights reported on SAMe may represent a promising alternative to the treatment of depression, neuropsychiatric disorders, and co-morbid medical conditions. In fact, the risks of SAMe compare quite favorably with prescription antidepressants, particularly in that it does not cause sexual dysfunction or weight gain (two of the most common causes for antidepressant discontinuation) and it is less likely to be life-threatening in patients who are at risk for overdosing during suicide attempts.
One company highly active in the production of SAMe is Gnosis, which has commercialized the compound under the brand name of Adonat. The Italian-based biotechnology company manufactures both pharmaceutical and nutraceutical grades of SAMe.
Silvia Pisoni, Marketing Manager of Gnosis comments: “The exploration of the full range of potential benefits of SAMe through controlled clinical studies needs to go ahead considering the broad range of reactions where this human biochemical methyl donor is involved – including multiple crucial biochemical pathways, such as the biosynthesis of hormones and neurotransmitters – and the new aspects that are recently emerging.”
“SAMe is the most active methyl donor produced in the human body and it is essential to sustain the normal function of the one-carbon metabolism pathway. It has role in the methylation of DNA and may take part in the control of stress stimuli and in the mechanisms of aging physiology and physiopathology, providing a natural help to sustain biological functions, integrate possible nutritional deficiencies caused by the modern way of life, ensure an healthy aging, support the body and mental wellness,” she continues.
“In the last decades, different studies have pointed out that methylation in the testes is an important step for testosterone production. A randomized placebo-controlled clinical trial SAMe supplementation was associated with a significant improvement of libido, sexual arousal and erectile dysfunction in drug non-responsive depressed males independently of amelioration of depressive symptoms,” she tells NutritionInsight, speaking on future avenues for research, adding that the endocrine effects of SAMe supplementation should be investigated in women.”
“The most interesting area of research and development is the identification of active metabolites contained in nutrients that are responsible for the interaction with organs, systems and vital functions and that can modify and impact the health status of people at all the stages of life. These naturally occurring components are known to affect and modulate a wide range of enzymatic routes, contributing significantly to health when they are consumed throughout life as part of the daily diet,” Pisoni notes.
“This is in line with the same approach used to identify the active isomer of S-adenosylmethionine in the past and more recently in the active isomer of reduced folate and vitamin K2. All these products have become milestones in their respective area of applications and tools that every good formulator should look at in preparing highly effective finished products,” she says.
According to Pisoni, Gnosis is actively looking for a new production plant to extend its capabilities in fermentation-derived products and for scaling up the current pipeline.
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