SAM-e Depression Treatment Alternative

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Julie Dodson, MA, LCSW
Updated September 26, 2024by BetterHelp Editorial Team

SAM-e (S-adenosyl L-methionine) is a compound that can be naturally produced in the human body. It is often sold over the counter as a supplement in the United States. In other countries, it may be used as a prescription medication for treating depression and other ailments. 

Research on using SAM-e as a depression treatment is inconclusive. Some studies report that SAM-e is effective, but the studies don’t often contain a representative sample of participants, so more research may be necessary. Please speak with a medical professional before taking any supplement or medication, as they may cause side effects or interact with existing treatments, vitamins, or supplements you take. 

Online therapy may alleviate depression symptoms

What does the research say about SAM-e depression treatment? 

In the United States, forms of treatment not officially classified as medicine or controlled by the Food and Drug Administration (FDA) often meet skepticism. Some natural remedies receive little attention in clinical trials, so determining their degree of effectiveness can be challenging. However, there are a few studies on S-adenosyl methionine (SAM-e).

SAM-e as an alternative to antidepressant medication

While it has not gained much notoriety in the US, the compound is a prescription medication in Europe and has been the subject of several studies. In these studies, researchers have introduced SAM-e orally, intravenously, and intramuscularly, and the doses have ranged from 300 to 3200 milligrams daily. While some variation exists, most experiments support SAM-e as a treatment for mood challenges and depression. Often, these results are based on comparing its effects to a placebo.

One clinical trial compared the effects of SAM-e to those of SSRI medications commonly used in treating depression. The supplement may be more effective than SSRIs in some cases, but the results are unclear. One exception is that SAM-e does not seem to result in specific side effects, such as weight changes or sexual dysfunction, like some medications may. 

Conflicting SAM-e depression treatment research

In a 2016 study on SAM-e for depression in adults, researchers reviewed eight trials comparing SAM-e with placebos or SSRIs. The review involved 934 adults of any gender from inpatient and outpatient settings. According to the researchers, SAM-e had no more significant impact than placebo or SSRIs, except for one or two studies with positive outcomes. Still, the study acceptability was low. 

Note that some of these studies may have shortcomings. For example, many SAM-e clinical trials utilize a small pool of participants. When conducting an experimental study, it can be crucial to analyze a representative sample. 

Potential side effects of SAM-e

Some online sources may claim that SAM-e is harmless, as it can be bought over the counter. Some regard SAM-e as a safe supplement that can be taken alongside other medications. Other sources disagree and insist on using one form of treatment at a time. Potential interactions include antidepressants, antipsychotics, amphetamines, dextromethorphan, levodopa, narcotics, and St. John’s wort. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Balancing serotonin and exploring a natural alternative to antidepressant medication

The danger of simultaneously administering several antidepressant drugs may be related to serotonin levels. A shortage of serotonin is thought to be the cause of depression in some people. To counter this, medications may stimulate serotonin production and release to alleviate depression symptoms. Taking more than the prescribed dosage can be harmful if it amplifies side effects or withdrawal symptoms. When using SAM-e depression treatment alongside prescription antidepressants, serotonin levels may be elevated to harmful amounts.

Seek the guidance of a medical professional before starting or stopping any medication or supplement. 

SAM-e affordability

Effectiveness and safety may not be the only considerations for depression treatment. Often, affordability can be a benefit of SAM-e. With quality insurance coverage, obtaining prescription antidepressants can be affordable. After accounting for insurance coverage, prescription medication may be less expensive than SAM-e.

However, if someone has a poor healthcare plan or does not have one at all, SAM-e depression treatment could be more affordable than prescription medication. Without financial assistance, the cost of traditional treatment with SSRIs can be a barrier. A bottle of SAM-e capsules can often be easy to find at the grocery store and may cost less than prescription medication. However, talk to your doctor before buying SAM-e. 

Online therapy may alleviate depression symptoms

Therapy and alternative support options 

Prescription medications and supplements like SAM-e may not be the only way to overcome depression. Therapy has been used for many years to treat this mental health condition successfully, and working with a licensed mental health professional can provide you with the tools to improve your mental health long-term. 

Comparing medication and online therapy for depression

If you’re currently experiencing depression, you may find it challenging to find a nearby therapist, make an appointment, leave the house, drive to the therapist’s office, sit in the waiting room, and attend a session in person. You may find that trying online therapy through a platform like BetterHelp can eliminate potential barriers to treatment, as you may attend sessions from home or any location with an internet connection.

As one study explains, online therapy can be an effective alternative to traditional in-person therapy. The study’s participants experienced an improvement in their depression symptoms that was sustained long-term and associated with a more significant quality of life. 

Takeaway

S-adenosyl L-methionine, commonly called SAM-e, is often sold as an over-the-counter supplement in the US. However, in some other countries, it is used as a prescription treatment for depression. 

Although there are many studies about SAM-e, they are contradictory, and some do not have large study samples. Therefore, although it can be said that SAM-e may show promise as a treatment for depression, more research may be needed. Consult a doctor before taking any type of supplement or medication. You can also reach out to a therapist to learn more about counseling for depression.

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