When standard medication fails to improve depression symptoms, adding the dietary supplement SAMe may help, preliminary research suggests.

The study involved 30 patients with persistent depression despite treatment with selective serotonin reuptake inhibitors (SSRIs) such as Prozac,Paxil and Zoloft, or with the drug Effexor, another type of antidepressant.

The researchers found that when they added the dietary supplement SAMe to the patients’ treatment for six weeks, half saw their symptoms improve and 43 percent had a complete remission.

The findings are published in the December issue of the Journal of Clinical Psychopharmacology.

SAMe, short for S-adenosyl-L-methionine, is a substance produced naturally in the body that is involved in a number of biochemical processes including the synthesis of brain chemicals called neurotransmitters that relay messages between nerve cells. Serotonin, the prime target of antidepressant drugs, is one such neurotransmitter.

While the new findings suggest that SAMe may enhance a person’s response to antidepressant therapy, the study was an “open trial” - meaning all patients received SAMe and there was no group that received an inactive placebo for comparison purposes.

A larger, placebo-controlled trial of combination SAMe and antidepressant therapy has just been launched, the study’s lead author, Dr. Jonathan E. Alpert, told AMN Health.

“We were encouraged enough by these findings to go ahead” with the larger study, he said.

Still, with SAMe being readily available over-the-counter, Alpert - who is at the Massachusetts General Hospital in Boston - cautioned that people on antidepressants should not design their own treatment regimens around the supplement.

“An important message is that they (patients) need to be evaluated,” he said.

When people don’t respond to an antidepressant, Alpert explained, it’s possible that they need a higher dose, don’t truly have depression, or have a condition such as bipolar disorder, only one aspect of which is depression.

He also noted that there is limited information on the side effects of SAMe, and people should add the supplement to their therapy only under medical supervision.

In this study, some of the most common side effects attributed to SAMe were constipation - which affected half the patients - stomach upset, diarrhea and headache.

Northridge, California-based supplement maker Pharmavite supplied the SAMe product and funded the research.

In addition to the larger study of adding SAMe to antidepressant treatment, Alpert and his colleagues are conducting a second trial looking at the effects of taking the supplement alone.

SOURCE: Journal of Clinical Psychopharmacology, December 2004.