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SAM-e and Anxiety in the Body

Henry Vyner, MD, Psychiatrist
SAM-e and Anxiety in the Body

S-Adenosyl methionine, or SAM-e, for short, is a molecule that is naturally produced by our bodies all of the time. It is produced by the pineal gland — which is located in the brain. It participates in millions of biochemical reactions in the body every day.

SAMe is also the focus of much interest in the worlds of both mainstream medicine and alternative medicine because early research is indicating that it might be an effective medication for a broad spectrum of illnesses; and that includes depression and anxiety. We’ll come back to that in a moment.

The Role of SAMe in the Body

SAMe participates in three different types of biochemical reactions in our bodies.

The reactions that are of interest to understanding and treating anxiety and depression are a group of reactions that are called “methylations.” A methylation is a reaction in which the SAMe molecule donates a methyl group (CH3) to another molecule. 

SAMe can and does donate a methyl group to  DNA, proteins, lipids, RNA and neurotransmitters. In other words, SAMe plays a role, a crucial role at that,  in the synthesis of serotonin, norepinephrine and dopamine. 

All of these neurotransmitters affect our moods — including anxiety and depression, and this is why science is now investigating whether or not SAMe’s can be used as a medication for depression and anxiety. 

SAMe seems, at least in theory, to be relevant to the treatment of depression and anxiety because SAMe determines the rate at which serotonin, norepinephrine and dopamine are synthesized. SAMe determines how much serotonin, norepinephrine and dopamine are present in the brain and central nervous system.

In other words, if more SAMe is present in your body, more of these neurotransmitters will be produced and present in your central nervous system. If, on the other hand, less than enough SAMe is present in your body, this will reduce the amount of neurotransmitters in your nervous system.

SAMe and Depression

There have been many scientific studies done of the efficacy of SAMe in the treatment of depression. 

In June of 2017, a group of psychiatrists from four Ivy League Medical Schools and other schools as well, evaluated 132 scientific studies that have been done to determine whether or not SAMe is effective in the treatment of several psychiatric disorders — including depression and anxiety.

They found, and I quote, that studies have shown that there is “promising but limited evidence of efficacy and safety to support the use of SAMe” in the treatment of depression. After their review of 132 studies, they concluded that “SAMe holds promise as a treatment for multiple neuropsychiatric conditions, but the body of evidence has limitations. The encouraging findings support further study of SAMe in both psychiatric and co-morbid medical illnesses.”

One specific study found that SAMe is equally as effective as imipramine in the treatment of depression, and that in addition, it has much less side effects than imipramine. Five percent of the patients treatead with SAMe had side effects, whereas twenty percent of the patients treated with imipramine had side effects.  

In other words, the science to date is beginning to shows that if used correctly, SAMe can be of help in the treatment of depression, but that further research is needed. The best thing to do, if possible, is to consult with your doctor about how to use SAMe and what doses to take.

SAME and Anxiety

Anxiety actually appears to cause anxiety because it is one of the side effects of the use of SAMe. It appears to have an activating effect in several respects. In the words of the authors of the review study that evaluated 132 research studies of SAMe:

“The most common side effect of SAMe is nausea and, less frequently, diarrhea, abdominal discomfort, or vomiting. Occasionally agitation, anxiety, or insomnia can occur in patients  sensitive to activating effects of SAMe. As with other antidepressants, SAMe can trigger hypomanic or manic symptoms in patients with bipolar disorder.”

Finally, they could not find any studies of the effects of SAMe on anxiety, and again this study was published in 2017. 

In addition, the Mayo Clinic lists anxiety as one of the side effects of SAMe.

In other words, we still do not know if SAMe can be used successfully to treat anxiety, and it a few studies indicate that it is actually a side effect of SAMe. However, future research may well find that it can help in the treatment of anxiety.

Article Resources
  1. Sharma, A. et al, S-Adenosylmethionine (SAMe) for Neuropsychiatric Disorders: A Clinician-Oriented Review of Research. J Clin Psychiatry. 2017 June ; 78(6): e656–e667. doi:10.4088/JCP.16r11113. 
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