Diet drug also fights depression

By Karen S. Peterson
USA Today

The dietary supplement SAMe is about as effective as older, conventional antidepressants in treating depression, a preliminary, government-financed study says. It also finds SAMe to be comparable to nonsteroidal anti-inflammatory medications in treating the pain of osteoarthritis. Such drugs include aspirin, ibuprofen and naproxen.

Both possible uses of SAMe will interest the medical community. Serious depression affects 10 million to 15 million in any given year. Osteoarthritis is the most common form of arthritis, affecting about 15 percent of Americans.

SAMe (pronounced Sammy) is shorthand for S-adenosyl-L-methionine. Unlike an herb such as St. John's wort, SAMe occurs naturally in the body. It is produced in labs for use as a supplement. Dietary supplements are not regulated by the government and cannot make health claims.

The major distributor of the product in the United States is Pharmavite, which markets SAMe through its Nature Made label in outlets including drug and discount stores. Price varies from 60 cents to $1 a tablet.

The government report on SAMe is a meta-analysis, or study of other studies. Many of the studies on depression were done with older generations of antidepressants rather than newer treatments such as Prozac and Paxil.

That does not invalidate the study's findings, says researcher and neuropharmacologist Teodoro Bottiglieri of Baylor University's Institute for Metabolic Diseases in Dallas. The older drugs are still the "gold standard" for comparing new treatments, he says.

Just what works to treat depression — with the fewest side effects and at the most reasonable cost — is increasingly debated among professionals. Standard treatments include antidepressants and some form of psychotherapy.

Bottiglieri says the depressed should not self-medicate. He calls SAMe a "starting point" for those with mild to moderate depression who are reluctant to get formal treatment. "It may pull them back from a severe crisis."

Paul Shekelle, a doctor and consultant to the Rand Corp., which did the study for the Department of Health and Human Services, cautions: "I would not recommend SAMe as a first-line therapy for depression for anybody. What we have here are a handful of trials with suggestive evidence of some benefit."

He is more enthusiastic about the findings on SAMe and osteoarthritis. "We have middling therapies" with drugs that can cause bleeding, particularly with seniors who may take them for long periods, he says. The supplement does not appear to cause "common, serious side effects."

Although psychiatrist and researcher Norman Rosenthal of Georgetown University has not studied the new report, he is skeptical about meta-analyses in general. "The term sounds very professional. But it really means that often you are mixing apples and oranges and coming up with fruit salad."

The full government report is due by the year's end.