Pregnancy Use

SAMe has been used intravenously in the last trimester of pregnancy with no adverse effects to mother or fetus. However, safety has not yet been conclusively established for either injectable or oral dose forms and possible effects on prolactin levels need to be considered.

PRACTICE POINTS/PATIENT COUNSELLING

• SAMe is involved in myriad biochemical reactions within the body and found within every cell.

• Clinically, it has anti-inflammatory, analgesic, antidepressant and hepatoprotective activity.

• A 2002 meta-analysis concluded that SAMe is as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects associated with NSAIDs. A recent study has found it is as effective as celecoxib for providing symptom relief; however, SAMe has a slower onset of action.

• Clinical trials have also shown it to be a safe and effective treatment for depression, comparable to tricyclic antidepressant drugs, yet with a faster onset of action.

• SAMe also appears to be useful in fibromyalgia, and possibly migraine headache. Its usefulness in alcoholic liver disease is unclear. Other uses include general fatigue, elevated homocysteine levels, allergies and poor digestion.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this supplement do for me?

SAMe has anti-inflammatory, analgesic, antidepressant and protective effects on the liver. It effectively reduces pain and inflammation in OA and elevates mood in depression. In fibromyalgia, SAMe reduces pain, fatigue and morning stiffness and may also reduce pain in migraine headache. When will it start to work?

Beneficial effects are usually seen within 4-5 weeks for OA, whereas antidepressant effects are experienced within 1 week. Benefits in fibromyalgia can take up to 6 weeks to establish.

Are there any safety issues?

SAMe should be used with caution by people with bipolar disorder, schizophrenia or schizoaffective disorder, Parkinson's disease or taking antidepressant medicines. Monitoring of homocysteine levels may be required with long term supplementation.

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