SAM-e - Too Good To Be True? - Page 2

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Nov 30, 1999

Nevertheless, Dr David Burns, of cognitive therapy fame and author of "The Feeling Good Handbook", is skeptical: "If you give SAM-e to 100,000," he is quoted in USA Today, "about 50,000 will want to go on Oprah and talk about the new truth, and everybody will believe them."

The reason Americans have not heard about SAM-e before this year, according to the authors of "Stop Depression Now", has to do with the economics of bringing a new drug to market. The massive investment in meeting FDA criteria was hardly worth the effort for a natural substance that could not be patented. But a law passed in 1994 changed all that. Now, any product with a good safety record can hit the shelves, and this year, for the first time, SAM-e became available over the counter in the States, with a veritable host of companies getting into the act.

The authors are quick to note that SAM-e may not be for everyone, and that deeply depressed or suicidal people should only take the supplement under a doctor's supervision. But they do set out a program for self-treatment for the rest of the population, especially for those who are not inclined to seek help in the first place. Perhaps easy access to SAM-e is a boon to these people, particularly if their other option is to suffer in silence, but for the purposes of this article anyone who acts as his own doctor has a fool for a patient.

Following are some general guidelines:

Buy only from a reputable supplier. The over-the-counter market is virtually unregulated. According to an article in USA Today: "The market is getting cluttered with fraudulent product ... Some smaller players who want to make a buck are putting labels on bottles of baby powder."
Buy only entric coated tablets. This allows SAM-e to pass into the intestines, where it is best absorbed.
400 mgs daily (2 x 200 mgs) is the typical starting dose, which can be increased.
Use only under a doctor's supervision. A doctor may recommend SAM-e in conjunction with other antidepressants.
Do not stop taking after your depression has lifted. Like traditional antidepressants, SAM-e is a long-tern treatment, at least four months.
Ask you doctor about using if you are pregnant or breast feeding.
Do not take if you are bipolar.
Using alcohol is permissible.

And finally bear in mind how complex and subtle and downright mischievous depression actually is. Even if there is a magic bullet and even if that magic bullet is SAM-e, all your problems will hardly crumple overnight in the face of a pill-induced methylation onslaught. SAM-e is not retroactive. It will not replace your bad memories with good ones, nor will it take over the heavy lifting in changing sad thoughts to happy ones. But it may get you back on your feet again. It may, like more traditional antidepressants, bring you back from the living dead, and that certainly is a start.

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