PMID- 20595412
OWN - NLM
STAT- MEDLINE
DCOM- 20100824
LR  - 20221207
IS  - 1535-7228 (Electronic)
IS  - 0002-953X (Linking)
VI  - 167
IP  - 8
DP  - 2010 Aug
TI  - S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for 
      antidepressant nonresponders with major depressive disorder: a double-blind, 
      randomized clinical trial.
PG  - 942-8
LID - 10.1176/appi.ajp.2009.09081198 [doi]
AB  - OBJECTIVE: Despite the progressive increase in the number of antidepressants, 
      many patients with major depressive disorder continue to be symptomatic. Clearly, 
      there is an urgent need to develop better tolerated and more effective treatments 
      for this disorder. The use of S-adenosyl methionine (SAMe), a naturally occurring 
      molecule that serves as a methyl donor in human cellular metabolism, as 
      adjunctive treatment for antidepressant nonresponders with major depressive 
      disorder represents one such effort toward novel pharmacotherapy development. 
      METHOD: Participants were 73 serotonin reuptake inhibitor (SRI) nonresponders 
      with major depressive disorder enrolled in a 6-week, double-blind, randomized 
      trial of adjunctive oral SAMe (target dose: 800 mg/twice daily). Patients 
      continued to receive their SRI treatment at a stable dose throughout the 6-week 
      trial. The primary outcome measure for the study was the response rates according 
      to the 17-item Hamilton Depression Rating Scale (HAM-D). RESULTS: The HAM-D 
      response and remission rates were higher for patients treated with adjunctive 
      SAMe (36.1% and 25.8%, respectively) than adjunctive placebo (17.6% versus 11.7%, 
      respectively). The number needed to treat for response and remission was 
      approximately one in six and one in seven, respectively. There was no 
      statistically significant difference in the proportion of SAMe- versus 
      placebo-treated patients who discontinued the trial for any reason (20.6% versus 
      29.5%, respectively), due to adverse events (5.1% versus 8.8%, respectively), or 
      due to inefficacy (5.1% versus 11.7%, respectively). CONCLUSIONS: These 
      preliminary results suggest that SAMe can be an effective, well-tolerated, and 
      safe adjunctive treatment strategy for SRI nonresponders with major depressive 
      disorder and warrant replication.
FAU - Papakostas, George I
AU  - Papakostas GI
AD  - Center for Treatment-Resistant Depression, Depression Clinical and Research 
      Program, Massachusetts General Hospital, Harvard Medical School, 15 Parkman St., 
      Boston, MA 02114, USA. gpapakostas@partners.org
FAU - Mischoulon, David
AU  - Mischoulon D
FAU - Shyu, Irene
AU  - Shyu I
FAU - Alpert, Jonathan E
AU  - Alpert JE
FAU - Fava, Maurizio
AU  - Fava M
LA  - eng
SI  - ClinicalTrials.gov/NCT00093847
GR  - 5-K23 MH-069629/MH/NIMH NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20100701
PL  - United States
TA  - Am J Psychiatry
JT  - The American journal of psychiatry
JID - 0370512
RN  - 0 (Antidepressive Agents)
RN  - 0 (Placebos)
RN  - 0 (Serotonin Uptake Inhibitors)
RN  - 0 (adenosyl-methionine 1,4-butanedisulfonate)
RN  - 7LP2MPO46S (S-Adenosylmethionine)
SB  - IM
CIN - Am J Psychiatry. 2010 Aug;167(8):889-91. PMID: 20693465
CIN - Am J Psychiatry. 2010 Dec;167(12):1533; author reply 1533. PMID: 21131413
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antidepressive Agents/*therapeutic use
MH  - Depressive Disorder
MH  - Depressive Disorder, Major/diagnosis/*drug therapy/psychology
MH  - Double-Blind Method
MH  - Drug Resistance
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Dropouts
MH  - Placebos
MH  - Psychiatric Status Rating Scales/statistics & numerical data
MH  - S-Adenosylmethionine/*analogs & derivatives/therapeutic use
MH  - Selective Serotonin Reuptake Inhibitors/*therapeutic use
MH  - Treatment Outcome
EDAT- 2010/07/03 06:00
MHDA- 2010/08/25 06:00
CRDT- 2010/07/03 06:00
PHST- 2010/07/03 06:00 [entrez]
PHST- 2010/07/03 06:00 [pubmed]
PHST- 2010/08/25 06:00 [medline]
AID - appi.ajp.2009.09081198 [pii]
AID - 10.1176/appi.ajp.2009.09081198 [doi]
PST - ppublish
SO  - Am J Psychiatry. 2010 Aug;167(8):942-8. doi: 10.1176/appi.ajp.2009.09081198. Epub 
      2010 Jul 1.