S‐Adenosyl Methionine in the Therapy of Depression and Other Psychiatric Disorders

Abstract

Preclinical Research S-adenosyl methionine (SAM) is a major methyl donor and as such exerts its influence on CNS function through methylation reactions, such as methylation of several catecholamine moiety-containing neurotransmitters, epigenetic changes through methylation of DNA, RNA, RNA-binding proteins and histones, and phospholipid methylation. Based on available evidence, SAM is currently recommended as a next-step (second-line) treatment option following inadequate treatment response to a first-line antidepressant. It shows significant promise in the treatment of pediatric and perinatal depression, as well as Alzheimer's disease, but to make this a recommendation further clinical trials are needed. SAM is safe to use in most patients, but is contraindicated in those with bipolar disorder. Concerns considering the possible increase of homocysteine levels (and cardiovascular complications) due to long-term SAM therapy need to be further addressed in clinical trials taking into account individual`s ability to metabolize homocysteine and his/her folate status. Drug Dev Res 77 : 336-346, 2016. © 2016 Wiley Periodicals, Inc.

Alexithymia, Suicide Ideation and Homocysteine Levels in Drug Naïve Patients with Major Depression: A Study in the “Real World” Clinical Practice

“…Therefore, we recommend to screen depressed patients for both alexithymia and suicide ideation (as all authors do in their everyday clinical practice), regardless of depression severity, and to evaluate also homocysteine in order to have a further indirect potential biomarker for suicide risk. One can argue that treating hyperhomocysteinemia would reduce suicide risk; however, to date, no studies are present confirming this hypothesis even if oxidative stress may play a role in depression severity thus increasing suicide risk 17,18)…”

Folato E Seu Papel Na Depressão

“…A disponibilidade de folato também interfere diretamente na expressão correta de S-adenosil metionina (SAM), que regula de forma epigenética a correta expressão da Catecol-O-Metiltransferase (COMT). A COMT atua no metabolismo nas catecolaminas relacioadas aos transtornos depressivos (KUZELICKI, 2016).…”

The Way to a Human’s Brain Goes Through Their Stomach: Dietary Factors in Major Depressive Disorder

“…Accordingly, SAH is inhibitor of methyltransferases (Berger and Sassone-Corsi, 2016). Notably, there is accumulating evidence that SAM may have antidepressant effects (De Berardis et al, 2016;Karas Kuželièki, 2016). Rats fed with a diet rich in methyl-donors show improved depressive-like behaviors (McCoy et al, 2016) Folate deficiency is associated with increased levels of DNA methyltransferases and histone methyltransferases (Ghoshal et al, 2006).…”