S-adenosyl methionine (AdoMet, SAM, ademetionine)
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Function
- S-adenosylmethionine provides a methyl group in synthesis of:
Pharmacology
- SAMe
Indications
(uses)
- osteoarthritis*
- rheumatoid arthritis
- fibromyalgia
- liver disease
- migraines
- depression[5][6] (widely use in Europe)
- insomnia
* Preliminary suggest SAM-e may be as beneficial as NSAIDs for treatment of osteoarthritis[3]
Contraindications
- not effective for bipolar disorder
- not effective for hyperhomocysteinemia[4]
Dosage
- 400 mg PO BID
- 800 mg PO BID (depression)
- parenteral form used for depression[2]
- discontinue >= 14 days prior to surgery[4]
Adverse effects
- generally well tolerated
- primarily gastrointestinal distress
- insomnia[4]
- dizziness[4]
- xerostomia[4]
- headache[4]
- anxiety restlessness[4][5]
- potential to cause agitation, mania, or hypomania via alterations in neurotransmitter levels
Drug interactions
Mechanism of action
- increases plasma cortisol & ACTH
- reduces plasma prolactin
- increases catechol-O-methyltransferase (COMT) activity
- inhibits MAO-B in the brain
- enhances MAO activity in heart & brain
- enhances proteoglycan production by chondrocytes
- anti-inflammatory properties
- analgesic properties
- serotonin agonist
More general terms
Additional terms
- carnitine biosynthesis
- catecholamine metabolism
- methionine adenosyltransferase, S-adenosylmethionine [SAM] synthetase or ADOMET synthetase
- methionine metabolism (trans-sulfuration pathway)
Component of
References
- ↑ Stryer Biochemistry WH Freeman & Co, New York, 1988 pg 582
- ↑ 2.0 2.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
- ↑ 3.0 3.1 Prescriber's Letter 10(5):27 2003
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 5.0 5.1 5.2 5.3 5.4 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - ↑ 6.0 6.1 Alpert JE, Papakostas G, Mischoulon D et al S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J Clin Psychopharmacol. 2004 Dec;24(6):661-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15538131
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=34755
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5136
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=34756
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=1079
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=446104