Report on SAM-e Effects and Usage


Natural health supplements sometimes have unexpected side effects or interactions with medication that can lead to adverse reactions that are sometimes life threatening. The following is a list of cautions that you should be aware of before using SAM-e. These are referred to as drug/herb interactions.

Warning 1 – Antidepressants: SAM-e increases a brain chemical called serotonin. When combined with antidepressants that also increase serotonin may lead to serotonin syndrome. Experts recommend avoiding concurrent use. Medications for depression that may cause this effect when used with SAM-e include amitriptyline (Elavil), clomipramine (Anafranil), fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.

Warning 2 – Parkinson’s disease: Those who use levodopa for Parkinson’s disease should know that SAM-e can chemically change levodopa in the body and decrease the effectiveness of levodopa. Taking SAM-e together with levodopa might make Parkinson’s disease symptoms worse. Experts recommend avoiding concurrent use.

Warning 3 – Bipolar disorder: The use of SAM-e can cause patients with bipolar disorder to convert from depression to mania.

Warning 4 – Surgery: SAM-e may affect the central nervous system, which could interfere with surgery. Experts recommend discontinuing SAM-e at least 2 weeks before a scheduled surgery.

Caution: SAM-e can affect a brain chemical called serotonin. When using drugs that also affect the level of serotonin too much may be produced in the brain, which might cause serious side effects. These drugs include but are not limited to dextromethorphan (Robitussin DM, others), meperidine (Demerol), Pentazocine (Talwin), and Tramadol (Ultram).

SAM-e is a substance naturally found in all body tissues. The body uses it in chemical reactions for making complex substances such as proteins, hormones, neurotransmitters and enzymes. However, the levels decline as you age. Low levels of SAM-e may cause many of the essential chemical processes in the body to slow down, which leads to a variety of health problems such as depression and osteoarthritis.

Used as a dietary supplement: SAM-e is used internally for the following benefits and conditions:

  • Alzheimer’s disease
  • Anti-aging
  • Anxiety
  • Attention deficit-hyperactivity disorder (ADHD) in adults
  • Bipolar disorder
  • Bursitis and tendonitis
  • Chronic fatigue syndrome (CFS)
  • Dementia
  • Depression (see warning number 1 above)
  • Enhance mental performance
  • Fibromyalgia
  • Heart disease
  • Improving intellectual performance
  • Infertility
  • Lead poisoning
  • Liver disease (Cirrhosis and Cholestasis)
  • Lower back pain
  • Migraine headache
  • Multiple sclerosis (MS)
  • Osteoarthritis (See other herbs for inflammation)
  • Parkinson’s disease
  • Premenstrual dysphoric disorder (PMDD)
  • Premenstrual syndrome (PMS)
  • Seizures
  • Slowing the aging process
  • Spinal cord injury
  • Tendonitis

Side Effects of SAM-e

SAM-e is probably safe for most people. However a small percentage of people experience the following side effects:

  1. anorexia
  2. constipation
  3. diarrhea
  4. dizziness
  5. dry mouth
  6. gas
  7. headache
  8. mild insomnia
  9. nervousness
  10. sweating
  11. vomiting

These side effects are more likely to occur when using high doses. SAM-e may also make some people with depression feel anxious. Other side effects may also occur when using SAM-e. (See form below)

As with any herb, a serious allergic reaction is possible. Seek immediate medical attention if you notice any symptoms of a serious allergic reaction. These may include a rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.

Return to the Herb List.

For questions and answers about the side effects of herbs see the Herb Forum

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