with S-Adenosylmethionine (SAMe)|
Intraperitoneal administration of SAM-e (2.5 mmol/kg) within 1 to 5 hours of
reduced the lethality of toxic doses of acetaminophen (APAP) (2 to 3 mmol/kg) in
mice; lower doses of SAM-e (0.5 mmol/kg) did not reduce mouse mortality (Bray et
al. 1992). SAM-e reduced the hepatotoxic effects of APAP by metabolizing the
active moiety to glutathione. SAM-e may be a useful antidote, along with
N-acetylcysteine, for the treatment of APAP poisoning.
In a double-blind, placebo-controlled trial, 40 patients with moderate to
severe depression received imipramine (titrated from 50 mg/day to 150 mg/day)
with either SAM-e (200 mg/day IM) or placebo; improvements on the Hamilton
Rating Score for Depression (HRSD) occurred as early as day 4 for patients
treated with both SAM-e and imipramine (Berlanga et al. 1992). However, there is
a case report of serotonin syndrome associated with the combination of tricyclic
antidepressants and SAM-e (Iruela et al. 1993). Specifically, a 71-year-old
female became increasingly anxious, agitated, and confused within 48 to 72 hours
after ingesting a higher dose of clomipramine (75 mg/day) while she was taking
SAM-e (100 mg/day IM). Patients should be cautioned about this possible
Berlanga C, Ortega-Soto HA, Ontiveros M, Senties H. Efficacy of
S-adeno-L-methionine in speeding the onset of action of imipramine.
Psychiatry Res. 1992;44(3):257-262.
Bray GP, Tredger JM, Williams R. S-adenosylmethionine protects against
acetaminophen hepatotoxicity in two mouse models. Hepatotol.
Iruela LM, Minguez L, Merino J, Monedero G. Toxic interaction of
S-adenosylmethionine and clomipramine. Am J Psychiatry.
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