II. Indications
III. Physiology
- Endogenous compound synthesized in liver from Methionine
- Increases chondrocytes and decreases their Cytokine-induced damage
- Increases cartilage thickness
IV. Efficacy
- Symptom improvement does not occur for weeks after starting treatment
- Comparable to NSAIDs for Osteoarthritis pain
- Although Celebrex was more effective in the first month, no difference at 3 months
- References
V. Adverse Effects
- May be better tolerated than NSAIDs
- Serotonergic effects
- Anxiety
- Headache
- Mania
- Risk of Serotonin Syndrome
VI. Dosing
- SAMe 200 mg orally three times daily
VII. Disadvantages
- Very expensive
- Short and unpredictable shelf life
- Butanedisulfonate salt formulation appears to be most stable of available preparations