S-adenosyl-L-methionine in the treatment of major depression complicating chronic alcoholism

S-adenosyl-L-methionine (SAMe) is a methyl donor endowed with both antidepressant and detoxifying activity. In a 4-week trial, 40 alcoholic patients with major depression received 200 mg of SAMe daily administered intravenously and 400 mg BID administered orally. After a 1-week placebo period during which placebo responders were eliminated, patients were evaluated with the Hamilton Rating Scale for Depression, the Zung Self-Rating Scale for depression, the Hamilton Rating Scale for Anxiety, and the Lorish and Maisiak face scale at baseline and at days 7, 14, 21, and 28. Standard laboratory values were measured at baseline and at the completion of the trial. Significant improvements were seen in most psychometric scores beginning on day 14 and continuing through the end of the study. Baseline values for gamma-glutamyltranspeptidase, alkaline phosphatase, bilirubin, and mean corpuscular volume dropped dramatically and, in some cases, returned to normal. No adverse reactions were reported. Although standard antidepressant therapy has very often been unsuccessful in treating depression in these patients, SAMe proved to be well tolerated at the study dosage and was effective in reducing depression.