SAMe reduces symptoms in depression, osteoarthritis, liver

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SAMe reduces symptoms in depression, osteoarthritis, liver

Postby malernee » Wed Dec 10, 2003 12:10 pm

Citation 22.
Link to... • • Accession Number
00021607-200307000-00022

Title
Review: SAMe reduces symptoms in depression, osteoarthritis, and liver disease.

Source
ACP Journal Club. v139(1):p.20, July/August, 2003.

Abstract
Question:

In patients with depression, osteoarthritis, or liver disease, is treatment with S-adenosyl-L-methionine (SAMe) effective?

Data sources:

Studies were identified by searching 25 biomedical databases for the year 2000, reviewing bibliographies of relevant articles, and contacting experts in the field.

Study selection:

Studies published in any language were selected if they were randomized controlled trials (RCTs) or controlled clinical trials that compared SAMe with placebo or other drugs for treatment of depression, osteoarthritis, or chronic liver disease; or presented any historical or descriptive background information about SAMe and its use.

Data extraction:

2 reviewers independently extracted data on study design, sample size, patient characteristics, intervention, study quality, and outcomes. Main outcomes included symptoms of depression measured by the Hamilton Depression Rating Scale (HDRS) or any other equivalent measure, pain (osteoarthritis), and pruritus and serum bilirubin levels (liver disease).

Main results:

47 studies (30 RCTs) of depression, 14 (11 RCTs) of osteoarthritis, and 41 (24 RCTs) of liver disease met the selection criteria. Meta-analyses were done using random-effects models. Depression: Reduction in HDRS scores was greater in the SAMe group than in the placebo group . SAMe did not differ from other antidepressant drugs for decrease in HDRS scores . Osteoarthritis: 1 large RCT showed a greater decrease in pain in the SAMe group than in the placebo group . SAMe did not differ from nonsteroidal anti-inflammatory drugs for pain reduction . Cholestasis of pregnancy: Decrease in pruritus and serum bilirubin levels was greater in the SAMe group than in the placebo group . Intrahepatic cholestasis for conditions associated with liver disease (other than pregnancy): Meta-analysis of 4 studies (n = 393) showed a lower rate of unresolved pruritus in the SAMe group than in the placebo group (relative risk 0.45, 95% CI 0.37 to 0.55). Reduction in serum bilirubin levels was greater in the SAMe group than in the placebo group .

Conclusion:

In patients with depression, osteoarthritis, or liver disease, S-adenosyl-L-methionine is effective for reducing symptoms, pain, and pruritus and bilirubin levels, respectively.
malernee
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