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(sam-ee) ,


(trade name),


(trade name), (trade name)


Therapeutic: antidepressants
Pregnancy Category: UK
Treatment of depressionHas also been used to manage:
  • osteoarthritis
  • fibromyalgia
  • liver disease
  • migraine headaches


May aid in the production, activation, and metabolism of various amines, phospholipids, hormones, and neurotransmitters. May stimulate articular cartilage growth and repair.

Therapeutic effects

Decreased depression.
Anti-inflammatory and analgesic effects improve symptoms of osteoarthritis.


Absorption: Rapidly and extensively metabolized following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Actively metabolized by the liver.
Half-life: 100 min.

Time/action profile (antidepressant action)

PO (depression)1–2 wkunknownunknown
PO (osteoarthritis)30 daysunknownunknown


Contraindicated in: Hypersensitivity; Bipolar disorder.
Use Cautiously in: Pregnancy, lactation, or children (safety not established); Bipolar disorder (can induce mania); Parkinson's disease (may worsen symptoms); Surgery (discontinue 2 weeks prior to elective procedures).

Adverse Reactions/Side Effects

Central nervous system

  • agitation
  • dizziness
  • mild insomnia
  • manic reactions (in patients with bipolar disorder)


  • vomiting
  • diarrhea
  • flatulence


Avoid use with antidepressants, meperidine, pentazocine, tramadol, and dextromethorphan (additive serotinergic effects may occur).May ↓ effectiveness of levodopa and worsen Parkinsonian symptoms.Should not be used concurrently with MAO inhibitors. Avoid use of SAMe within 2 wk of using a MAO inhibitor.Avoid use with natural products that increase serotonin levels such as l-tryptophan and St. John's wort.
Oral (Adults) Depression—200 mg once or twice daily, adjusted upward over 2 wk (range 400–1600 mg/day); Liver disorders—1200–1600 mg/day; Osteoarthritis—200 mg tid; Fibromyalgia—800 mg/day.


Tablets: 100 mg, 200 mg, 400 mgOTC

Nursing implications

Nursing assessment

  • Assess mental status for symptoms of depression prior to and periodically during therapy; advise patients with depression to be evaluated by a health care professional.
  • Assess symptoms of pain and fatigue prior to and periodically during therapy.

Potential Nursing Diagnoses

Ineffective coping (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Oral: Administer on an empty stomach. Initial dose should be 200 mg once or twice daily to minimize GI disturbances. Dose may be adjusted upward over 1–2 wks depending on response and tolerance.

Patient/Family Teaching

  • Instruct patient to take SAMe as directed.
  • Advise patients to discontinue 2 weeks prior to elective surgical procedures.
  • Advise women to consult health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

  • Decrease in symptoms of depression.
  • Improvement in osteoarthritis symptoms.
References in periodicals archive ?
Reservations manager Djamel Guermit commented: "This is initiative by Sameness Project is really wonderful and amazing, it gives you the opportunity to go out there and get to know these men that works hard to build this city and keeping it beautiful.
We want to show them that they are not invisible, that we are also workers in Dubai and that we can share a moment of sameness.
Dina Sami, a UAE-based art-director whose collaborative work with another labourer made it to the final, described her experience by saying "We were two different human beings from different parts of this green earth yet sharing sameness to the world".
Some apes plus baboons have also passed tests as difficult as this one, with just two symbols for determining sameness or difference, Wasserman says.
Even a scene that should be horrifyingly gruesome--the death of a newborn twin, whose crime is sameness, by lethal injection--fails to stir emotions from its viewer.
The sameness of the documents that are being distributed to us stems from the fact that eight years of rule of this coalition has no difference in determining the strategic goals and priorities.
Dubai-born Lina Nahhas, who has founded the group Sameness Project, told XPRESS: "It is quite common to see people living in the same building or on the same street but not knowing each other.
What shapes our imaginations of sameness and difference?
I'd like us to strengthen nursing by strengthening ourselves, creating space for all nurses to come together with our diverse traditions and values, to be united based on solidarity, not sameness.
As he also pointed out, a world of absolute difference between two things seems as impossible as one where absolute sameness exists.
I'm spiritual enough to know the sameness is not our friend, variety and diversity are.
National identity is very much centered around difference rather than sameness and kiwiana is very much about celebrating difference.