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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 ?
With the emergence of porting the group-term product, departing workers have been able to carry the same benefits and provisions as they had at work.
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Thecost to companies of complying with the OPS data standards is expected to be minimal, according to both Craig and Sames.
Sames added that Wolters Kluwer Financial Services' Wiz Sentinel anti-predatory lending software will also begin testing mortgages against the FRB's new higher-priced mortgage threshold when the Regulation Z revisions go into effect on Oct.
Lord George Carey said Christians should not assume there was necessarily anything ``sinister'' about same sex relationships.
Richard Marbrow, Kevin Firth and Juli Sames are visiting the war-torn district of Eastern Serbia which bore the brunt of a NATO bombing campaign two years ago.
Birmingham Organic Gardeners, Tree Walk around Woodbrooke and Fircroft Gardens, with Mr Tony Sames, Fircroft College, 1018 Bristol Road, Selly Oak, 7.
The center's work with Martin Guitar is a good example of the importance of a technology center such as this, said Keith Sames, PP&L program director and liaison between the center and PP&L customers.
Gary Kasper offers the experience and perspective that is often difficult to find in the mortgage origination space," said Kurt Sames, vice president and general manager, Consumer Compliance, Wolters Kluwer Financial Services.
Lori Traweek, senior vice president of operations and chief operating officer for the AGA whose members now serve nearly 170 million users of natural gas, and the operating section committee members of her staff, led by vice president of operations Christina Sames and conference organizer Kimberly Denbow, hosted a record turnout (in a non-exhibition year) of 850 attendees.
Cristina Sames, vice president, operations and engineering management, American Gas Association, had argued while there are benefits to using warning tape, there could be a potentially adverse impact on safety if there is confusion regarding which pipeline will or will not use warning tape.
A prototype multi-component electronically driven spray gun has been developed by Binks Sames Corp.