Williams Anna-leila, Girard Christine, Jui Danny, Sabina Alyse, Katz David L
Yale Prevention Research Center, Derby, CT 06418, USA.
Clin Invest Med. 2005 Jun;28(3):132-9.
To assess the evidence evaluating S-adenosylmethionine (SAMe) supplementation as treatment for depression.
Searches of Medline, Psychinfo, AMED, and Cochrane Controlled Trials Register were conducted from database inception through September 2001. Randomized controlled trials, controlled clinical trials, intervention studies, case-control studies, reviews, and case reports examining the evidence behind S-adenosylmethionine (SAMe) supplementation in depression among humans were selected. No limits were placed on study populations for demographics or co-morbidities. Only English language papers were abstracted and assessed for trial quality. Two abstractors independently evaluated each study, and then reconciled findings. As data were available, between group treatment effect size was noted or, as needed, calculated.
Eleven articles met initial inclusion criteria; five intervention trials, two RCTs, two reviews, one controlled clinical trial, and one meta-analysis. Using the one common outcome measure among all the intervention studies and RCTs, the Hamilton Rating Scale for Depression, direct comparison of effect sizes was made. A favourable and significant between group effect was seen.
All of the studies reviewed were short term, making translation to the clinical setting difficult. However, there appears to be a role for SAMe in the treatment of major depression in adults. Questions remain about mechanism of action, bioavailability, and absorption of oral SAMe. Further study of SAMe as independent and adjuvant therapy for major depression in adults is indicated.
评估关于补充S-腺苷甲硫氨酸（SAMe）治疗抑郁症的证据。
检索了从数据库建立至2001年9月的Medline、Psychinfo、AMED和Cochrane对照试验注册库。选择了随机对照试验、对照临床试验、干预研究、病例对照研究、综述以及病例报告，这些研究探讨了人类补充S-腺苷甲硫氨酸（SAMe）治疗抑郁症背后的证据。对研究人群的人口统计学特征或合并症未设限制。仅提取英文论文并评估试验质量。两名摘要提取人员独立评估每项研究，然后协调结果。如有可用数据，记录或根据需要计算组间治疗效应大小。
11篇文章符合初步纳入标准；5项干预试验、2项随机对照试验、2篇综述、1项对照临床试验和1项荟萃分析。使用所有干预研究和随机对照试验中一个共同的结局指标，即汉密尔顿抑郁评定量表，对效应大小进行直接比较。观察到组间有显著的有利效应。
所有纳入综述的研究均为短期研究，难以转化应用于临床。然而，SAMe在成人重度抑郁症治疗中似乎有一定作用。关于口服SAMe的作用机制、生物利用度和吸收仍存在疑问。有必要进一步研究SAMe作为成人重度抑郁症的独立治疗和辅助治疗方法。
