To help ensure safe treatment with SAM-e, safety warnings and precautions for the supplement should be discussed with your healthcare provider beforehand. Before taking it, talk to your healthcare provider if you have Parkinson's disease, bipolar disorder, or any allergies. You should also tell him or her about any other medications you are taking, as many drugs can interact with SAM-e.
S-adenosyl-L-methionine (SAM-e) is a dietary supplement often used to treat depression, although it can be used for other uses as well. In order to safely use SAM-e, you should talk with your healthcare provider prior to taking it if you have:
- Bipolar disorder, also known as manic depression
- Parkinson's disease
- Any allergies, including to medications, foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Precautions and warnings to be aware of concerning the safety of SAM-e include the following:
- Supplements are not regulated as closely as drugs. In the United States, supplements such as SAM-e can be sold without ever having been shown to be safe or effective.
- Just like prescription antidepressants, SAM-e can cause mania in people with bipolar disorder. If you have this condition, do not take SAM-e without your healthcare provider's approval and supervision.
- Theoretically, SAM-e could make Parkinson's disease symptoms worse. However, this has not been demonstrated in humans. If you have Parkinson's disease, check with your healthcare provider before taking this supplement.
- SAM-e supplements may interact with medications (see SAM-e Drug Interactions).
- It is not known whether SAM-e is safe for pregnant or breastfeeding women (see SAM-e and Pregnancy and SAM-e and Breastfeeding).
- If you decide to use supplements, be aware that what you see on the label may not reflect what is in the bottle. For example, some dietary supplements have been found to be contaminated with heavy metals or prescription drugs, and some have been found to have much more or much less of the featured ingredient than their label states.
Therefore, make sure the manufacturer of your SAM-e product is trusted and reputable. It is a good sign if a manufacturer abides by the rules of Good Manufacturing Practices (GMP) for drugs. It is also a good sign if a product has the United States Pharmacopoeia (USP) seal, which means that it has been independently tested and shown to contain the correct ingredients in the amounts listed on the label. Your pharmacist is a good resource for information about which manufacturers are most reputable.