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SAMe
Aka: SAMe, S-Adenosylmethionine
- Indications
- Osteoarthritis
- Physiology
- Endogenous compound synthesized in liver from methionine
- Increases chondrocytes and decreases their cytokine-induced damage
- Increases cartilage thickness
- Efficacy
- Symptom improvement does not occur for weeks after starting treatment
- Comparable to NSAIDs for Osteoarthritis pain
- Although Celebrex was more effective in the first month, no difference at 3 months
- References
- Muller-Fassbender (1987) Am J Med 83:81-3
- Najm (2004) BMC Musculoskelet Disord 5:6
- Adverse Effects
- May be better tolerated than NSAIDs
- Serotonergic effects
- Anxiety
- Headache
- Mania
- Risk of Serotonin Syndrome
- Dosing
- SAMe 200 mg orally three times daily
- Disadvantages
- Very expensive
- Short and unpredictable shelf life
- Butanedisulfonate salt formulation appears to be most stable of available preparations
- References
- Gregory (2008) Am Fam Physician 77:177-84