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S-adenosyl methionine (AdoMet, SAM, ademetionine)

Function: - S-adenosylmethionine provides a methyl group in synthesis of: a) phosphatidylcholine b) 5-methylcytosine Pharmacology: - SAMe Indications: (uses) 1) osteoarthritis* 2) rheumatoid arthritis 3) fibromyalgia 4) liver disease 5) migraines 6) depression [5,6] 7) insomnia * Preliminary suggest SAM-e may be as beneficial as NSAIDs for treatment of osteoarthritis [3] Contraindications: - not effective for bipolar disorder - not effective for hyperhomocysteinemia [4] Dosage: 1) 400 mg PO BID 2) 800 mg PO BID (depression) 3) parenteral form used for depression [2] 4) discontinue >= 14 days prior to surgery [4] Adverse effects: 1) generally well tolerated 2) primarily gastrointestinal distress - nausea, vomiting, diarrhea [5] 3) insomnia [4] 4) dizziness [4] 5) xerostomia [4] 6) headache [4] 7) anxiety restlessness [4,5] 8) potential to cause agitation, mania, or hypomania via alterations in neurotransmitter levels Drug interactions: - antidepressants - tricyclic antidepressants, SSRI [5] - St John's wort - antiplatelet agents including NSAIDs [4] - anticoagulants Mechanism of action: 1) increases plasma cortisol & ACTH 2) reduces plasma prolactin 3) increases catechol-O-methyltransferase (COMT) activity 4) inhibits MAO-B in the brain 5) enhances MAO activity in heart & brain 6) enhances proteoglycan production by chondrocytes 7) anti-inflammatory properties 8) analgesic properties 9) serotonin agonist

Interactions

molecular events

Related

carnitine biosynthesis catecholamine metabolism methionine adenosyltransferase, S-adenosylmethionine [SAM] synthetase or ADOMET synthetase methionine metabolism (trans-sulfuration pathway) S-adenosylmethionine (SAM) in serum/plasma S-adenosylmethionine in body fluid S-adenosylmethionine in CSF S-adenosylmethionine in urine S-adenosylmethionine/creatinine in urine

General

metabolic agent (metabolic modifier) purine nucleoside

Properties

Database Correlations

PUBCHEM correlations

References

  1. Stryer Biochemistry WH Freeman & Co, New York, 1988 pg 582
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
  3. Prescriber's Letter 10(5):27 2003
  4. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  5. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  6. Alpert JE, Papakostas G, Mischoulon D et al S-adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J Clin Psychopharmacol. 2004 Dec;24(6):661-4. PMID: 15538131

Substructures

adenosine (Adenocard, Adenoscan) methionine

Component-of

Flexium