Ademetionine is a form of the amino acid methionine. It also is called S-adenosylmethionine, or SAMe.
Typically, a human body makes all the ademetionine it needs for good health. However, low levels of methionine, folate, or vitamin B12 can cause a drop in ademetionine levels. Since this chemical doesn’t exist in foods, a synthetic version is sometimes used to normalize levels in the body.
Ademetionine is sold as a dietary supplement in the United States. In Europe, it is used as a prescription drug.
SAMe plays a role in the immune system, maintains cell membranes, and helps produce and break down brain chemicals, such as serotonin, melatonin, and dopamine.
Additional but inconclusive research suggests that it also may be useful for treating symptoms of:
- cirrhosis of the liver
- chronic viral hepatitis
- jaundice in pregnancy
- Gilbert’s syndrome
- nerve problems related to AIDS
- cholestasis (blocked bile flow from the liver to the gall bladder)
Ademetionine is safe for most adults. However, it can sometimes cause the following side effects:
- dry mouth
- mild insomnia
- skin rashes
- serotonin syndrome
Patients with depression may feel anxiety. An upset stomach can also occur when patients begin taking this supplement. Starting with smaller doses and working up to a full dose can help the body adjust.
Patients who are allergic to ademetionine may have symptoms of an anaphylactic reaction. These include:
- flushing or reddening of the skin
Ademetionine is made in oral and intravenous forms. Based on evidence from some clinical trials, the following oral dosages have been effective for some adults with the following conditions (Mayo Clinic, 2012):
- osteoarthritis: 600 to 1,200 milligrams in one to three divided doses daily
- cholestasis: up to 1,600 milligrams daily
- depression: 800 to 1,600 milligrams daily
- fibromyalgia: 400 milligrams taken twice daily
- liver disease: 600 to 1,200 milligrams daily
A full dose of ademetionine is usually 400 milligrams, taken three or four times daily. This can be lowered to 200 milligrams twice a day if symptoms begin to improve (New York Langone Medical Center, 2013).
Ademetionine is not considered safe for children.
Ademetionine is effective in relieving the pain of osteoarthritis.
The benefits of ademetionine for the treatment of other conditions are uncertain. Some evidence suggests that it may help treat:
- attention deficit hyperactivity disorder (ADHD) in adults
- cholestasis in both pregnant and non-pregnant patients
- liver disease
There is not enough evidence to determine whether ademetionine is helpful for the many conditions it is used to treat. It also is used for:
- premenstrual syndrome (PMS)
- heart disease
- migraine headaches
- spinal cord injuries
- multiple sclerosis
Consult with a health care provider before taking any medications, including herbs and supplements.
Ademetionine is considered safe for most adults. However, it can worsen symptoms in patients with certain disorders, such as bipolar disorder or Parkinson’s disease. Pregnant or breastfeeding women should not take ademetionine.
Since it affects the central nervous system, ademetionine may interfere with surgery. Its use should be discontinued at least two weeks prior to surgery.
Ademetionine interacts with serotonin, a chemical in your brain. When combined with medications that also affect serotonin, ademetionine can increase the risk of serotonin syndrome. This is a potentially serious condition caused by too much serotonin. Side effects can include heart problems, shivering, and anxiety.
Ademetionine should not be taken with the following medications:
- dextromethorphan (an active ingredient in many over-the-counter cough medicines)
- antidepressant drugs
- fluoxetine (for example, Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
- amitriptyline (for example, Elavil)
- clomipramine (for example, Anafranil)
oxidase inhibitors (MAOIs) for depression
- phenelzine (for example, Nardil)
- tranylcypromine (for example, Parnate)
- meperidine (Demerol)
- pentazocine (Talwin)
- tramadol (for example, Ultram)
Ademetionine should not be taken with herbs and supplements that increase serotonin levels. These include:
- Hawaiian baby woodrose
- St. John’s wort
Ademetionine should not be taken with diabetes medications because it may increase the effects of these drugs. This can increase the risk of low blood sugar, or hypoglycemia.
An upset stomach and digestive side effects can occur if a patient begins with the fully recommended dose. Starting with smaller doses until these effects subside can help the body adjust.
Ademetionine is useful in relieving the pain of osteoarthritis. It seems to be as effective as non-steroidal anti-inflammatory drugs (NSAIDs) in treating this condition (Mayo Clinic, 2012).
There is not enough evidence on the use of ademetionine for depression, fibromyalgia, and liver cholestasis. More information is needed to recommend its use for treatment of these conditions (Mayo Clinic, 2012).