Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


Objective: The objective of the selective EBM review is to determine whether or not “Is Sadenosylmethionine (SAMe) an Effective Drug to Help Treat Patients with Depression?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2016-2020.

Data Sources: All three RCTs were discovered using PubMed. The articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question.

Outcome Measured: A reduction in depressive symptoms was the outcome measured in all three studies using the Montgomery-Asbery Depression Rating Scale (MADRS). The mean change in baseline was calculated once intervention was received.

Results: In the RCT led by Sarris J, Murphy J, Stough C, et al., monotherapy with SAMe in combination with co-factor vitamin B12 and folininc acid led to a reduction in depressive symptoms compared with the control group (P = 0.13), indicated by a mean change from baseline of -11.4. In the RCT led by Sarris J, Bryne GJ, Bousman C, et al., adjunctive therapy with SAMe, in combination with co-factor B12 and folinic acid, led to a reduction in depressive symptoms, indicated by a mean change from baseline of -11.4 (P = 0.51). Lastly, Sarris J, Byrne GJ, Stough C, et al. illustrated a reduction in depressive symptoms using a nutraceutical combination with SAMe, indicated by a mean change from baseline of -9.95 with a statistical significance of P = 0.33 in the SAMe treatment group.

Conclusion: All three studies in this review demonstrated that SAMe did not lead to a significant reduction in depressive symptoms as measured by the MADRS. In fact, two of the three studies showed a greater reduction in depressive symptoms with the placebo than withintervention with SAMe. This suggests that SAMe is not an effective or beneficial treatment for patients with depression. Due to high placebo response rates, future studies should include a placebo run-in period.