mental health

Italian Remedies for Depression: Pizza, Shoes and S-adenosyl-L-methionine (SAMe)

Italians know how to do things right: art, pizza, shoes…


When it comes to natural remedies for depression, you’ve likely heard of St. John’s Wort. It’s a superstar herb when it comes to treating mood disorders. For years, it stood alone as a natural remedy for treating depression. Yet, if it didn’t work, or you experienced side effects in its use, you were left wanting… waiting.

The wait is over. SAMe has arrived.

S-adenosyl-methionine, or SAMe (pronounced sam-EE) was discovered in 1952 by Italian scientist, Giulio Cantoni. SAMe is a naturally occurring substance in our body and helps metabolize brain hormones like dopamine, serotonin and norepinephrine. People with depression can have impaired synthesis and low levels of SAMe. European practitioners have used SAMe in treating depression for decades.

Does it work?

For some. Studies are small, but evidence is promising. In studies, SAMe was as effective as the prescription-strength antidepressant medications it was been pitted against. When combined with other anti-depressants, it augmented their effect. Early evidence suggests it may also help treat sexual side effects often seen in patients on antidepressants such as SSRIs (selective serotonin reuptake inhibitors).

The benefits of SAMe over St. John’s Wort and prescription anti-depressants is that it works quickly — within a couple of weeks. (Anti-depressants often take a month or longer to work). Increased arousal or anxiety can be noted in the beginning, as well as stomach upset, decreased appetite, dry mouth and headache. These lessen over time. Typically, sexual side effects and weight gain that are bothersome to so many patients on other anti-depressants are not experienced.

Who can take it?

If you suffer from depression and prefer a more natural remedy, SAMe may be an option for you. It can also be utilized if you want to limit or reduce the amount of your prescription antidepressants, for instance, if you’re experiencing side effects.

How do I take it?

Talk to your doctor, naturopath or pharmacist first.

  • Start at 200mg twice daily, with the second dose several hours before bedtime, so as not to interfere with sleep.
  • Increase slowly, waiting at least a week between dose increases, and if you notice side effects, wait until they settle first.
  • Do not exceed the maximum dose of 800mg twice daily
  • Store as directed, and ensure you’re getting enough B12 and folic acid in your diet.

Who needs to use caution?

If you suffer from bipolar disorder, SAMe may not be the right fit for you as it can predispose toward mania. SAMe should not be used in children, pregnancy or breastfeeding, unless recommended specifically by a physician. Similarly, if you suffer other health conditions or take other medications, talk to your doctor about interactions.

Finally, if you’re feeling depressed, please seek support from your friends, family and physician. We’re here to help, and though it can be a big step — you just need to ask.

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