Cochrane · systematic review · CD011286
S‐adenosyl methionine (SAMe) for depression in adults
Galizia, I, Oldani, L, Macritchie, K, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
16
No studies
4
Included studies
NR
No studies 4 · 20%Ungraded 0 · 0%Very low 4 · 20%Low 12 · 60%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
S‐adenosyl methionine as monotherapy compared to placebo as monotherapy for depression in adults
Population: adults with depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy. Change in scores from baseline to end of treatment on the depression rating scale A larger negative SMD indicates greater improvement in the SAMe group S‐adenosyl methionine as monotherapy vs placebo | no estimate extracted | 2 studies · 142 participants | Very low Downgraded: imprecision, inconsistency |
Acceptability Participants dropping out of treatment during the study period for any reason S‐adenosyl methionine as monotherapy vs placebo | RR 0.88 [0.61, 1.29] | 2 studies · 142 participants | Low Downgraded: imprecision |
Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as monotherapy vs placebo | RR 1.77 [0.51, 6.13] | 2 studies · 142 participants | Low Downgraded: imprecision, inconsistency |
Proportions of participants achieving remission Depression rating scale score within the normal range at the end of the study A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as monotherapy vs placebo | RR 1.69 [0.85, 3.36] | 1 study · 124 participants | Low Downgraded: imprecision |
Acceptability. Participants experiencing troublesome adverse effects of any nature S‐adenosyl methionine as monotherapy vs placebo | no estimate extracted | NR | No studies |
S‐adenosyl methionine as monotherapy compared to tricyclic antidepressant agent as monotherapy for depression in adults
Population: adults with depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy. Change in scores from baseline to end of treatment on the depression rating scale A larger negative SMD indicates greater improvement in the SAMe group S‐adenosyl methionine as monotherapy vs tricyclic antidepressant agent | no estimate extracted | 4 studies · 619 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Acceptability Participants dropping out of treatment during the study period for any reason S‐adenosyl methionine as monotherapy vs tricyclic antidepressant agent | RR 0.61 [0.28, 1.31] | 3 studies · 78 participants | Very low Downgraded: risk of bias, imprecision |
Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as monotherapy vs tricyclic antidepressant agent | RR 1.14 [0.83, 1.56] | 4 studies · 622 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportions of participants achieving remission Depression rating scale score within the normal range at the end of the study S‐adenosyl methionine as monotherapy vs tricyclic antidepressant agent | no estimate extracted | NR | No studies |
Acceptability. Participants experiencing troublesome adverse effects of any nature S‐adenosyl methionine as monotherapy vs tricyclic antidepressant agent | RR 0.68 [0.52, 0.88] | 3 studies · 604 participants | Low Downgraded: risk of bias, imprecision |
S‐adenosyl methionine as monotherapy compared to SSRI antidepressant agent as monotherapy for depression in adults
Population: adults with depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy. Change in scores from baseline to end of treatment on the depression rating scale A larger negative MD indicates greater improvement in the SAMe group S‐adenosyl methionine as monotherapy vs SSRI antidepressant agent | no estimate extracted | 1 study · 129 participants | Low Downgraded: imprecision |
Acceptability Participants dropping out of treatment during the study period for any reason S‐adenosyl methionine as monotherapy vs SSRI antidepressant agent | RR 0.81 [0.57, 1.16] | 1 study · 129 participants | Low Downgraded: imprecision |
Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as monotherapy vs SSRI antidepressant agent | RR 1.06 [0.66, 1.7] | 1 study · 129 participants | Low Downgraded: imprecision |
Proportions of participants achieving remission depression rating scale score within the normal range at the end of the study A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as monotherapy vs SSRI antidepressant agent | RR 1.02 [0.58, 1.77] | 1 study · 129 participants | Low Downgraded: imprecision |
Acceptability. Participants experiencing troublesome adverse effects of any nature S‐adenosyl methionine as monotherapy vs SSRI antidepressant agent | no estimate extracted | NR | No studies |
S‐adenosyl methionine as adjunctive treatment compared to placebo as add‐on to SSRI for depression in adults
Population: adults with depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy. Change in scores from baseline to end of treatment on the depression rating scale A larger negative MD indicates greater improvement in the SAMe group S‐adenosyl methionine as adjunctive treatment vs placebo | no estimate extracted | 1 study · 73 participants | Low Downgraded: imprecision, indirectness |
Acceptability Participants dropping out of treatment during the study period for any reason S‐adenosyl methionine as adjunctive treatment vs placebo | RR 0.7 [0.31, 1.56] | 1 study · 73 participants | Very low Downgraded: imprecision, indirectness |
Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment. A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as adjunctive treatment vs placebo | RR 2.62 [1.17, 5.83] | 1 study · 73 participants | Low Downgraded: imprecision, indirectness |
Proportions of participants achieving remission depression rating scale score within the normal range at the end of the study. A larger RR indicates greater response to treatment in the SAMe group S‐adenosyl methionine as adjunctive treatment vs placebo | RR 3.05 [1.11, 8.39] | 1 study · 73 participants | Low Downgraded: imprecision, indirectness |
Acceptability. Participants experiencing troublesome adverse effects of any nature S‐adenosyl methionine as adjunctive treatment vs placebo | no estimate extracted | NR | No studies |