Efficacy of the dietary supplement S-adenosyl-L-methionine
Efficacy of the dietary supplement S-adenosyl-L-methionine
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DOI：
10.1345/aph.1z443
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发表时间：
2001-11-01
影响因子：
2.9
通讯作者：
Avila, JR
中科院分区：
文献类型：
--
作者：
Fetrow, CW;Avila, JR
目的：回顾有关膳食补充剂 SAMe（S-腺苷-L-蛋氨酸）的现有已发表的临床证据。 数据来源：大部分信息来自通过 MEDLINE 搜索（1966 年至 2001 年 2 月）确定的主要已发表文献。信息也是通过二级和三级来源获得的。 研究选择和数据提取：对从数据源确定的所有文章进行了评估，所有相关信息都包含在本次综述中。 数据综合：大多数临床试验证据围绕 SAMe 在各种抑郁症、骨关节炎和纤维肌痛中的应用。这些试验的样本量和使用的剂量差异很大。几项综述和至少两项荟萃分析对 1994 年之前完成的试验中有关 SAMe 治疗抑郁症的现有证据进行了审查，并得出结论，SAMe 在治疗抑郁症方面优于安慰剂，并且与标准三环类抗抑郁药大致相同。这些信息大部分以孤立病例报告或孤立临床试验的形式存在。 SAMe 似乎具有良好的耐受性，大多数不良反应表现为轻度至中度胃肠道不适。然而，显然该药物并非没有发生更严重的精神和心血管不良事件的风险。记录药物或食物与 SAMe 相互作用的信息非常有限。 结论：应指导消费者避免在不受监控的情况下食用这种膳食补充剂，直到与其主要医疗保健提供者进行充分讨论。尽管 SAMe 具有巨大的治疗应用潜力，但其不确定的风险状况目前无法做出明确的推荐。医疗保健提供者和消费者可能应该降低对这种膳食补充剂的热情，直到获得足够的信息。
OBJECTIVE: To review existing published clinical evidence surrounding the dietary supplement SAMe (S-adenosyl-L-methionine).DATA SOURCES:The majority of information was obtained from primary published literature identified through MEDLINE search(1966-February 2001). Information was also obtained through secondary and tertiary sources when available.STUDY SELECTION AND DATA EXTRACTION:All articles identified from data sources were evaluated and all relevant information included in this review.DATA SYNTHESIS: The majority of clinical trial evidence surrounds the application of SAMe for various depressive disorders, osteoarthritis and fibromyalgia. Sample sizes of these trials and the dose employed have varied considerably. Several reviews and at least two meta-analyses have examined the available evidence surrounding SAMe in the therapy of depression for trials completed prior to 1994 and concluded that SAMe prior to placebo in treating depressive disorders and approximately as as standard trycyclic antidepressants. Much of this information exists in the form of isolated case reports or solitary clinical trials. SAMe appears to be well tolerated, with the majority of adverse effects presenting as mild to moderate gastrointestinal complaints. However, it is apparent that this agent is not without risk of more significant psychiatric and cardiovascular adverse events. Information documenting drug or food interactions with SAMe is very limited.CONCLUSIONS: Consumers should be instructed to avoid unmonitored consumption of this dietary supplement until sufficient discussion has taken place with their primary healthcare provider. Although there exists significant potential for therapeutic application of SAMe, its uncertain risk profile precludes definitive recommendation at this time. Healthcare providers and consumers should likely temper their enthusiasm for this dietary supplement until sufficient information becomes available.