Met7.5

L-Methionine Research

40 peer-reviewed studies · Evidence score: 7.5/10

S-Adenosylmethionine (SAMe) as an adjuvant therapy for patients with depression: An updated systematic review and meta-analysis

Peng TR et al. • General hospital psychiatry (2024)

SAMe may provide relief of depression symptoms similar to imipramine or escitalopram.

SAMe may provide relief of depression symptoms similar to imipramine or escitalopram.
However, the results of the comparisons should be interpreted with caution due to the small number of studies and the large range of SAMe doses that were used in the included trials.
Therefore, we recommend that patients discuss treatment options with their doctor before taking SAMe.

Meta-Analysisn=1,522

DOI

Antidepressants for smoking cessation

Hughes JR et al. • The Cochrane database of systematic reviews (2014)

The antidepressants bupropion and nortriptyline aid long-term smoking cessation.

There was high quality evidence that, when used as the sole pharmacotherapy, bupropion significantly increased long-term cessation (44 trials, N = 13,728, risk ratio [RR] 1.62, 95% confidence interval [CI] 1.49 to 1.76).
There was moderate quality evidence, limited by a relatively small number of trials and participants, that nortriptyline also significantly increased long-term cessation when used as the sole pharmacotherapy (six trials, N = 975, RR 2.03, 95% CI 1.48 to 2.78).
There is insufficient evidence that adding bupropion (12 trials, N = 3487, RR 1.9, 95% CI 0.94 to 1.51) or nortriptyline (4 trials, N = 1644, RR 1.21, 95% CI 0.94 to 1.55) to nicotine replacement therapy (NRT) provides an additional long-term benefit.

Meta-Analysisn=13,728

DOI

S-adenosyl-L-methionine for the treatment of chronic liver disease: a systematic review and meta-analysis

Guo T et al. • PloS one (2015)

However, SAMe also demonstrated limited clinical value in the treatment of certain chronic liver diseases.

In a subgroup analysis of gravidas and children, several of the included data indicated that there was a significant difference in the pruritus score.
Furthermore, the results regarding ursodeoxycholic acid (UDCA) and stronger neo-minophagen C (SNMC) indicated that both treatments were more effective than SAMe was in certain chronic liver diseases.
These findings suggest that SAMe could be used as the basis of a medication regimen for liver function improvement because of its safety.

Meta-Analysisn=705

DOI

An integrated meta-analysis of peripheral blood metabolites and biological functions in major depressive disorder

Pu J et al. • Molecular psychiatry (2021)

This meta-analysis examined the effects of Acetyl-L-Carnitine.

Pathway and network analyses revealed altered amino acid metabolism and lipid metabolism, especially for the tryptophan-kynurenine pathway and fatty acid metabolism, in the peripheral system of MDD patients.
Our findings may facilitate biomarker development and the elucidation of the molecular mechanisms that underly MDD.
Further research warranted to confirm findings

Meta-Analysisn=46

DOI

Efficacy and acceptability of S-adenosyl-L-methionine (SAMe) for depressed patients: A systematic review and meta- analysis

Limveeraprajak N et al. • Progress in neuro-psychopharmacology & biological psychiatry (2024)

Moderate-certainty evidence suggests that SAMe monotherapy may offer a moderate therapeutic benefit in alleviating depressive symptoms.

Moderate-certainty evidence suggests that SAMe monotherapy may offer a moderate therapeutic benefit in alleviating depressive symptoms.
Considering its favorable acceptability profile, SAMe monotherapy should be considered as a treatment option for patients with depression.
However, uncertainties regarding its efficacy as an adjunct to AD and its comparative efficacy with ADs remain unresolved.

Systematic Review

DOI

Urinary pH and antibiotics, choose carefully. A systematic review

Ordaz G et al. • Actas urologicas espanolas (2023)

We suggest performing urine cultures with antibiogram tests, in both acidic and alkaline media, to define the bacterial susceptibility profile.

We suggest performing urine cultures with antibiogram tests, in both acidic and alkaline media, to define the bacterial susceptibility profile.
There is insufficient in vivo evidence to support whether choosing an antibiotic based on a patient's urinary pH or adding urinary pH modifiers will lead to a higher cure rate.

Systematic Review

DOI

Effectiveness and side effects of psychopharmacotherapy in individuals with 22q11.2 deletion syndrome with comorbid psychiatric disorders: a systematic review

Mosheva M et al. • European child & adolescent psychiatry (2020)

Further trials with RCT design, larger sample sizes and more syndrome-specific pharmacological agents are needed to improve evidence-based psychiatric care of 22q11.2DS individuals with comorbid mental disorders.

Pharmacological interventions included three studies for antipsychotic treatment, two studies for stimulants, one study for selective serotonin reuptake inhibitors (SSRIs), one study for S-adenosyl-L-methionine (SAMe), and one case series for metyrosine.
The presented data support the clinical impression that individuals with 22q11.2DS and comorbid psychiatric disorders are treated in a manner comparable to non-22q11.2DS individuals.
However, distinct medical comorbidities common in individuals with 22q11.2DS may complicate the administration of pharmacotherapy.

Systematic Reviewn=182

DOI

S-Adenosylmethionine (SAMe) for Neuropsychiatric Disorders: A Clinician-Oriented Review of Research

Sharma A et al. • The Journal of clinical psychiatry (2017)

S-adenosylmethionine holds promise as a treatment for multiple neuropsychiatric conditions, but the body of evidence has limitations.

S-adenosylmethionine holds promise as a treatment for multiple neuropsychiatric conditions, but the body of evidence has limitations.
The encouraging findings support further study of SAMe in both psychiatric and comorbid medical illnesses.
Further research warranted to confirm findings

Systematic Reviewn=132

DOI

Dietary supplements for preventing postnatal depression

Miller BJ et al. • The Cochrane database of systematic reviews (2013)

There is insufficient evidence to conclude that selenium, DHA or EPA prevent postnatal depression.

This included study (n = 85) found selenium had an effect on EPDS scores but did not reach statistical significance (P = 0.07).
There was a mean difference (MD) of -1.90 (95% confidence interval (CI) -3.92 to 0.12) of the self-reported EPDS completed by participants within eight weeks of delivery.
No benefit was found for EPA-rich fish oil (MD 0.70, 95% CI -1.78 to 3.18) or DHA-rich fish oil supplementation (MD 0.90, 95% CI -1.33 to 3.13) in preventing postpartum depression.

Systematic Reviewn=85

DOI

Diagnostic Accuracy of PET Tracers for the Differentiation of Tumor Progression from Treatment-Related Changes in High-Grade Glioma: A Systematic Review and Metaanalysis

de Zwart PL et al. • Journal of nuclear medicine : official publication, Society of Nuclear Medicine (2020)

Our results support the incorporation of amino-acid PET tracers for the treatment evaluation of high-grade gliomas.

Results: The systematic review included 39 studies (11 tracers). 18F-FDG (12 studies, 171 lesions) showed a pooled sensitivity and specificity of 84% (95% confidence interval, 72%-92%) and 84% (95% confidence interval, 69%-93%), respectively.
O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) (7 studies, 172 lesions) demonstrated a sensitivity of 90% (95% confidence interval, 81%-95%) and specificity of 85% (95% confidence interval, 71%-93%).
For S-11C-methyl)-l-methionine (11C-MET) (8 studies, 151 lesions), sensitivity was 93% (95% confidence interval, 80%-98%) and specificity was 82% (95% confidence interval, 68%-91%).

Meta-Analysisn=39

DOI

Dietary Ingredients as an Alternative Approach for Mitigating Chronic Musculoskeletal Pain: Evidence-Based Recommendations for Practice and Research in the Military

Crawford C et al. • Pain medicine (Malden, Mass.) (2019)

Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients.

Currently the scientific evidence is insufficiently robust to establish definitive clinical practice guidelines, but processes could be established to track the impact of these ingredients.
Until then, providers have the evidence needed to make informed decisions about the safe use of these dietary ingredients, and future research can address existing gaps.
Further research warranted to confirm findings

Meta-Analysis

DOI

WITHDRAWN: S-adenosyl-L-methionine for alcoholic liver diseases

Rambaldi A et al. • The Cochrane database of systematic reviews (2015)

The editorial group responsible for this previously published document have withdrawn it from publication.

The review is withdrawn as it was abandoned and has not been updated since its last edition in 2008.
A new team of authors resumed the work on the review, and so far, a major update to the protocol is published.
The review is expected to be finalised towards the end of 2016.

Meta-Analysis

DOI

Dietary Ingredients Requiring Further Research Before Evidence-Based Recommendations Can Be Made for Their Use as an Approach to Mitigating Pain

Crawford C et al. • Pain medicine (Malden, Mass.) (2019)

No recommendations were made when the evidence was low quality or trade-offs were so closely balanced that any recommendation would be too speculative.

No recommendations were made when the evidence was low quality or trade-offs were so closely balanced that any recommendation would be too speculative.
Research recommendations are provided to enhance the quality and body of evidence for the most promising ingredients.
Clinicians and those with chronic pain can rely on evidence-based recommendations to inform their decisions.

Systematic Review

DOI

Efficacy of adding nutritional supplements in unipolar depression: A systematic review and meta-analysis

Schefft C et al. • European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology (2017)

The preliminary data on inositol was negative, while one RCT for vitamin D demonstrated positive results.

The preliminary data on inositol was negative, while one RCT for vitamin D demonstrated positive results.
For vitamin B12 one and for SAMe two RCTs and a few open trials are available reporting positive and mixed results.
To summarize, for most of the substances, the available data is not yet sufficient or inconclusive.Copyright © 2017 Elsevier B.V. and ECNP.

Meta-Analysis

DOI

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments

Ravindran AV et al. • Canadian journal of psychiatry. Revue canadienne de psychiatrie (2016)

For MDD of mild to moderate severity, exercise, light therapy, St.

For MDD of mild to moderate severity, exercise, light therapy, St.
John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments.
Adjunctive exercise and adjunctive St.

Meta-Analysis

DOI

A systematic review and meta-analysis of the evidence base for add-on treatment for patients with major depressive disorder who have not responded to antidepressant treatment: a European perspective

Turner P et al. • Journal of psychopharmacology (Oxford, England) (2014)

However, there is currently a paucity of high-quality data regarding the use of add-on treatments in patients with MDD who are inadequate responders to antidepressants, with quetiapine XR presenting the most comprehensive evidence base to date.

Comparison of the different drug classes indicated that most interventions had similar efficacy.
The likelihood of response was significantly greater with SAMe versus placebo and lithium and with quetiapine XR versus placebo.
Most add-on interventions demonstrated comparable efficacy in patients with MDD and an inadequate response to initial antidepressants.

Meta-Analysis

DOI

Nutritional supplementation in the treatment of violent and aggressive behavior: A systematic review

Qureshi FM et al. • Aggressive behavior (2021)

The methodological shortcoming of existing studies and directions for future research are discussed to facilitate high-quality research in this evolving area of nutritional psychiatry.

Out of the 14 studies, 5 reported a beneficial effect of nutritional supplementation (omega-3 fatty acids, vitamins/minerals, S-adenosyl-l-methionine, or tryptophan).
The results overall indicated that research in this area is in its infancy: very few studies examined the same composition of nutritional supplementation and when they did so the results were contradictory.
The methodological shortcoming of existing studies and directions for future research are discussed to facilitate high-quality research in this evolving area of nutritional psychiatry.

Systematic Reviewn=14

DOI

Complementary and alternative medicine for major depressive disorder: a meta-analysis of patient characteristics, placebo-response rates, and treatment outcomes relative to standard antidepressants

Freeman MP et al. • The Journal of clinical psychiatry (2010)

Participants in CAM trials were more likely to be female and to have a lower placebo-response rate compared to those in standard antidepressant trials for MDD.

Participants in CAM trials were more likely to be female and to have a lower placebo-response rate compared to those in standard antidepressant trials for MDD.
Trials of standard antidepressants and CAM therapies were composed of patients with similar depression severity.
Further research warranted to confirm findings

Meta-Analysisn=185

DOI

Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a multicenter, placebo controlled, double blind, randomized clinical trial

Torrecilla C et al. • BMC urology (2020)

Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation.

The intervention group benefits from a lower global encrustation rate of stent ends than placebo group (1% vs 8.2%; p < 0.018).
Our data suggest that the use of this new oral composition is beneficial in the context of ureteral double J indwelling by decreasing mean, as well as global encrustation.
Further research warranted to confirm findings

RCTn=105

DOI

A systematic review of antioxidant treatment for amyotrophic lateral sclerosis/motor neuron disease

Orrell RW et al. • Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases (2008)

While there is no substantial clinical trial evidence to support their clinical use, there is no clear contraindication.

Further well-designed trials of medications such as vitamin C and E are unlikely to be performed.
If future trials of antioxidant medications are performed, careful attention should be given to sample size, outcome measures, and duration of the trial.
The high tolerance and safety, and relatively low cost of vitamins C and E, and other considerations related to the lack of other effective treatments for amyotrophic lateral sclerosis, explain the continuing use of these vitamins by physicians and people with amyotrophic lateral sclerosis.

Systematic Reviewn=23

DOI

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