The feasibility and safety of S-adenosyl-L-methionine (SAMe) for the treatment of neuropsychiatric symptoms in 22q11.2 deletion syndrome: a double-blind placebo-controlled trial.

Abstract

The goal of this trial was to assess the feasibility and safety of using S-adenosyl-L-methionine (SAMe) to treat depressive disorder, attention deficit/hyperactivity disorder (ADHD) and cognitive deficits in individuals with the 22q11.2 deletion syndrome (22q11.2DS). SAMe supposedly enhances the activity of the COMT enzyme. Because individuals with 22q11.2DS have only one copy of the gene responsible for the enzyme, COMT haploinsufficiency may be associated with their psychiatric morbidity and cognitive deficits. We assessed twelve 22q11.2DS individuals with depressive disorder or ADHD in a randomized double-blind cross-over placebo-controlled trial, using SAMe 800 mg bid. Individuals were evaluated for treatment safety and effectiveness during the trial and upon completion at sixth week. Compared to placebo, there were no significant differences in the rate of reported side effects between SAMe and placebo. Despite a general concern that SAMe might induce mania in vulnerable individuals, no manic or psychotic symptoms were exhibited during the SAMe treatment. Individuals with 22q11.2DS with comorbid depressive disorder with or without psychotic symptoms (n = 5) had a larger numerical improvement on relevant clinical scales compared to placebo. No treatment effect was found on ADHD symptoms in subjects who suffered from 22q11.2DS with comorbid ADHD (n = 7). Cognitive performance did not improve or deteriorate following treatment with SAMe compared to placebo. In conclusion SAMe treatment up to 1,600 mg/day for 6 weeks in 22q11.2DS individuals appears to be safe, well tolerated and with no serious side effects. No significant benefit in depressive or ADHD symptoms was detected.

• Authors: Tamar Green, Lital Steingart, Amos Frisch, Omer Zarchi, Abraham Weizman, Doron Gothelf
• Journal: Journal of neural transmission (Vienna, Austria : 1996) (J Neural Transm (Vienna)) Vol. 119 Issue 11 Pg. 1417-23 (Nov 2012) ISSN: 1435-1463 [Electronic] Austria
• PMID: 22678699 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• S-Adenosylmethionine

Topics

• Adolescent
• Adult
• Antipsychotic Agents (therapeutic use)
• Attention Deficit Disorder with Hyperactivity (drug therapy, etiology)
• Child
• Cross-Over Studies
• Depressive Disorder, Major (drug therapy, etiology)
• DiGeorge Syndrome (complications)
• Double-Blind Method
• Feasibility Studies
• Female
• Humans
• Male
• Mental Disorders (drug therapy, etiology)
• Psychiatric Status Rating Scales
• S-Adenosylmethionine (therapeutic use)
• Young Adult