A Prospective, Open-Label, 12 Week Trial of S-adenosylmethionine in the Symptomatic Treatment of Alzheimer’s Disease

Objective: To determine if treatment with S-adenosylmethionine (SAM-e) might lead to cognitive and behavioral improvement in patients with Alzheimer’s disease (AD). Interventions: We conducted a prospective, open-label study of six subjects who were given oral SAM-e over 12 weeks and measured the effects on cognition and behavior. Outcome measures: Outcome measures of cognition and behavior included the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Mini-Mental State Examination (MMSE), Behave-AD, Clinical Global Impression Scale (CGI), Hamilton Rating Scale for Depression (HAM-D), informant version, Blessed Dementia Scale to assess activities of daily living (ADL), the Physical Self-Maintainance Scale (PSMS), and the Lawton-Brody IADL Scale to measure instrumental activities of daily living. Results: At study completion, two subjects were “moderately improved” and 4 were “minimally improved” on the CGI. Five subjects improved on the ADAS-Cog by an average of 20%. No significant side effects were reported. Conclusions: In this small open label study, SAM-e appeared to have a beneficial effect in patients with AD, but the small subject number didn’t provide enough power to show statistical significance. Controlled trials with adequate statistical power to investigate its utility in AD are warranted.