Q: Can SAM-e be given to geriatric patients?
A: Since SAM-e has shown no adverse interactions with other substances, it is particularly well suited to the geriatric population, who may be taking several concomitant medications.

Q: What about giving SAM-e to pregnant/nursing women?
A: While no adverse effects have been reported in mothers or babies from studies involving pregnant and/or nursing women [Frezza 1987 Hepatol; Frezza 1990 Hepatogastroenterol], SAM-e has not been tested in large segments of this population.

Q: Can children take SAM-e?
A: SAM-e has not been tested in children.

Q: Can I recommend SAM-e to patients with bipolar disorder?
A: In a very small number of documented cases [Carney 1989 Br J Psychiatry; Lipinski 1984 Am J Psychiatry], patients with bipolar disorder who are taking SAM-e without mood stabilizers have experienced a manic swing. It should be noted that this is an expected response to antidepressant medication given as monotherapy to treat bipolar depression.

Q: Can patients with panic disorder take SAM-e?
A: Patients with panic disorder should take the lowest possible dose of SAM-e and titrate up slowly, and only when they are comfortable with their initial dose.*

Q: Can SAM-e be used with prescription antidepressants or joint remedies?
A: Since SAM-e has shown no negative interactions, it is safe to use with other products. In fact, because of its rapid effects, many practitioners recommend it to patients to speed the onset of prescription antidepressants. SAM-e is also often recommended when patients are experiencing prescription antidepressant fade-out or when prescription side effects are unacceptable. Additionally, because of its protective qualities, SAM-e may be a beneficial addition to joint remedies like NSAIDs, which may cause long-term damage.*