Summary of Use during Lactation

SAM-e (S-adenosylmethionine) is a naturally occurring methyl radical donor involved in enzymatic transmethylation reactions in humans and animals. SAM-e has no specific lactation-related uses, but it has been used therapeutically for treating postpartum depression, cholestatic jaundice, osteoarthritis and numerous other conditions. SAM-e has poor oral bioavailability. SAM-e is generally well tolerated in adults. The most frequent adverse effects reported are gastrointestinal, such as nausea. Skin rashes have also been reported. No information is available on the clinical use of SAM-e during breastfeeding. However, use of SAM-e by a nursing mother would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.[1,2]

Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Depression) Nortriptyline, Paroxetine, Sertraline; (Cholestatic Jaundice) Ursodiol

References

1.

Mischoulon D. Update and critique of natural remedies as antidepressant treatments. Obstet Gynecol Clin North Am 2009;36:789-807, x. [PMC free article: PMC2786903] [PubMed: 19944301]

2.

Deligiannidis KM, Freeman MP. Complementary and alternative medicine for the treatment of depressive disorders in women. Psychiatr Clin North Am 2010;33:441-63. [PubMed: 20385346]

Substance Name

SAM-e

Scientific Name

S-adenosylmethionine

CAS Registry Number

29908-03-0

Drug Class

Breast Feeding

Lactation

Milk, Human

Complementary Therapies