Improvement of aggressive behavior and quality of life impairment following S-adenosyl-methionine (SAM-e) augmentation in schizophrenia

Eur Neuropsychopharmacol. 2009 Jan;19(1):14-22. doi: 10.1016/j.euroneuro.2008.08.004. Epub 2008 Sep 27.


S-adenosyl-methionine (SAM-e), functions as a primary methyl group donor for several metabolic compounds. Since SAM-e is involved in several metabolic processes, its administration may have a role in the amelioration of several disorders. In addition, SAM-e increases catechol-O-methyltransferase (COMT) enzyme activity, which may ameliorate aggressive symptoms in certain patients. We have therefore investigated the efficacy of SAM-e in managing schizophrenia symptomatology in patients with the low activity COMT polymorphism. Eighteen patients with chronic schizophrenia were randomly assigned to receive either SAM-e (800 mg) or placebo for 8 weeks in double-blind fashion. Results indicated some reduction in aggressive behavior and improved quality of life following SAM-e administration. Female patients showed improvement of depressive symptoms. Clinical improvement did not correlate with serum SAM-e levels. Two patients receiving SAM-e exhibited some exacerbation of irritability. This preliminary pilot short-term study cautiously supports SAM-e as an adjunct in management of aggressive behavior and quality of life impairment in schizophrenia.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aggression / drug effects*
  • Aggression / psychology*
  • Cognition / drug effects
  • Depression / etiology
  • Depression / psychology
  • Dietary Supplements
  • Dopamine / metabolism
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Norepinephrine / metabolism
  • Psychiatric Status Rating Scales
  • Psychomotor Performance / drug effects
  • Quality of Life / psychology*
  • S-Adenosylmethionine / adverse effects
  • S-Adenosylmethionine / blood
  • S-Adenosylmethionine / therapeutic use*
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*
  • Sex Characteristics
  • Treatment Outcome
  • Young Adult


  • S-Adenosylmethionine
  • Dopamine
  • Norepinephrine