THE CLINICAL POTENTIAL OF ADEMETIONINE (S-ADENOSYLMETHIONINE) IN NEUROLOGICAL DISORDERS

This review focuses on the biochemical and clinical aspects of methyla tion in neuropsychiatric disorders and the clinical potential of their treatment with ademetionine (S-adenosylmethionine; SAMe). SAMe is req uired in numerous transmethylation reactions involving nucleic acids, proteins, phospholipids, amines and other neurotransmitters. The synth esis of SAMe is intimately linked with folate and vitamin B-12(cyanoco balamin) metabolism, and deficiencies of bath these vitamins have been found to reduce CNS SAMe concentrations. Both folate and vitamin B-12 deficiency may cause similar neurological and psychiatric disturbance s including depression, dementia, myelopathy and peripheral neuropathy . SAMe has a variety of pharmacological effects in the CNS, especially on monoamine neurotransmitter metabolism and receptor systems. SAMe h as antidepressant properties, and preliminary studies indicate that it may improve cognitive function in patients with dementia. Treatment w ith methyl donors (betaine, methionine and SAMe) is associated with re myelination in patients with inborn errors of folate and C-1 (one-carb on) metabolism. These studies support a current theory that impaired m ethylation may occur by different mechanisms in several neurological a nd psychiatric disorders.