A Case Report of a Manic Episode Triggered by S-Adenosylmethionine (SAMe)

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Sir: As previously described in the Companion,¹ an evergrowingnumber of Americans seek alternative therapies fortheir medical problems. Among those alternative therapies isthe use of herbal medicines, substances that can elicit changesin mood, cognition, and behavior.² S-adenosylmethionine(SAMe) is a natural substance found in all human cells that isinvolved in methylation reactions such as gene expression andneurotransmitter synthesis, among others.³