From January to December, these are the updates that changed our practice in 2022.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat's Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Kelly, we've got a lot to cover in this episode, so let's just get right into it.

We started 2022 with a review of Sam E.

This antioxidant methyl donor is involved in the production of

the three major monomines, serotonin, dopamine and norepinephrine. In that sense, it functions a bit

like a traditional antidepressant. And one of the big takeaways from this article is that it

works about as well as an antidepressant.

That is based on head-to-head studies, as well as meta-analyses, where Sam E comes up with a respectable medium effect size.

Sam E is also better tolerated than most antidepressants, particularly when it comes to sexual

side effects.

In one study, Sam E successfully treated SSRI-induced

sexual dysfunction when added on to an SSRI. Sam E can be safely added to an antidepressant,

and there is good reason to do so. As long as it's not an MAOI, that would not be safe.

In a controlled trial, Sam E augmented antidepressants

in people who had not responded to their first trial of antidepressant.

So that's people who didn't respond to a single trial, not two trials,

so we can't go as far as say that Sam E works

in treatment-resistant depression, but it does augment an antidepressant.

Another reason to consider Sam E is that it has benefits in some medical conditions that often go

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