Generality
Academetionine - also known as S-adenosyl-methionine - is an amino acid naturally present in the body. In detail, the academetionine is a coenzyme capable of transferring methyl groups.
Trans-methylation reactions carried out with the aid of academic acetonine are indispensable in the synthesis of the phospholipid double layer of cell membranes, but this is not the only action performed by the aforementioned amino acid.
In fact, adheptothionine is ubiquitously present in tissues and organs and takes part in numerous metabolic reactions. In particular, this molecule is very interesting from the pharmaceutical point of view, since it is involved in the synthesis of some types of neurotransmitters - such as, serotonin and dopamine - implicated in the mechanisms of mood regulation, but not only. Indeed, the academetionine also exerts interesting activities in the liver, where it is able to favor the synthesis of sulfur compounds involved in liver detoxification mechanisms .
Examples of Medicinal Specialties containing Ademetionina
- Donamet®
- Transmetil®
- Samyr®
Therapeutic indications
What is Ademetionine used for
Given its multiple mechanisms of action, the academicumionine constitutes the active principle of various medicinal specialties, used in the treatment of equally different pathologies.
Specifically, the use of the academetionine is indicated for the treatment of:
- Depressive syndromes;
- Intrahepatic cholestasis, pregnancy;
- Intrahepatic cholestasis in pre-cirrhotic and cirrhotic states in adults.
Warnings
Before starting ademetionine therapy, you must inform your doctor if you are in one of the following situations:
- If you suffer from vitamin deficiencies, as the deficiency of vitamin B12 and / or folic acid can decrease the levels of ademetionina, potentially making the therapy ineffective.
- If you suffer from bipolar disorder, as treatment with ademetionine is not recommended in patients with this condition.
- If you suffer from kidney problems, because in these cases, the adhemationine must be administered with caution;
- If you are suffering from anemia;
- If there has been an increase in blood ammonia levels following a previous intake of ademetionine.
Furthermore, it is important to remember that the intake of ademetionine is able to induce false positives in immunoassays for homocysteine.
Finally, ademetionine therapy can cause dizziness, therefore, patients experiencing this symptom should not drive vehicles and / or use machinery.
Pharmacological Interactions
Because of the drug interactions that can occur, you must tell your doctor if you are taking:
- Tricyclic antidepressants (or TCA);
- Selective inhibitors of serotonin reuptake (or SSRIs);
- Medicines or supplements that contain tryptophan.
However, before starting ademetionine treatment, it is advisable to tell your doctor if you are taking - or if you have recently been - drugs and / or substances of any kind, including medicines without a prescription., herbal products and homeopathic products.
Side effects
Like any other active ingredient, even academethionine can cause side effects. The type and intensity of these effects may vary from individual to individual, both as a function of the dose of active ingredient taken, and as a function of the sensitivity of each patient to the same ademetionina.
Nervous System Disorders
Ademetionine treatment can cause headache, dizziness and paraesthesia.
Psychiatric disorders
Academetionine can cause insomnia, anxiety and confusional states.
Gastrointestinal disorders
Ademetionine therapy may give rise to several undesirable effects on the gastrointestinal tract. Among these, we find:
- Diarrhea;
- Abdominal pain and / or distention;
- Dyspepsia;
- Esophagitis;
- Nausea and vomit;
- Flatulence;
- Dry mouth;
- Gastrointestinal hemorrhage.
Cardiovascular disorders
The treatment based on ademetionina can give rise to cardiac disorders, hot flushes and superficial phlebitis.
Disorders of the Skin and Subcutaneous Tissue
While taking ademetionine, undesirable effects such as hyperhidrosis, skin reactions and itching may occur.
Other Side Effects
Other side effects that may occur during treatment with ademetionine are:
- Allergic reactions in sensitive individuals;
- Joint pain;
- Muscle spasms;
- Biliary colic;
- Reactions at the injection site (when the active ingredient is administered parenterally);
- General malaise;
- Temperature;
- Chills;
- Asthenia;
- Peripheral edema;
- Flu-like symptoms;
- Laryngeal edema.
Overdose
If you take excessive doses of ademetionine, you must contact your doctor immediately or contact your nearest emergency department. This is because patients must be kept under medical supervision and must receive the necessary supportive therapies.
Action mechanism
As mentioned, the academetionina is able to perform various activities in various districts of the organism. For this reason, it can be used for the treatment of very different disorders, such as intrahepatic cholestasis and depressive syndromes.
Intrahepatic cholestasis
The academetionina is able to exercise its anticolestatic action mainly through two mechanisms of action:
- Increases the ademetionin-dependent synthesis of membrane phospholipids, thus favoring the restoration of microfluidity of cytoplasmic membranes;
- Increases the synthesis of sulfur-containing compounds involved in endogenous liver detoxification processes, necessary to prevent cholestasis.
Depressive syndromes
Several studies have shown that the levels of ademetionina in patients suffering from depression are definitely lower than the levels present in healthy individuals. The trans-methylation reactions mediated by the academetionine are fundamental for the synthesis of the neurotransmitters involved in the regulation of mood and not only. Indeed, the academetionine is implicated in the synthesis of catecholamines (dopamine, noradrenaline and adrenaline), in the synthesis of serotonin, in the synthesis of melatonin and even in the synthesis of histamine.
Once assumed, the academetionina is able to go beyond the blood-brain barrier, restoring its levels in the central nervous system and favoring the production of the neurotransmitters involved in mood-regulating mechanisms.
The antidepressant effect of ademethionine is faster than with other antidepressant drugs, as it occurs within 5-7 days of starting therapy.
Method of use and Posology
Academetionine is available in pharmaceutical formulations suitable for oral (tablets) or parenteral (powder and solvent for solution for injection).
The dosages usually used in therapy will be reported below. However, it will be the doctor who will determine, on a case-by-case basis, the exact dose of active ingredient that each patient will have to take.
Treatment of Intrahepatic Cholestasis
When the academetionina is administered parenterally (intramuscularly, or intravenously), the attack dose for the treatment of intrahepatic cholestasis is 500-800 mg a day.
When, on the other hand, the academetionine is administered in the form of tablets for oral use, the attack dose usually used is 800-1600 mg per day.
Maintenance therapy is performed by administering the oral acetethionine at a dose of 800-1600 mg of active ingredient per day.
The duration of treatment should be established by the doctor.
Depression Treatment
For the treatment of depressive syndromes, the dose of ademetionina usually used parenterally is 400 mg per day for a period of at least 15-20 days. At the end of this period, the doctor will decide if it is necessary to repeat the parenteral treatment, or if to continue the therapy by mouth.
When administered orally, the dose of ademetionina usually prescribed in the treatment of depression is 800-1200 mg a day.
The duration of treatment should be established by the doctor.
Pregnancy and breastfeeding
Although academic acetonine is indicated for the treatment of gravidic intrahepatic cholestasis, pregnant women and breastfeeding mothers must inform their state doctor before taking this active ingredient.
Furthermore, the use of ademetionine during the first trimester of pregnancy must be carried out only in cases of real need and only under the strict supervision of the doctor.
However, intrahepatic cholestasis of pregnancy usually occurs in the last trimester of pregnancy: the use of ademetionine at the recommended therapeutic dosages should not cause any kind of adverse effect at this stage of gestation.
Contraindications
When Ademetionine should not be used
Ademetionine treatment is contraindicated in the following cases:
- In patients with known hypersensitivity to the same ademetionina;
- In patients suffering from genetic diseases that influence the methionine cycle, which cause homocystinuria (presence of homocysteine in the urine) and / or which cause hyperhomocysteinemia (high concentration of homocysteine in the blood);
- In children and adolescents.
