Where and when do you offer sessions?

All sessions are either online using Microsoft Teams or in person. I am based in Bayswater, London, Monday to Friday, and at Chancery Lane (Gray's Inn) on Monday, Wednesday and Friday mornings. My availability is 8.00 am to 6.00 pm. Appointments can be scheduled as needed at a frequency that best meets your goals.

What type of intervention do you offer?

I am trained to provide a range of different psychological approaches. This enables me to develop a bespoke intervention plan based on your particular needs and preferences. The models I use most often are Schema Therapy (ST), Eye Movement Desensitisation and Reprocessing (EMDR), Cognitive Behavioural Therapy (CBT), and Person-Centred Therapy.

How many sessions will I need?

This is different for everyone, depending on your situation and what your goals are. Some people find that a handful of sessions is all they need, while others find it helpful to have ongoing support over a number of months.

Do you accept insurance clients?

Yes. I accept clients from Aviva, BUPA, Vitality, and WPA primarily but also some lesser known ones, so please ask. I can also provide invoices for clients to seek reimbursement from their insurer after paying me.

What's the next step?

I offer a free initial 10 minute consultation which enables us to think together about what you need, and whether I am the right practitioner for you. Research shows that the most significant factor in the success of psychological intervention is the rapport we have with our practitioner.

SAM-e for depression and mood: an honest look at the evidence

Please read this first

I am a counselling psychologist, not a medical doctor. I cannot prescribe, I cannot advise you on supplements or medication for your particular situation, and nothing here is medical advice or a recommendation to start or stop anything. SAM-e can interact dangerously with antidepressants and can destabilise bipolar disorder. Please do not act on this article. Use it only to have a better-informed conversation with your GP, pharmacist, or psychiatrist, who are the people who can actually weigh it for you.

In a hurry? The short version

There is a real antidepressant signal. Several trials and older meta-analyses suggest SAM-e can lift depression more than placebo, and one good trial found it helped as an add-on when antidepressants alone were not working.
But the evidence is thinner than it looks. The most rigorous review, a Cochrane review, concluded the evidence was too limited and too low in quality to draw firm conclusions. It is not a licensed antidepressant in the UK and is not recommended in national guidance.
The safety points are the important part. SAM-e can trigger mania or hypomania in people with bipolar disorder, and combining it with antidepressants raises the risk of serotonin syndrome, which can be serious.
In the UK it is sold as a food supplement, not a regulated medicine, so dose and quality are not guaranteed in the way a prescription is.
Bottom line: plausibly helpful for some people, but genuinely not something to self-prescribe, especially if you take an antidepressant or have any history of bipolarity. A conversation with a doctor comes first.

SAM-e (short for S-adenosyl-methionine) is little known and little discussed here in the UK. In the United States it is a different story: there it is a popular, long-established over-the-counter supplement for low mood, talked about far more openly and sold in every pharmacy. Because of that gap, most people who ask me about it in this country have come across it through American articles, podcasts, or friends, and want to know whether the enthusiasm is justified or just marketing. As with everything I write in this vein, I want to be useful without pretending to be something I am not. I am a counselling psychologist. I read the research, and I can tell you what it does and does not show, but I cannot tell you whether SAM-e is right for you, and I would be doing you a disservice if I tried. So this is a map of the evidence, wrapped in caveats I mean sincerely, to help you ask better questions of the people who can actually prescribe.

On a personal note, it is also how I first came across it myself. When people ask me about alternatives to an antidepressant, I often mention that SAM-e was recommended to me years ago by a nutritionist in New York, Lyn-Genet Recitas, when I was living in Bermuda. I share that as a piece of my own story, not as a recommendation to you: where I first heard of something is not evidence that it is right for anyone else, which is exactly why the rest of this article, and a conversation with your own doctor, matter more than my anecdote.

First, what SAM-e actually is

SAM-e is a compound your body makes naturally from the amino acid methionine. It plays a central role in a process called methylation, and it is involved, indirectly, in the making of neurotransmitters such as serotonin, dopamine and noradrenaline, the very chemicals that most antidepressants act on. That biochemical link is part of why it was investigated for depression in the first place, and it gives the idea a plausible mechanism rather than pure wishful thinking.

Its legal status is worth understanding, because it varies, and it partly explains why the drug is so much more familiar on one side of the Atlantic than the other. In some countries, including parts of Europe, SAM-e has been available as a prescription medicine. In the United States it has been sold over the counter as a dietary supplement since the late 1990s and became one of the more popular supplements taken for mood, which is a large part of why it is so widely discussed there. In the United Kingdom it is also legal to sell as a food supplement, but it never caught on in the same way and can be harder to find. Either way, that distinction matters: a supplement is not held to the same standards of testing, dosing and quality control as a licensed medicine, so "you can buy it without a prescription" is not the same as "it is proven, standardised, and safe for everyone."

What the evidence says for depression

Here the honest picture is genuinely mixed, and it is worth holding two things at once. On one hand, there is a real and long-standing signal that SAM-e can help. An early and often-cited meta-analysis pooled the older controlled trials and concluded that SAM-e was more effective than placebo, and roughly comparable to the tricyclic antidepressants of the day, for depressive symptoms.1 That is not nothing, and it is more than can be said for many supplements marketed for mood.

The single most useful modern study, to my mind, looked at SAM-e not on its own but as an add-on. In a double-blind randomised controlled trial, adults with major depression who had not responded to a standard antidepressant were given either SAM-e or a placebo alongside their existing medication. The group who added SAM-e showed significantly higher rates of response and of remission.2 For the common and demoralising situation of an antidepressant that is only half working, that is a genuinely interesting result.

On the other hand, when the evidence is examined at its most rigorous, the picture becomes much more cautious. A Cochrane review, the kind of systematic review designed specifically to be sceptical and thorough, looked at SAM-e for depression in adults and concluded that the evidence was too limited, and generally of too low a quality, to support firm conclusions either way.3 A more recent clinician-oriented review reached a similarly balanced view: SAM-e is promising and reasonably well tolerated, but the trials are heterogeneous, and it is best thought of as a possible adjunct considered with a doctor, not a proven stand-alone treatment.4,5

So where does that leave us? With a supplement that has a plausible mechanism, a real but inconsistent evidence base, and nothing like the weight of trials behind the licensed antidepressants or the established talking therapies. It is telling that SAM-e is not recommended as a treatment for depression in UK national guidance, which points instead to psychological therapies and antidepressant medication as the interventions with the strongest evidence.6 "Might help some people" is a fair summary. "Proven and ready to self-prescribe" is not.

The safety points that matter most

This is the part I would ask you to read most carefully, because it is where a "natural" label is most misleading. Natural does not mean harmless, and SAM-e has two risks in particular that are serious enough to make self-prescribing genuinely unwise.

Bipolar disorder and the risk of a manic switch. Like other antidepressant-type treatments, SAM-e can tip some people into mania, hypomania, or an agitated mixed state. If you have bipolar disorder, or a family history of it, or have ever had a period of unusually elevated, wired, or sleepless "high" mood, this is a real hazard and SAM-e should not be taken without specialist psychiatric guidance.
Serotonin syndrome when combined with antidepressants. Because SAM-e can increase serotonin activity, taking it alongside an SSRI, SNRI, MAOI, or other serotonergic medication can, in principle and in reported cases, contribute to serotonin syndrome, a potentially dangerous build-up of serotonin causing agitation, sweating, tremor, a racing heart, and in severe cases much worse. If you already take an antidepressant, combining it with SAM-e is precisely the kind of decision that needs a prescriber, not a supplement aisle.
More everyday side effects. SAM-e can cause anxiety, restlessness, insomnia (many people are advised to take it earlier in the day rather than at night), digestive upset, sweating, and palpitations. These are usually mild but are worth knowing about.
Pregnancy, breastfeeding, and other conditions. There is not enough good safety data to recommend SAM-e in pregnancy or breastfeeding outside of specialist medical care, and it may interact with other conditions and drugs. This is, again, doctor territory.
Quality and dose vary. As a UK food supplement, SAM-e is not regulated like a medicine, so the actual dose and purity in a given product are not guaranteed. Trials have typically used substantial daily doses, and the form and stability of the compound matter, which is one more reason not to improvise.

So, is it worth considering?

Holding both halves honestly: SAM-e is one of the more plausible and better-studied supplements for low mood, with a real antidepressant signal and a coherent mechanism, and for some people, particularly as a carefully supervised add-on, it may genuinely help. At the same time, its evidence base is smaller and shakier than that of the treatments we already know work, and it carries specific, non-trivial risks around bipolarity and around combining it with antidepressants. Those two facts are not in tension; they are just the reality of a promising-but-unproven option.

What I would gently steer you away from is the idea that, because it is sold without a prescription, SAM-e is a casual, consequence-free thing to try on your own. If you are low enough to be looking for help, the most valuable steps are the ones with the strongest evidence: talking therapy, and a conversation with your GP about whether medication has a place. If, in that conversation, you want to raise SAM-e as something you have read about, that is a perfectly reasonable thing to do, and this article has done its job if it helps you raise it well.

A closing word

Depression is treatable, and you do not have to work it out alone or self-experiment your way through it. If something here has been useful, take it to your GP or a psychiatrist rather than to a checkout. And if you would like to think about the psychological side of things, the

free 10-minute consultation

is a good place to start.

This article is general information, not a diagnosis, treatment, or medical advice, and I cannot speak to any one person's situation. Please do not start, stop, or combine any supplement or medication on the basis of it. If you are struggling to keep yourself safe, please contact your GP, call NHS 111, or call the Samaritans on 116 123 at any time. In an emergency, call 999.

References and further reading

This is a plain-language research summary, not clinical advice. The evidence on SAM-e is genuinely mixed and still developing, and conclusions may change.

Bressa GM. S-adenosyl-l-methionine (SAMe) as antidepressant: meta-analysis of clinical studies. Acta Neurologica Scandinavica Supplementum. 1994;154:7–14.

doi:10.1111/j.1600-0404.1994.tb05403.x. An early meta-analysis of the controlled trials.

Papakostas GI, Mischoulon D, Shyu I, Alpert JE, Fava M. S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial. American Journal of Psychiatry. 2010;167(8):942–948.

doi:10.1176/appi.ajp.2009.09081198. The SSRI-augmentation trial.

Galizia I, Oldani L, Macritchie K, et al. S-adenosyl methionine (SAMe) for depression in adults. Cochrane Database of Systematic Reviews. 2016;10(10):CD011286.

doi:10.1002/14651858.CD011286.pub2. The rigorous review finding the evidence inconclusive.

Sharma A, Gerbarg P, Bottiglieri T, et al. S-Adenosylmethionine (SAMe) for neuropsychiatric disorders: a clinician-oriented review of the literature. Journal of Clinical Psychiatry. 2017;78(6):e656–e667.

doi:10.4088/JCP.16r11113. A balanced clinician-facing review, including safety.

Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. American Journal of Clinical Nutrition. 2002;76(5):1158S–1161S.

doi:10.1093/ajcn/76.5.1158S.

National Institute for Health and Care Excellence. Depression in adults: treatment and management. NICE guideline [NG222]; 2022.

nice.org.uk/guidance/ng222. The UK guidance on evidence-based treatments for depression.