Suicide attempt by self-burning associated with ingestion of S-adenosylmethionine: a review of the literature and case report.

The treatment of major depressive disorder continues to be challenging in many cases. The high nonresponse rates as well as the poor tolerability of some antidepressants often prompt patients to seek other forms of treatment. S-Adenosylmethionine (SAMe) is one of the most popular over-the-counter antidepressants currently sold in the United States. SAMe's antidepressant effect has been clearly demonstrated, but safety and tolerability remain understudied at this time. This report describes the case of a 61-year-old woman with no previous history of suicidal ideations who self-prescribed SAMe for her depressive symptoms and attempted suicide 4 days later by burning herself. Given the rise in the use of over-the-counter antidepressants, further research should be performed regarding the safety of these products, including a need for warnings to the public and adequate labels if necessary.