Nine of 14 identified studies included subjects with mild-to-moderate depressive symptoms (Table 6) and five included subjects with moderateto-severe symptoms (Table 7).Only six of the 14 studies were restricted to subjects with MDD (three in mild-moderate MDD, three in moderate severe MDD).All 14 studies enrolled only adults; no placebo controlled studies of SAM-e in pediatric patients with depression were identified.Only one study included an active comparator arm (imipramine) .Eleven of the 14 studies were conducted in Europe and three were conducted in the United States. All 14 studies were short-term, ranging from 2-6 weeks. No placebo controlled studies were identified that assessed the long-term antidepressant efficacy of SAM-e.