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299 Although concerns have been raised about the possibility that SAMe supplementation might increase homocysteine production, a trial in subjects with major depressive disorder found that 8001,600 mg SAMe per day for six weeks did not raise homocysteine levels

The conservative escalation approach: when moving to a new dose, maintain that dose for 4 weeks before deciding whether heartburn is tolerable

Adjusting the treatment plan as needed Dose escalation should be dependent of patient side effect profile and gastrointestinal tolerability

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