Seasonal affective disorder (SAD), a type of depression associated with seasonal variations in daylight, is a common experience for many Americans. In 2006, Norman Rosenthal, M.D. in his book “Winter Blues,” revealed that seasonal affective disorder and its milder cousin the winter blues affect approximately 20 percent of the U.S. population. For many SAD sufferers, the standard treatment of light therapy using a light box works wonders and effectively alleviates their symptoms. For some people, though, light therapy alone is not enough. Medication, especially when combined with light therapy, may benefit these people greatly.
As of 2010, the only medication approved by the FDA to treat SAD, Wellbutrin XL is thought to work by influencing the neurotransmitters (brain chemicals) dopamine (DA) and norepinephrine (NE). Of note not only because of its FDA-backed pedigree, Wellbutrin XL may effectively prevent SAD from even starting. On June 14th, 2006, in a special report written for CNN.com entitled “Seasonal Affective Disorder Drug Wellbutrin XL Wins Approval,” the Mayo Clinic declared the results from three large studies, involving more than 1000 patients, showed Wellbutrin XL to be effective in preventing SAD if used before the onset of symptoms.
The most widely used class of antidepressants, selective serotonin reuptake inhibitors (SSRIs) may effectively treat winter depression in SAD patients. As their name suggests, SSRIs produce antidepressant effects by influencing the brain chemical serotonin (5-HTP). No solid evidence exists suggesting one SSRI as better than another, although for certain individuals one SSRI may work better than another. Also used to treat certain anxiety disorders, SSRIs may prove particularly effective for the SAD patient experiencing significant anxiety as well.
Influencing both norepinephrine (NE) and 5-HTP systems, combined serotonin and norepinephrine reuptake inhibitors (SNRIs) may relieve SAD symptoms when Wellbutrin XL or the SSRIs do not. Effexor, a common SNRI approved for the treatment of some anxiety disorders and depression, has proved helpful for some SAD sufferers. Common side effects include activation, sedation, increased blood pressure, sleep disruption and sexual side effects.
Dating back to the 1950s, tricyclic antidepressants (TCAs) were, for years, the only drugs used to treat depression, and remain reliable drugs useful in alleviating SAD symptoms if the newer ones do not work first. Because of their troubling side effects–which include blurred vision, constipation and seizures–most doctors now prescribe TCAs only after other medications have failed to work. Despite these problems, TCAs remain useful drugs for those who find the newer drugs ineffective in providing relief.
About this Author
A former corporate health coach, Charles Yin has counseling experience in obesity management, and chronic mental illness. He graduated magna cum laude with a B.A. in psychology from Carleton College. Yin completed one year of doctoral studies at Azusa Pacific University (APU) and is currently an MFT trainee at APU.