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Seasonal Affective Disorder
For winter SAD, the most effective treatment is bright light
therapy.
Verla Chatsis, BScPharm, Drug Information Pharmacist,
Regional Drug Information Centre, University of Alberta Hospital
Seasonal affective disorder is a form of depression that is
associated with a particular season. In northern countries like
Canada, the depression generally starts in the fall or winter,
and ends in spring or summer. Signs and symptoms of SAD include
a lack of energy, sadness, anxiety, irritability, a lowered sex
drive, overeating, weight gain, and cravings for sugars and starchy
foods. People with SAD are relatively inactive and withdraw from
normal social activities. They have trouble sleeping, which makes
them want to sleep longer.
To be diagnosed with SAD, a person must be depressed during
a specific season over at least two years. The depression is
not considered to be SAD if it caused by sources of stress which
occur at the same time annually such as seasonal unemployment
or going back to school. SAD mostly affects adults and usually
starts from ages 20 to 30. Men are more likely to experience
a more severe form of SAD than women.
The cause(s) of SAD are not fully understood. Shorter days associated
with winter may trigger SAD by disturbing normal body rhythms.
Changes in rhythm affect the levels of substances in the body
like melatonin and serotonin, which may cause the depression.
For winter SAD, the most effective treatment is bright light
therapy. The light must have a brightness of at least 2500 lux
(the average home is around 100 lux). Patients receive light
treatment for 1 – 2 hours daily. Patients usually start
to improve after one to two weeks of treatment. If the light
therapy works, the treatment is continued throughout the winter
season at least 5 times per week. Although most people tolerate
light therapy well, they may have some side effects like eyestrain,
headache, and hypomania (persistent elevated mood, hyperactivity,
inflated self esteem).
Antidepressant medications may be used in patients that don’t
respond to light therapy. These drugs are helpful in those who
are severely depressed. Other treatments including negative ion
treatments, dawn therapy (which mimics dawn by raising light
levels in the morning), and aerobic exercise with sleep deprivation
have been tried in SAD but they are not as effective as light
therapy. You may find more information about SAD at www.nosad.org,
or at http://familydoctor.org/267.xml.
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The information in this newsletter was prepared and reviewed
by pharmacists for the Canadian Pharmaceutical Journal.
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Ask Your Pharmacist newsletter is produced through
an unconditional educational grant from APOTEX/PACE. |
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