Seasonal affective disorder

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Secondary prevention

Given the relative predictability of seasonal changes and risk for seasonal affective disorder (SAD) symptom onset, the risks and benefits of prophylactic treatments across time should be discussed with the patient.[54] Prophylactic measures can be taken in the months before the seasonal mood pattern, and include:[15][54]

Bright-light therapy
Bupropion (extended-release) [ ]
Ongoing antidepressant therapy
Moving to a more southerly latitude.

Outcome trials are very limited, but do show some support for using bright light therapy to prevent relapsing symptoms.[86] Bupropion (extended-release) is the only approved drug for prevention of SAD in some countries.[6][85] Treatment begins in early autumn and should be continued through winter.[85] Bupropion is unstudied as an acute treatment for mid-episode seasonal depression. Bupropion is not recommended for patients with a history of bipolar disorder. Initiation of antidepressant pharmacotherapy after successful treatment of seasonal depression may also be helpful in preventing relapse.[76] Cognitive behavioural therapy may also help prevent the recurrence of seasonal depression.[101]

Use of this content is subject to our disclaimer