Patients who have severe symptoms of SAD may benefit from antidepressant medications used in treating clinical depression. In general, doctors prescribe antidepressants for SAD treatment only after non-invasive treatments like lifestyle changes, psychotherapy and light therapy have failed.
Types of Antidepressants for SAD
Winter-onset SAD is seasonal affective disorder triggered during the fall and winter months. Light therapy, also called phototherapy, is usually the first choice in treating winter-onset SAD. Although studies show that light therapy is effective in treating over 80 percent of SAD patients, symptoms of seasonal affective disorder persist in some patients even after light therapy.
Those who don’t respond to light therapy may be candidates for antidepressants. SAD that occurs from March through August, known as summer SAD, may also be treated with antidepressant medication.
Antidepressants are considered viable SAD treatment for patients who have:
- A history of depressive disorders unrelated to SAD
- Significant regression in work and social environments
- Success with prior use of antidepressants
- Pre-existing suicidal tendencies.
How Antidepressants Work
Antidepressants affect neurotransmitters such as epinephrine, dopamine and norepinephrine. These chemicals reside in the brain, and control many natural bodily functions including sleep, appetite and emotions.
MAOIs (monoamine oxidase inhibitors) and tricyclics were the first two groups of antidepressants to hit the market. While these early types of antidepressants have proven effective at elevating mood, they can also destroy the brain’s receptors over time.
By the 1980s, researchers focused on serotonin as the primary neurotransmitter that affects mood, and a new class of antidepressants, known as selective-serotonin reuptake inhibitors (SSRIs), became depression treatments, including SAD treatment.
This family of drugs appeared to be more effective and have fewer associated side effects than the earlier tricyclics and MAOIs. The next wave of antidepressant medication included selective-serotonin and norepinephrine reuptake inhibitors (SSNRIs) that also affected both serotonin and norepinephrine neurotransmitters.
Because all antidepressants affect one or more neurotransmitters, they may cause reverse effects over time, including decreased serotonin levels. Consequently, many individuals undergoing SAD treatment must switch to a different class of drugs to maintain the same level of benefits.
Another complication in treating seasonal depression with antidepressants is that they start working only after several weeks have gone by. Some doctors recommend that patients begin taking antidepressants before their symptoms even develop.
Your physician may recommend continuing treatment beyond the time that symptoms disappear, and wean you off the medication gradually. You may have to try several medications to find one that works for you.
Side Effects of Antidepressants
As with any medication, antidepressant have some associated side effects, including:
- Daytime drowsiness
- Dry mouth
- Panic attacks
- Sexual dysfunction
- Suicidal tendencies.
Mild side effects often dissipate within a few days. If you experience serious side effects, you doctor may switch to a different medication or take you off antidepressant medication entirely and explore other treatment options.
Proponents of homeopathic remedies suggest using natural herbs and amino acids as antidepressants for treating seasonal depression, including:
- 5-HTP (5-hydroxytriptophan)
- Sam-E (S-adenosyl-L-methionine)
- St. John’s Wort extract.
Over-the-counter forms of these products aren’t necessarily regulated by the FDA, nor specifically approved for SAD treatment. Talk to your doctor and study labels carefully before starting an herbal regimen.
Medical News Today. (2005). SAD patients who take antidepressants in autumn can prevent winter depression. Retrieved July 19, 2010 from http://www.medicalnewstoday.com/articles/33309.php.
Pick, M. (2007). Antidepressants and alternative treatments for depression. Retrieved July 19, 2010, from http://www.womentowomen.com/depressionanxietyandmood/antidepressants.aspx.
Rousseau, H. (2006). New treatments offer ray of hope for SAD sufferers. Retrieved July 19, 2010, from http://www.patient.co.uk/showdoc/23068678/.