Antidepressant medications for the treatment of seasonal affective disorder (SAD)

Antidepressant medications effectively treat episodes of depression in people with seasonal affective disorder (SAD). They can be used along with light therapy or alone. The most common antidepressants used to treat people with seasonal affective disorder include the following:¹

Selective serotonin reuptake inhibitors (SSRIs)

• Citalopram (Celexa)
• Fluoxetine (such as Prozac)
• Sertraline (Zoloft)

Other antidepressants

• Bupropion (Wellbutrin, Wellbutrin XL, or Zyban)
• Desipramine (Norpramin or Pertofrane)
• Venlafaxine (Effexor)

SSRIs usually are the first type of medication given to treat SAD. SSRIs often have less serious side effects that are more easily tolerated. You may start to feel better within 1 to 3 weeks of taking an SSRI. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor. All antidepressant medications are started at low doses and increased gradually. When stopped, they should be decreased gradually to avoid side effects. General side effects of antidepressant medications can include:

• Nausea, loss of appetite, or diarrhea.
• Anxiety or nervousness.
• Difficulty sleeping or drowsiness.
• Loss of sexual desire or ability.
• Headaches.

Bupropion can cause dry mouth. Bupropion should not be taken if you have seizures, severe problems with eating, or an eating disorder because it can cause seizures.

For more information, see the topic Depression or see Drug Reference. (Drug Reference is not available in all systems.)

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• A warning on the antidepressants Paxil and Paxil CR (paroxetine) and birth defects. One new study showed that women who took Paxil during their first 12 weeks of pregnancy had a slightly higher chance of having a baby with birth defects.
• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.

Citations

1. Lam RW, Levitt AJ (1999). Canadian Consensus Guidelines for the Treatment of Seasonal Affective Disorder: A Summary of the Report of the Canadian Consensus Group on SAD. Vancouver, BC: Clinical and Academic Publishers. Also available online: http://www.psychdirect.com/depression/d-treatmentguidelinesSAD.htm.