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Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL.

AbstractBACKGROUND:
Seasonal affective disorder (SAD) can cause significant distress and impairment. No antidepressant studies have previously attempted to prevent the onset of autumn-winter depression.
METHODS:
Three prospective, randomized, placebo-controlled prevention trials were conducted on 1042 SAD patients, enrolled in autumn and treated while still well, across the northern US and Canada. Patients received either bupropion XL 150-300 mg or placebo daily by mouth from enrollment until spring and were then followed off medications for 8 additional weeks. Primary efficacy variables were end-of-treatment depression-free rates and survival distributions of depressive recurrence.
RESULTS:
Despite a reported average of 13 previous seasonal depressive episodes, almost 60% of patients had never previously been treated for depression. Major depression recurrence rates during the three studies for bupropion XL and placebo groups were 19% versus 30% (p = 0.026), 13% versus 21% (p = 0.049), and 16% versus 31%; yielding a relative risk reduction across the three studies of 44% for patients taking bupropion XL. Survival analyses for depression onset also favored bupropion XL over placebo (p = .081, .057, and <.001).
CONCLUSIONS:
It is possible to prevent recurrence of seasonal major depressive episodes by beginning bupropion treatment early in the season while patients are still well.
AuthorsJack G Modell, Norman E Rosenthal, April E Harriett, Alok Krishen, Afsaneh Asgharian, Vicki J Foster, Alan Metz, Carol B Rockett, Donna S Wightman
JournalBiological psychiatry (Biol Psychiatry) Vol. 58 Issue 8 Pg. 658-67 (Oct 15 2005) ISSN: 0006-3223 [Print] United States
PMID16271314 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antidepressive Agents, Second-Generation
  • Bupropion
Topics
  • Adult
  • Antidepressive Agents, Second-Generation (therapeutic use)
  • Body Weight (drug effects)
  • Bupropion (therapeutic use)
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Seasonal Affective Disorder (prevention & control)
  • Secondary Prevention
  • Time Factors
  • Treatment Outcome

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