Feeling SAD? Wellbutrin XL may help.
The Food and Drug Administration (FDA) recently approved Wellbutrin XL (bupropion HCL extended-release tablets) for the prevention of major depressive episodes in people with a history of seasonal affective disorder (SAD). Wellbutrin XL is the first drug officially approved for seasonal affective disorder, which is characterized by recurrent bouts of major depression that coincide with the shorter daylight hours of autumn and winter (thus the nickname "winter depression”).
At this time of year, changes in the amount of daily sunlight cause changes in the body’s internal biological clock, known as circadian rhythm. This rhythm is a 24-hour cycle that affects our eating and sleeping patterns, brain wave activity, hormone production, and other biological activities. In some people, less daily sunlight and changes in circadian rhythm can bring about depression. One theory is that the relative lack of sunlight during these times may alter brain levels of certain mood-related chemicals. People with seasonal affective disorder often eat and sleep excessively, crave sugary or starchy foods, and have a full remission of seasonal affective disorder in the spring and summer when more daily sunlight is available.
The efficacy of Wellbutrin XL for the prevention of seasonal affective disorder episodes was demonstrated in three double-blind, placebo-controlled trials -- the gold standard of medical research -- in adults with a history of recurrent major depressive disorder in autumn and winter. Treatment for seasonal affective disorder was started before the onset of symptoms in the autumn (September to November) and was discontinued following a two-week taper starting the first week of spring (fourth week of March). In these trials, the percentage of patients who were depression-free at the end of treatment was significantly higher for those on Wellbutrin XL than for those on placebo. Combining data from all three studies, the overall rate of patients depression-free at the end of treatment was 84% for those on Wellbutrin XL, compared to 72% for those on placebo.
These findings have not surprised psychiatrists and primary care physicians, who have long been using antidepressant drugs off label for treating seasonal affective disorder. But the stamp of approval by the FDA adds credibility to this treatment approach.
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