Seasonable affective disorder

Melatonin [73-31-4] C 2H N202 (31) has marked effects on circadian rhythm (11). Novel ligands for melatonin receptors such as (32) (12), C2yH2gN202, have affinities in the range of 10 Af, and have potential use as therapeutic agents in the treatment of the sleep disorders associated with jet lag. Such agents may also be usehil in the treatment of seasonal affective disorder (SAD), the depression associated with the winter months. Histamine (see Histamine and histamine antagonists), adenosine (see Nucleic acids), and neuropeptides such as corticotropin-like intermediate lobe peptide (CLIP) and vasoactive intestinal polypeptide (VIP) have also been reported to have sedative—hypnotic activities (7). 

PTA Prior to admission percutaneous transluminal SAD Seasonal affective disorder... 

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. 

Disturbances of sleep are typical of mood disorders, and belong to the core symptoms of major depression. More than 90% of depressed patients complain of impaired sleep quality [60], Typically, patients suffer from difficulties in falling asleep, frequent nocturnal awakenings, and early morning awakening. Not only is insomnia a typical symptom of depression but, studies suggest, conversely, insomnia may be an independent risk factor for depression. In bipolar disorders sleep loss may also be a risk factor for the development of mania. Hypersomnia is less typical for depression [61] and, in contrast to insomnia, may be related to certain subtypes of depression, such as seasonal affective disorder (SAD). 

Bright light therapy (i.e., the patient looking into a 10,000-lux intensity light box for about 30 min/day) may be used for patients with seasonal affective disorder and as adjunctive use for major depression. 

After more than a decade of use, bupropion (24) is considered a safe and effective antidepressant, suitable for use as first-line treatment. In addition, it is approved for smoking cessation and seasonal affective disorder. It is also prescribed off-label to treat the sexual dysfunction induced by SSRIs. Bupropion is often referred to as an atypical antidepressant and has much lower affinity for the monoamine transporters compared with other monoamine reuptake inhibitors. The mechanism of action of bupropion is still uncertain but may be related to inhibition of dopamine and norepinephrine reuptake transporters as a result of active metabolites [71,72]. In a recently reported clinical trial, bupropion extended release (XL) had a sexual tolerability profile significantly better than that of escitalopram with similar re-... 

I work out every day now and, if I can get in a walk, too, I ll do that. That saved me last winter from seasonal affective disorder. I get affected by the weather and by hormones. Pm pretty good at identifying it now, and I can shake myself out of it. I know it s really good for me to be social when it happens. I ll call a friend and say, Pet s go to Buddha class —that s a meditation class. 

Kasper S. (1997). Treatment of seasonal affective disorder (SAD) with hypericum extract. Pharmacopsychiatry. 30(suppl 2) 89-93. 

Levitan, R. D., Masellis, M., Basile, V. S., et al. (2002) Polymorphism of the serotonin-2A receptor gene (HTR2A) associated with childhood attention deficit hyperactivity disorder (ADHD) in adult women with seasonal affective disorder. J. Ajfect. Disord. 71, 229-233. 

Uniabeied Uses Treatment of attention-deficit/hyperactivity disorder, brain injury-re-lafed underarousal, depression, endozepine stupor, multiple sclerosis-related fatigue, parkinson-related fatigue, seasonal affective disorder... 

Han, L., Nielson, D.A., Rosenthal, N.E., Jefferson, K., Kaye, W., Murphy, D., Altemus, M., Humphries, J., Casssano, G., Rotondo, A., Virkkhunen, M., Linnoila, M., and Goldman, D. (1999) No coding variant of the tryptophan hydroxylase gene detected in seasonal affective disorder, obsessive-compulsive disorder, anorexia nervosa, and alcoholism. Biol Psychiatry 45 615-619. 

Bove, 1998, Walter et al., 2000). People using St. John s wort should take extra care if they go out in the sunshine and avoid sun bathing. This can be difficult for children and adolescents. Furthermore, concerns have been raised that St. John s wort and bright light may lead to the development of cataracts (Schey et ah, 2000). In this context, the combination of St. John s wort and light-box therapy in patients with seasonal affective disorder could be hazardous. 

Kupfer 1987 Soldatos et al. 1987). However, despite these intergroup differences, a subgroup of depressed patients may actually sleep more than the control subjects (Garvey et al. 1984 Kupfer 1984 Michaelis and Hofmann 1973) this subgroup includes mainly patients with seasonal affective disorder (Rosenthal et al. 1984) and those with anergic depression of the bipolar type (Detre et al. 1972 Kupfer et al. 1972). 

Depue RA, Arbisi P, Spoont MR, et al Dopamine functioning in the behavioural facilitation system and seasonal variation in behaviour normal populations and clinical studies, in Seasonal Affective Disorders and Phototherapy. Edited by Rosenthal NE, Blehar MC. New York, Guilford, 1989, pp 230-259 Derkach V, Surprenant A, North RA 5-E1T3 receptors are membrane ion channels. Nature 339 706-709, 1989... 

Oppenheim G Estrogen in the treatment of depression neuropharmacological mechanisms. Arch Gen Psychiatry 43 569-573, 1986 Oren DA, Moul DE, Schwartz PJ, et al A controlled trial of levodopa plus carbidopa in the treatment of winter seasonal affective disorders a test of the dopamine hypothesis. J Chn Psychopharmacol 14 196-200, 1994 Ormandy G, Jope RS Analysis of the convulsant-potentiating effects of lithium in rats. Exp Neurol 111 356-361, 1991... 

Blehar MC, Rosenthal NE. Seasonal affective disorders and phototherapy report of a National Institute of Mental Health-Sponsored Workshop. Arch Gen Psychiatry 1989 46 469-474. 

Eagles JM, Wileman SM, Cameron IM, et al. Seasonal affective disorder among primary care attenders and a community sample in Aberdeen. Br J Psychiatry 1999 175 472-475. 

Magnusson A. An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 2000 101 176-184. 

Schwartz PJ, Brown C, WehrTA, et al. Winter seasonal affective disorder a follow-up study of the first 59 patients of the National Institute of Mental Health Seasonal Studies Program. AmJ Psychiatry 1996 153 1028-1036. 

Rosenthal NE, WehrTA. Seasonal affective disorders. Psychiatr Ann 1987 17 670-674. 

Rosenthal NE, Sack DA, Gillin JC, et al. Seasonal affective disorder a description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry 1984 41 72-80. 

Postolache TT, Hardin TA, Myers FS, et al. Greater improvement in summer than with light treatment in winter in patients with seasonal affective disorder. Am J Psychiatry 1998 155 1614-1616. 

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