Seasonal effective disorde

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). 

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-... 

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... 

Meesters Y, Jansen JHC, Bursma DGM, et al. Light therapy for seasonal affective disorder the effects of timing. Br J Psychiatry 1995 166 607-612. 

Melatonin has been used to regulate the sleep-wake cycle and is used often to treat insomnia. It is not recommended during pregnancy and breast-feeding becanse of a lack of information abont its safety. Lower doses of melatonin (e.g., 0.1-1 mg at bedtime) are effective in initiating sleep higher doses may not improve the hypnotic effect. The rednction in daytime snnUght, which increases melatonin secretion, may exacerbate PMS in the winter this type of seasonal mood disorder may respond to phototherapy. Early sleep deprivation also may help to correct circadian rhythm disturbances in PMDD. ... 

Lam, R. W., Zis, A. R, Grewal, A., Delgado, P L., Charney, D. S., and Krystal, J. H., Effects of rapid tryptophan depletion in patients with seasonal affective disorder in remission after light therapy, Arch. Gen. Psychiatr., 53, 41, 1996. 

Neumeister, A., Praschak-Rieder, N., Besselmann, B., Rao, M. L., Gluck, J., and Kasper, S., Effects of tryptophan depletion on drug-free patients with seasonal affective disorder during a stable response to bright light therapy, Arch. Gen. Psychiatr., 54, 133, 1997. 

Neumeister A. Neurotransmitter depletion and seasonal affective disorder relevance for the biologic effects of light therapy. Primary Psychiatry 2004 11 44-48. 

Rudorfer MV, Skwerer RG, Rosenthal NE et al. Biogenic amines in seasonal affective disorder effects of light therapy. Psychiatry Res 1993 46 19-28. 

Eat regularly. Never skip breakfast. Try to eat something every four to five hours that you are awake. Have a small midmoming and midafternoon snack, and try a pure complex-carbohydrate snack at bedtime. By the way, there is some evidence to suggest that people with seasonal af fective disorder may find light therapy more effective if they eat a midaftemoon carbo-rich snack. (For more on seasonal affective disorder, see Chapter 6.)... 

L-tryptophanS4o S4p S4q as effective as imiprimine and amitriptylene in treatment of unipolar depression fewer side-effects than tri-cyclic drugs more effective than light therapy for treatment of Seasonal Affective Disorder (SAD) patients with normal or high urinary MHPG levels more likely to respond... 

Denoble VJ, Schrack LM, Reigel AL, et al Visual recognition in squirrel monkeys effects of serotonin antagonists on baseline and hypoxia induced performance deficits. Pharmacol Biochem Behav 39 991-996, 1991 Depue RA, Karuss SP, Spoont MR A two-dimensional threshold model of seasonal bipolar affective disorder, in Psychopathology An Interactional Perspective. Edited by Magnusson D, Ohman A. Orlando, FL, Academic Press, 1987, pp 95-123... 

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