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General Medicine

Seasonal Affective Disorder

Matthew J. Filippo, DO and Janki Thakkar, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Seasonal affective disorder (SAD) describes mood episodes that occur as a part of major depressive or bipolar disorder in a seasonal pattern. Patients may more commonly experience de...

DIAGNOSIS

Under DSM-5, SAD is denoted by adding the “with seasonal pattern” specifier to a diagnosis of major depressive disorder, bipolar 1 disorder, or bipolar 2 disorder. 

  • Remission of symptoms duri...

TREATMENT

MEDICATION

There is a lack of evidence to determine whether light therapy or medication should be the first-line agent. Both are strongly supported by the literature and may have equal effica...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Regular monitoring for response to treatment; rarely, patients may become manic when treated with SSRIs or light therapy. 

Patient Monitoring

Monitored weekly when ...

REFERENCES

1
Lam  RW, Levitt  AJ, Levitan  RD, et al. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with wint...

SEE ALSO

  • Bipolar I Disorder; Bipolar II Disorder; Depression

  • Algorithm: Depressive Episode, Major

CODES

ICD10

  • F33.9 Major depressive disorder, recurrent, unspecified

  • F33.0 Major depressive disorder, recurrent, mild

  • F33.1 Major depressive disorder, recurrent, moderate

  • F33.2 Major depressv disorder, rec...

CLINICAL PEARLS

  • SAD is a subtype of unipolar and bipolar depression, with seasonal pattern. Once the patient has a diagnosed mood disorder ask whether the symptoms vary in a seasonal pattern to qualif...

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Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as antidepressants. MAO inhibitors enhance the actions of NE and 5-HT by preventing their enzymatic destruction. Tricyclics enhance NE and 5-HT action by blocking uptake. SSRIs act the same way but are selective for serotonin.

 

Antidepressant drugs and the biochemical life cycles of norepinephrine and serotonin. MAO inhibitors, tricyclics, and SSRIs are used as ant...

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