Seasonal Affective Disorder

Christopher White, MD, JD, MHA Reviewed 06/2019

BASICS

DESCRIPTION

Seasonal affective disorder (SAD) is a heterogeneous mood disorder with depressive episodes usually occurring in winter months, with full remissions in the spring and summer.
Ranges f...

DIAGNOSIS

Carefully document the presence or absence of prior manic episodes.
Screen for the existence of any suicidal ideation and safety risk factors.
Remission of symptoms during spring and summer
Sym...

TREATMENT

MEDICATION

Lack of evidence to determine whether light therapy or medication should be the first-line agent. Both supported by the literature and in some studies have equal efficacy. Medicati...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Regular monitoring by PCP or psychiatrist for response to treatment; patients may become manic when treated with SSRIs or light therapy.

Patient Monitoring

Patient...

REFERENCES

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 winter seasonal affective disor...

ADDITIONAL READING

Cools O, Hebbrecht K, Coppens V, et al. Pharmacotherapy and nutritional supplements for seasonal affective disorders: a systematic review. Expert Opin Pharmacother. 2018;19(11...

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 major depressive disorder. Once the patient has a diagnosed mood disorder, such as depression or bipolar, ask whether the symptoms vary in a seasonal pattern to qua...

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