Hypericum in the Treatment of Seasonal Affective Disorders

Seasonal affective disorder (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn/winter and full remission in spring/summer. Light therapy (LT) has become the standard treatment of this type of depression. Apart from this, pharmacotherapy with antidepressants also seems to provide an improvement of SAD symptoms. The aim of this controlled, single-blind study was to evaluate if hypericum, a plant extract, could be beneficial in treating SAD patients and whether the combination with LT would be additionally advantageous. Patients who fulfilled DSM-III-R criteria for major depression with seasonal pattern were randomized in a 4-week treatment study with 900 mg of hypericum per day combined with either bright (3000 lux, n = 10) or dim (< 300 lux, n = 10) light condition. Light therapy was applied for 2 hours daily. We found a significant (MANOVA, P < .001) reduction of the Hamilton Depression Scale score in both groups but no significant difference between the two groups. Our data suggest that pharmacologic treatment with hypericum may be an efficient therapy in patients with seasonal affective disorder.

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Light therapy for seasonal affective disorder in primary care

The British Journal of Psychiatry ◽

10.1192/bjp.178.4.311 ◽

2001 ◽

Vol 178 (4) ◽

pp. 311-316 ◽

Cited By ~ 33

Author(s):

Samantha M. Wileman ◽

John M. Eagles ◽

Jane E. Andrew ◽

Fiona L. Howie ◽

Isobel M. Cameron ◽

...

Keyword(s):

Primary Care ◽

Affective Disorder ◽

White Light ◽

Seasonal Affective Disorder ◽

Red Light ◽

Depression Scale ◽

Light Therapy ◽

Structured Interview ◽

Hamilton Depression Scale ◽

Treatment Expectations

BackgroundStudies of light therapy have not been conducted previously in primary care.AimsTo evaluate light therapy in primary care.MethodFifty-seven participants with seasonal affective disorder were randomly allocated to 4 weeks of bright white or dim red light. Baseline expectations for treatment were assessed. Outcome was assessed with the Structured Interview Guide for the Hamilton Depression Scale, Seasonal Affective Disorder Version.ResultsBoth groups showed decreases in symptom scores of more than 40%. There were no differences in proportions of responders in either group, regardless of the remission criteria applied, with around 60% (74% white light, 57% red light) meeting broad criteria for response and 31% (30% white light, 33% red light) meeting strict criteria. There were no differences in treatment expectations.ConclusionsPrimary care patients with seasonal affective disorder improve after light therapy, but bright white light is not associated with greater improvements.

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Effects of fluoxetine versus bright light in the treatment of seasonal affective disorder

Psychological Medicine ◽

10.1017/s0033291798006813 ◽

1998 ◽

Vol 28 (4) ◽

pp. 923-933 ◽

Cited By ~ 45

Author(s):

S. RUHRMANN ◽

S. KASPER ◽

B. HAWELLEK ◽

B. MARTINEZ ◽

G. HÖFLICH ◽

...

Keyword(s):

Affective Disorder ◽

Phase Ii ◽

Seasonal Affective Disorder ◽

Remission Rate ◽

Depression Scale ◽

Light Condition ◽

Bright Light ◽

Antidepressant Effect ◽

Hamilton Depression Scale ◽

Light Group

Background. Disturbances of serotonergic neurotransmission appear to be particularly important for the pathophysiology of winter depression. This study investigated whether fluoxetine has antidepressant effects comparable to bright light in the treatment of seasonal affective disorder (winter type).Method. A randomized, parallel design was used with rater and patients blind to treatment conditions. One week of placebo (phase I) was followed by 5 weeks of treatment (phase II) with fluoxetine (20 mg per day) and a placebo light condition versus bright light (3000 lux, 2 h per day) and a placebo drug. There were 40 patients (20 in each treatment condition) suffering from seasonal affective disorder (SAD) according to DSM-III-R who had a total score on the Hamilton Depression Scale of at least 16.Results. Forty patients entered phase II and 35 completed it (one drop-out in the fluoxetine group and four in the bright light group). Fourteen (70%) of the patients treated with bright light and 13 (65%) of those treated with fluoxetine were responders (NS). The remission rate in the bright light group tended to be superior (bright light 50%, fluoxetine 25%; P=0·10). Light therapy improved HDRS scores significantly faster, while fluoxetine had a faster effect on atypical symptoms. Light treatment in the morning produced a significantly faster onset of improvement, but at the end of treatment the time of light application seemed not to be crucial.Conclusion. Both treatments produced a good antidepressant effect and were well tolerated. An apparently better response to bright light requires confirmation in a larger sample.

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Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches

Depression Research and Treatment ◽

10.1155/2015/178564 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 26

Author(s):

Sherri Melrose

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Seasonal Pattern ◽

Light Therapy ◽

Early Summer ◽

Major Depressive ◽

Assessment And Treatment ◽

Typical Treatment ◽

Recurrent Major Depressive Disorder ◽

Assessment Questionnaire

Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as “winter blues.” Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

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Mood Worsening on Days with High Pollen Counts is associated with a Summer Pattern of Seasonality

Pteridines ◽

10.1515/pteridines-2019-0016 ◽

2019 ◽

Vol 30 (1) ◽

pp. 133-141 ◽

Cited By ~ 2

Author(s):

Faisal Akram ◽

Tyler B. Jennings ◽

John W. Stiller ◽

Christopher A. Lowry ◽

Teodor T. Postolache

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Airborne Pollen ◽

Seasonal Pattern ◽

High Pollen ◽

Pollen Counts ◽

Bonferroni Adjustment ◽

Significant Difference ◽

And Gender ◽

Post Hoc

Abstract Background: Summer/spring-type seasonal affective disorder (S-SAD) is the less common subtype of seasonal affective disorder and evidence regarding potential triggers of S-SAD is scarce. Recent reports support association of airborne-pollen with seasonal exacerbation of depression (mood seasonality) and timing of suicidal behavior. Therefore, we hypothesized that Old Order Amish (OOA) with summer/spring pattern of seasonality (abbreviated as summer pattern) and S-SAD will have significant mood worsening on high pollen days. Methods: A seasonal pattern of mood worsening and SAD parameters were estimated using Seasonal Pattern Assessment Questionnaire (SPAQ). Age- and gender-adjusted ANCOVAs and post hoc analyses were conducted to compare mood worsening on days with high pollen counts between summer-pattern vs no-summer-pattern of mood worsening, S-SAD vs no-S-SAD, winter-pattern vs no-winter-pattern of mood worsening, and W-SAD vs no-W-SAD groups. Results: The prevalence of S-SAD was 0.4%, while 4.5% of individuals had a summer pattern of mood seasonality. A statistically significant difference for mood worsening on high pollen days was observed between summer-pattern vs no-summer-pattern of mood worsening (p = 0.006). The significant association between S-SAD vs no-SAD groups (p = 0.032) for mood worsening on high pollen days did not withstand Bonferroni adjustment for multiple comparisons. No significant association was found for winter-pattern vs no-winter-pattern of mood worsening (p = 0.61) and for W-SAD vs no-W-SAD (p = 0.19) groups. Conclusion: Our results are consistent with previous studies implicating links between aeroallergen exposure and summer pattern of seasonality, but not the winter pattern of seasonality.

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Bright light therapy for symptoms of anxiety and depression in focal epilepsy: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.122119 ◽

2013 ◽

Vol 202 (5) ◽

pp. 352-356 ◽

Cited By ~ 14

Author(s):

Sallie Baxendale ◽

John O'Sullivan ◽

Dominic Heaney

Keyword(s):

Effective Treatment ◽

Affective Disorder ◽

Seasonal Affective Disorder ◽

Focal Epilepsy ◽

Depression Scale ◽

Bright Light ◽

Light Therapy ◽

Anxiety And Depression ◽

Bright Light Therapy ◽

Low Intensity

BackgroundBright light therapy is an effective treatment for seasonal affective disorder and non-seasonal depression. Depression and anxiety are common psychiatric comorbidities in epilepsy.AimsTo examine the efficacy of bright light therapy for symptoms of anxiety and depression in adults with focal epilepsy (trial registration at ClinicalTrials.gov: NCT01028456).MethodWe recruited 101 adults with medically intractable focal epilepsy. Participants completed the Hospital Anxiety and Depression Scale (HADS) at the beginning (T1) and end of a 12-week baseline period (T2) and again after 12 weeks of daily light therapy (T3), with 51 participants using a high-intensity light box and 50 using a low-intensity one. Seizure diaries were kept throughout the baseline and trial period.ResultsA total of 58 patients completed the trial. Anxiety and depression scores were significantly reduced following the light therapy at T3in both the high- and low-intensity groups.ConclusionsLight therapy resulted in a significant reduction in symptoms of anxiety and depression but we did not find any differences between high- v. low-intensity treatment This may, therefore, be an effective treatment for symptoms of low mood in epilepsy at lower intensities than those typically used to treat seasonal affective disorder. Further work is needed to investigate this possibility with an adequate placebo condition.

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Seasonal affective disorder (SAD) and light therapy: State of the science

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.713 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S528-S528

Author(s):

C. Glod

Keyword(s):

Affective Disorder ◽

White Light ◽

Seasonal Affective Disorder ◽

Ganglion Cells ◽

Light Emitting Diode ◽

Seasonal Pattern ◽

Clinical Effectiveness ◽

Light Therapy ◽

Light Sources ◽

State Of The Science

Major depression with a fall/winter seasonal pattern, also known as seasonal affective disorder (SAD), is a recurrent and prevalent disorder. Treatment may include either pharmacological (antidepressant) or non-pharmacological options, most commonly light therapy. Over the years, light therapy has been explored using various delivery methods including light-emitting diode (LED) devices. For over 20 years, cool-white fluorescent sources that yield 10,000 lux of polychromatic white light have been the standard treatment for SAD. Many investigations have confirmed the clinical effectiveness of white light, its overall tolerability, and adverse reactions, such as agitation, insomnia, and headache. Building upon this, more recent studies have compared alternative light sources and different wavelengths of light, such as white, red, green, and blue. If certain wavelengths are more potent and effective, lower intensities of light could reduce side effects and increase tolerability and adherence. Furthermore, studies of the ocular system particularly, intrinsically photosensitive retinal ganglion cells, discovered differences among specific wavelengths of light. While some reports have suggested that 446–477 nm wavelengths of blue light may be the most potent, published clinical trials have revealed mixed results. The purpose of this session is to review the state of the science on light therapy in the treatment of SAD, and suggest recommendations for clinical practice and implications for patients.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

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