oa SA Pharmaceutical Journal - Seasonal affective disorder : do people hibernate? : review
Seasonal affective disorder (SAD) is a subtype of major depressive disorder or bipolar disorder, where depressive symptoms develop commonly during the autumn and winter months and then resolve during the spring or summer. Patients exhibit neurovegetative signs of depression such as hypersomnia, hyperphagia and psychomotor retardation, reminiscent of winter hibernatory behaviour seen in some animals. Investigations into the pathophysiology of this disorder indicate that a complex interplay of genetic and environmental phenomena predicate a subtle imbalance in chronobiology in these patients, with depression being influenced by the photoperiod, circadian phase-shifting and neurotransmitter abnormalities. While clinical trials have shown equal efficacy between antidepressant drugs and light therapy in the treatment of SAD, other non-pharmacological management options such as negative air ions, psychotherapy and exercise are being investigated. With its stimulatory effects on melatonin receptors, the antidepressant agomelatine is a new therapeutic option.
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