TREATMENT OF SEASONAL AFFECTIVE-DISORDER - A REVIEW

Objective: To review the status of current treatment of seasonal affec tive disorder (SAD). Method: Treatment studies of SAD published betwee n January 1989 and March 1995 were identified using a computerized MED LINE literature search, Additional citations were obtained from the re ference sections of these articles. Studies included in this review we re selected using operational methodologic criteria Results: Many stud ies support the efficacy of bright light therapy using a fluorescent l ight box. The best studied protocol is > 2500 lux white light for 2 ho urs per day, but newer protocols using 10,000 lux for 30 minutes have comparable response rates. Studies of light visors and other head-moun ted devices also report similar response rates, but have not yet shown superiority over putative control conditions. There are fewer medicat ion studies in SAD, but controlled studies suggest that fluoxetine, d- fenfluramine and propranolol are effective. Other treatments such as d awn simulation require further study. No studies of psychological trea tments for SAD were found. Many studies had methodologic limitations, including brief treatment periods, small sample sizes, and lack of rep lication, that limit the generalizability of findings. Conclusion: The re are several well-studied, effective treatments for SAD, including l ight therapy and medications. However, further research must be done t o demonstrate sustained treatment response over time, to clarify the i ntensity-response relationship of light therapy, to clarify the role o f light therapy and medications, and to assess combination treatments.