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Second-generation antidepressants for seasonal affective disorder
Kylie Thaler1, Marlene Delivuk, Andrea Chapman
1Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria.
The Cochrane Database of Systematic Reviews
|December 14, 2011
Summary
Second-generation antidepressants (SGAs) show limited efficacy for Seasonal Affective Disorder (SAD), with fluoxetine not proving significantly better than placebo or light therapy. High rates of adverse effects led to study withdrawals, indicating a need for more research.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Seasonal Affective Disorder (SAD) is a recurrent depressive condition with seasonal patterns.
- Second-generation antidepressants (SGAs), light therapy, and psychotherapy are common SAD treatments.
Purpose of the Study:
- To evaluate the efficacy and safety of SGAs for adult SAD treatment.
- Comparisons include placebo, light therapy, other SGAs, and psychotherapy.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies.
- Searched specialized databases (CCDANCTR, Cochrane Library, EMBASE, MEDLINE, PsycINFO) and industry registers.
- Included adult participants meeting DSM criteria for SAD.
Main Results:
- One small trial showed fluoxetine was not significantly more effective than placebo for SAD response.
- Two trials indicated fluoxetine and light therapy were equivalent in treating seasonal depression.
- Adverse effects were reported in 22-100% of SGA recipients, leading to 15-27% withdrawal.
Conclusions:
- Limited evidence exists for SGA effectiveness in SAD, with trials showing non-significant or equivalent results.
- High rates of adverse events and withdrawals necessitate caution.
- Further large-scale RCTs are needed to establish SGA efficacy and safety for SAD.
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