Seasonal Affective Disorder and Wellbutrin

During this time of year in the Northern Hemisphere, people sometimes complain of feeling down or depressed. For some of them, this may not just be a case of the holiday blues but a real condition called Seasonal Affective Disorder (SAD).
SAD was recognized as a type of depression at the same time that bright light therapy was shown to be an effective treatment for it. Generally, SAD is a mild-to-moderate depression that occurs at the same time of year - starting in the autumn months and persisting until spring. SAD tends to be more common in latitudes further away from the equator.

Although people with SAD usually do not suffer a severe depression, the fact that it occurs for several months each year leads to significant impairment for these individuals. During the winter months they may feel sluggish, lack motivation, and be less productive than other times of the year. Often, they feel that they are unable to get enough sleep and may gain weight each year during the winter.
Even though the precise cause of this pattern of depression is not yet known, some experts have speculated about the relationships between shortened daylight hours and changing levels of melatonin secretion and serotonin activity. However, we still do not know why certain people are more vulnerable to this type of depression.
The use of therapeutic light boxes has become the standard treatment for this pattern of depression. Several different antidepressants also have been shown to help. In 2006, the antidepressant Wellbutrin XL (bupropion hydrochloride extended-release tablets) was approved by the FDA for a new indication: treatment of recurrent major depressive episodes with the SAD pattern.
Three separate clinical trials demonstrated the efficacy of Wellbutrin XL when treatment is started during autumn (September to November in the Northern Hemisphere) and continued until the following March.
While Wellbutrin XL was safe and effective in the SAD studies, side effects that may occur with this medication include agitation, insomnia, and anxiety. And, as with other antidepressants, the FDA-approved label includes a warning about possible increased suicidal thinking in children taking antidepressants.