title: Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL.
abstract: BACKGROUND
  Seasonal affective disorder (SAD) can cause significant distress and impairment. No antidepressant studies have previously attempted to prevent the onset of autumn-winter depression.
  
  
  METHODS
  Three prospective, randomized, placebo-controlled prevention trials were conducted on 1042 SAD patients, enrolled in autumn and treated while still well, across the northern US and Canada. Patients received either bupropion XL 150-300 mg or placebo daily by mouth from enrollment until spring and were then followed off medications for 8 additional weeks. Primary efficacy variables were end-of-treatment depression-free rates and survival distributions of depressive recurrence.
  
  
  RESULTS
  Despite a reported average of 13 previous seasonal depressive episodes, almost 60% of patients had never previously been treated for depression. Major depression recurrence rates during the three studies for bupropion XL and placebo groups were 19% versus 30% (p = 0.026), 13% versus 21% (p = 0.049), and 16% versus 31%; yielding a relative risk reduction across the three studies of 44% for patients taking bupropion XL. Survival analyses for depression onset also favored bupropion XL over placebo (p = .081, .057, and <.001).
  
  
  CONCLUSIONS
  It is possible to prevent recurrence of seasonal major depressive episodes by beginning bupropion treatment early in the season while patients are still well.
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina, USA.
authors.forename: Jack G
authors.initials: JG
authors.lastname: Modell
authors.forename: Norman E
authors.initials: NE
authors.lastname: Rosenthal
authors.forename: April E
authors.initials: AE
authors.lastname: Harriett
authors.forename: Alok
authors.initials: A
authors.lastname: Krishen
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Asgharian
authors.forename: Vicki J
authors.initials: VJ
authors.lastname: Foster
authors.forename: Alan
authors.initials: A
authors.lastname: Metz
authors.forename: Carol B
authors.initials: CB
authors.lastname: Rockett
authors.forename: Donna S
authors.initials: DS
authors.lastname: Wightman
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D016642:Bupropion / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016574:Seasonal Affective Disorder / Q000517:prevention & control*; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion