New Treatments Offer Ray of Hope for SAD Sufferers

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New Treatments Offer Ray of Hope for SAD Sufferers

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When it comes to exercise and mood, the experts agree. An outdoor morning walk is one of the best strategies people can use to offset the gloomy feelings that accompany SAD.

Here's the science behind it: When your bare skin is exposed to sunshine's ultraviolet light, it makes a chemical called cholecalciferol that the body changes into vitamin D.

Sunlight exposure also helps regulate your production of two hormones, serotonin and melatonin, which play a role in wakefulness and mood.

A fair-skinned person can reach daily vitamin D needs by exposure to as little as 45 minutes a week of sunshine; a person with dark skin may need up to three hours of exposure to get the same benefit.

Can't walk outside? A single bout of exercise, like 30 minutes on a treadmill, helps lift the moods of people with depression, studies show. But you'll miss the chance to get vitamin D outdoors from exposure to UV sunlight. That's why sitting indoors next to a window does not benefit you the same way an outdoor walk does.

Dr. Alan Rosenbaum, a Farmington Hills, Mich., psychiatrist who specializes in the drugs and supplements used to treat mental illness, including SAD, routinely gives his patients a blood test for vitamin D levels because so many are deficient. The hormone is key to a number of critical body systems, including bone formation and strength.

"Over 50 percent of people are vitamin D deficient because they don't get enough sunlight," Rosenbaum says. A person's vitamin D level should be at least 30 nanograms per milliliter, "but we have people coming in with vitamin D levels in the single digits," he says.

If you don't get vitamin D outdoors, you can get it in food or supplements. But be careful, because too much can be harmful to your bones.

Food sources of vitamin D are found in salmon, fortified milk and fortified cereal.

The Institute of Medicine's Food and Nutrition Board has set these daily requirements for vitamin D: 200 international units (IU) daily, ages 19-50; 400 IU, ages 51-70; 600 IU, 70 and older.

The fields of psychiatry and cardiology are looking at fish and fish oil supplements as ways to offset depression and heart disease. The answers aren't in yet, but doctors who recommend the supplements say evidence is building that they work to protect your heart and improve your mood.

"Fish oil is good for many reasons including cardiovascular and cognitive preventive measures," says Dr. Alireza Amirsadri, a Wayne State University School of Medicine psychiatrist who studies SAD. "It is a mood modulator and reduces anxiety and depression or even manic symptoms."

Fish and fish oil supplements contain omega-3 fatty acids, substances that help nerve cells in the brain communicate with each other. They are derived from the oil of cold-water fish, such as mackerel, salmon, sardines, anchovies, and tuna, or as extracted oils from plants, such as flaxseed, canola (rapeseed) or soybean.

The federal Food and Drug Administration suggests a daily omega-3 fatty acid intake of 3 grams or less, and no more than 2 grams should be from supplements.

Taking excessive amounts of omega-3 fatty acids can cause bleeding, stomach pain, anemia or stroke. Also, avoid taking fish oil supplements with aspirin or ibuprofen and anti-clotting medications because the supplements act like blood thinners.

Protein — found in fish, shellfish, skinless poultry, lean beef, low-fat dairy products, dried peas and beans — also may boost mood, research suggests.

So, too, may chocolate, particularly dark chocolate.

Wellbutrin XL was approved this summer by the federal Food and Drug Administration as the first official prescription medicine for SAD. It joins a list of antidepressants psychiatrists prescribe for the disorder.

An extended-release drug, Wellbutrin XL is a once-a-day antidepressant, to be taken in the fall. It is approved for adults 18 and older.

Three studies showed the drug prevented depression in patients with a history of SAD, compared to those getting sugar pills, according to the FDA, which reviewed the studies before granting approval for the drug for SAD in June.

Some doctors say Wellbutrin is no better than other antidepressants in treating SAD. Others find it much better.

"I think it is superior," says Rosenbaum. He typically prescribes a 300-milligram daily dose of Wellbutrin XL for SAD.

The drug carries a warning because it has been associated with an increased risk of suicidal thoughts and behavior in children and teens. Taking more than 450 milligrams daily can cause serious side effects, including seizures.

Wayne State's Amirsadri says Wellbutrin XL should not be used by people who drink alcohol, who have eating disorders or who have had seizures because of the seizure risk. He says many antidepressants are as effective as the newly approved drug.

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Doctors also use other prescription drugs and supplements to treat SAD. Rosenbaum, for example, also prescribes Provigil, a narcolepsy medicine; drugs known as MAO inhibitors and melatonin, a supplement often used to offset jet lag.

A study published this year in the Proceedings of the National Academy of Sciences, a respected journal, found that taking melatonin in the afternoon, combined with bright light exposure in the morning, helped to keep moods stable.

By Heather Rousseau
Source: Free Press

Last updated: 12/06

New Treatments Offer Ray of Hope for SAD Sufferers

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