Dilsaver S C, Qamar A B, Del Medico V J
Department of Psychiatry, Ohio State University, Columbus.
J Clin Psychiatry. 1992 Jul;53(7):252-5.
Seasonal affective disorder (SAD) refers to regularly recurring episodes of affective illness bearing a fixed relationship to season. Wintertime depression is its most widely recognized form. This study was undertaken to assess the efficacy of bupropion as a treatment for this disorder.
Fifteen consecutively presenting patients were treated with bupropion (200 to 400 mg/day). All met DSM-III-R criteria for major depression with a seasonal pattern. All were moderately to severely depressed. A modified version of the Hamilton Rating Scale for Depression (mHAM-D) including ratings of hypersomnia, increased appetite and carbohydrate craving, and weight gain was used to quantify the severity of illness. Up to 5 weeks of treatment was allowed before the subjects were categorized as nonresponders, partial responders, or responders.
The mean +/- SD mHAM-D scores before and after treatment were 25.5 +/- 6.4 and 4.1 +/- 3.1, respectively. Ten (66.7%) of the subjects had a complete response to treatment (mHAM-D score less than or equal to 5). The other 5 (33.3%) had a partial response (mHAM-D score = 6-10). Five of the subjects had chronic pain and 3 had panic attacks restricted to episodes of depression. These problems resolved simultaneously with the symptoms of depression.
The results of this open trial suggest that bupropion is an effective treatment for winter depression. However, controlled studies are required to confidently determine whether this is the case.
季节性情感障碍（SAD）是指情感性疾病的定期复发发作与季节有固定关系。冬季抑郁是其最广为人知的形式。本研究旨在评估安非他酮作为这种疾病治疗方法的疗效。
连续收治的15例患者接受安非他酮治疗（200至400毫克/天）。所有患者均符合DSM-III-R中重度抑郁伴季节性模式的标准。所有患者均为中度至重度抑郁。使用改良版汉密尔顿抑郁量表（mHAM-D），包括对嗜睡、食欲增加和碳水化合物渴望以及体重增加的评分，来量化疾病的严重程度。在将受试者分类为无反应者、部分反应者或反应者之前，允许进行长达5周的治疗。
治疗前后的平均±标准差mHAM-D评分分别为25.5±6.4和4.1±3.1。10名（66.7%）受试者对治疗有完全反应（mHAM-D评分小于或等于5）。另外5名（33.3%）有部分反应（mHAM-D评分为6 - 10）。5名受试者有慢性疼痛，3名有仅限于抑郁发作时的惊恐发作。这些问题与抑郁症状同时得到解决。
这项开放性试验的结果表明，安非他酮是治疗冬季抑郁的有效方法。然而，需要进行对照研究才能确定是否确实如此。
