Pathophysiological mechanism of seasonal affective disorder

Lee, Tatia M.C.; Blashko, Carl A.; Janzen, Henry L.; Paterson, John G.; Chan, Che Hin Chetwyn

doi:10.1016/s0165-0327(97)00076-1

Cited by 47 publications

(20 citation statements)

References 72 publications

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“…The studies aimed at testing these explanations showed that the symptoms of winter depression are still effectively reversed by midday bright light (Wehr et al 1986;Jacobsen et al 1987;Wirz-Justice et al 1994;Putilov et al in press) and by midday physical exercising (Pinchasov et al 2000;Putilov et al in press). Besides, the meta-analysis of light treatment data (Lee et al 1997) did not support the phase-shifting hypothesis: it indicated that the antidepressant effect of a single pulse of light was similar for morning, midday, and evening treatments, whereas the antidepressant effect of the combination of morning -evening light regime was superior to a single pulse of light administered at other times of day.…”

Section: Introductionmentioning

confidence: 94%

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

Putilov¹,

Danilenko

2005

Biological Rhythm Research

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Patients with winter depression (seasonal affective disorder) respond beneficially to sleep deprivation and bright light, but the mechanisms of these responses remain unknown. The study was designed to test whether afternoon/evening melatonin can prevent further relapse after sleep deprivation (presumably due to a pharmacologically induced advance shift of circadian phase). Compared to phase advancing by alteration of sleep -wake schedule or by bright light exposure, the melatonin intake is a more tolerated treatment procedure, and it provides a possibility of blind comparison between chronotherapeutic and placebo treatments. The depression was scored in 16 female patients with winter depression and 17 age-matched female controls before and after total night sleep deprivation and after subsequent six-day administration of melatonin (0.5 mg) or placebo under double blind conditions. The melatonin intake was scheduled at 17:00 in order to produce a phase advance of circadian rhythms. Sleep deprivation resulted in 38% reduction of depression score in patients, but it did not reduce depression score in controls. After subsequent treatment with placebo or melatonin, slight but significant improvement of mood was found in controls. These treatments also stabilized the antidepressant response to sleep deprivation in patients. However, neither differential effect of melatonin and placebo on depression score nor alteration of habitual sleep timing was found in patients and controls. Thus, the study results do not provide evidence for the antidepressant potential of melatonin in patients with winter depression under realistic clinical conditions. The finding of stabilization of mood in patients with placebo points to the contribution of psychological factors to the therapeutic action of this and other types of innovative treatments for winter depression. To include psychosocial aspects in the theoretical framework of seasonal depression, we conceptualized depression as an evolved feature of emotional response to psychosocial rather than physical environment. The seasonality of depression might be explained by cumulative effects of aperiodical psychosocial factors and periodical physical factors on one of the mechanisms of brain neurotransmission.

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Section: Introductionmentioning

confidence: 94%

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

Putilov¹,

Danilenko

2005

Biological Rhythm Research

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“…Meanwhile, the beneficial effect of light therapy has been generally accepted for a wide range of affective or rhythmical disturbances [1]. However, the underlying physiological modes of action remain an unresolved area [3,4], as does the therapeutic effect of the various parts ('colors') of the daylight spectrum [5]. Heart rate variability (HRV) has been a clinical tool for the diagnosis of disorders of the cardiovascular system for many years [6,7].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Colored Illumination on Heart Rate Variability

Schäfer

Kratky

2006

Complement Med Res

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We investigated the effects of illumination with colored fluorescent light on heart rate variability (HRV) and autonomic regulation. Previous examinations have only focused on full-spectrum fluorescent bright light as it is used for the therapy of seasonal affective disorder and disturbances of circadian rhythms. Materials and Methods: In 3 experiments, 12 healthy volunteers were exposed for 10 min to red, green and blue fluorescent light of 700 lux, respectively. These illumination periods were followed and preceded by 15 min of darkness. HRV series were recorded within the last minutes of each illumination and darkness period. HRV analysis encompassed time domain variables, frequency domain variables and detrended fluctuation analysis (DFA). Results: DFA yielded a highly significant increase of the self-similarity parameter aDFA under red and green illumination, while blue light was accompanied by a decrease. A spectral analysis revealed parallel behavior of very low frequency components in the range of 0.003-0.04 Hz. Green light also seemed to induce a reduction in high frequency components. Conclusions: Results show that colored light can influence HRV within minutes and that the effects of individual colors can be distinguished by HRV analysis.

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“…6 Pharmacological responses in SAD patients also suggest possible dysfunction in serotonergic transmission. 7 The efficacy of selective serotonin re-uptake inhibitors (SSRIs) in relieving the depressive symptoms of SAD has been demonstrated, particularly sertraline 8 and, to some extent, fluoxetine. 9,10 Meta-chlorophenylpiperazine (m-CPP), an agonist for several serotonin receptors, mainly 5-HT 2c but also 5-HT 2A and others, increases energy and euphoria in symptomatic SAD patients, but not following light treatment, nor in the summer, nor in controls.…”

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confidence: 99%

Association between seasonal affective disorder and the 5-HT2A promoter polymorphism, −1438G/A

et al. 1999

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Genes involved in serotonin metabolism are good candidates for the pathogenesis of seasonal affective disorder (SAD).A functional variant in the serotonin transporter promoter, 5-HTTLPR, has recently been shown to be associated with SAD and seasonality. The purpose of this study was to determine whether −1438G/A, a polymorphism in the 5-HT 2A promoter, is associated with SAD and seasonality, and whether it has additive effects with 5-HTTLPR on seasonality. Sixty-seven individuals with SAD and 69 normal volunteers, all screened with the SCID and diagnosed according to DSM-III-R criteria, were genotyped for the −1438G/A 5-HT 2A promoter polymorphism. All had been previously genotyped for 5-HTTLPR and had been assessed for seasonality by the Global Seasonality Scale. There was a significant increase in the frequency of the −1438A variant allele of the 5-HT 2A promoter polymorphism in SAD patients (0.47) compared to matched controls (0.36) (P Ͻ 0.01). The difference in genotype distribution was also significant (P Ͻ 0.05). We found no association between the −1438G/A polymorphism and seasonality scores, and there was no additive effect with 5-HTTLPR on seasonality. In conclusion, we have shown that the −1438G/A 5-HT 2A promoter variant is associated with SAD but not with seasonality. We suggest that the association may instead be with the depressive symptoms of SAD. However, these results should be treated with caution until replicated because of the possibility of false-positive findings in case-control association studies.

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Pathophysiological mechanism of seasonal affective disorder

Cited by 47 publications

References 72 publications

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

The Effect of Colored Illumination on Heart Rate Variability

Association between seasonal affective disorder and the 5-HT2A promoter polymorphism, −1438G/A

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