Winter Depression: Drug Therapy

Therapy goals

  • Mood elevation and activation

Therapy recommendations

  • St. John’s wort (psychotropic phytopharmaceuticals), first-line agent; indication: mild (to moderate?) depression:
    • Dosage: 3 x 300-350 mg dry extract;
    • Inhibits central reuptake of serotonin, norepinephrine and dopamine and leads to downregulation of central serotonin receptors and noradrenergic beta receptors.
    • Has a mood-lifting, drive-enhancing and relaxing effect and sets in with a latency period of 10-14 days
    • Side effects:
      • Risk of photosensitization with symptoms similar to sunburn. Thus, no exposure to natural or artificial sunbathing!
      • Allergic reactions (exanthema), gastrointestinal (gastrointestinal) complaints; fatigue and restlessness.
    • Caution with combination therapy: CYP 3A4 induction.
  • In the United States, bupropion (selective norepinephrine dopamine reuptake inhibitor) is the only antidepressant approved for the treatment of Seasonal Affective Disorder. In addition to mood elevation, the active ingredient has a mild drive-enhancing effect
  • See also under “Depression/Pharmacotherapy” if applicable.
  • Light therapy: prolonging the exposure to light with the help of artificial light (light with an illuminance of 2,500 to 10,000 lux).
  • See also under “Other therapy“.