Editing Seasonal affective disorder (section)

===Medication===
[[Selective serotonin reuptake inhibitor|SSRI]] (selective serotonin reuptake inhibitor) antidepressants have proven effective in treating SAD.<ref name = "Modell"/> Effective antidepressants are [[fluoxetine]], [[sertraline]], or [[paroxetine]].<ref name = "Lam"/><ref>{{cite journal | vauthors = Moscovitch A, Blashko CA, Eagles JM, Darcourt G, Thompson C, Kasper S, Lane RM | title = A placebo-controlled study of sertraline in the treatment of outpatients with seasonal affective disorder | journal = Psychopharmacology | volume = 171 | issue = 4 | pages = 390–397 | date = February 2004 | pmid = 14504682 | doi = 10.1007/s00213-003-1594-8 | author8 = International Collaborative Group on Sertraline in the Treatment of Outpatients with Seasonal Affective Disorders | s2cid = 683231 }}</ref> Both fluoxetine and light therapy are 67% effective in treating SAD, according to direct head-to-head trials conducted during the 2006 Can-SAD study.<ref>{{cite journal | vauthors = Lam RW, Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EM | title = The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder | journal = The American Journal of Psychiatry | volume = 163 | issue = 5 | pages = 805–812 | date = May 2006 | pmid = 16648320 | doi = 10.1176/appi.ajp.163.5.805 }}</ref> Subjects using the light therapy protocol showed earlier clinical improvement, generally within one week of beginning the clinical treatment.<ref name = "Lam"/> [[Bupropion]] extended-release has been shown to prevent SAD for one in four people, but has not been compared directly to other preventive options in trials.<ref>{{cite journal | vauthors = Gartlehner G, Nussbaumer-Streit B, Gaynes BN, Forneris CA, Morgan LC, Greenblatt A, Wipplinger J, Lux LJ, Van Noord MG, Winkler D | display-authors = 6 | title = Second-generation antidepressants for preventing seasonal affective disorder in adults | journal = The Cochrane Database of Systematic Reviews | volume = 3 | pages = CD011268 | date = March 2019 | issue = 4 | pmid = 30883669 | pmc = 6422318 | doi = 10.1002/14651858.CD011268.pub3 }}</ref> In a 2021 updated Cochrane review of [[second-generation antidepressant]] medications for the treatment of SAD, a definitive conclusion could not be drawn, due to lack of evidence, and the need for larger randomized controlled trials.<ref>{{cite journal | vauthors = Nussbaumer-Streit B, Thaler K, Chapman A, Probst T, Winkler D, Sönnichsen A, Gaynes BN, Gartlehner G | display-authors = 6 | title = Second-generation antidepressants for treatment of seasonal affective disorder | journal = The Cochrane Database of Systematic Reviews | volume = 2021 | issue = 3 | pages = CD008591 | date = March 2021 | pmid = 33661528 | pmc = 8092631 | doi = 10.1002/14651858.CD008591.pub3 }}</ref>

[[Modafinil]] may be an effective and well-tolerated treatment in patients with seasonal affective disorder/winter depression.<ref>{{cite journal | vauthors = Lundt L | title = Modafinil treatment in patients with seasonal affective disorder/winter depression: an open-label pilot study | journal = Journal of Affective Disorders | volume = 81 | issue = 2 | pages = 173–8 | date = August 2004 | pmid = 15306145 | doi = 10.1016/S0165-0327(03)00162-9 }}</ref>

Another explanation is that [[vitamin D]] levels are too low when people do not get enough [[Ultraviolet#Vitamin D|Ultraviolet-B on their skin]]. An alternative to using bright lights is to take vitamin D supplements.<ref>{{cite journal | vauthors = Wilkins CH, Sheline YI, Roe CM, Birge SJ, Morris JC | title = Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults | journal = The American Journal of Geriatric Psychiatry | volume = 14 | issue = 12 | pages = 1032–40 | date = December 2006 | pmid = 17138809 | doi = 10.1097/01.JGP.0000240986.74642.7c | s2cid = 19008379 }}</ref><ref>{{cite journal | vauthors = Lansdowne AT, Provost SC | title = Vitamin D3 enhances mood in healthy subjects during winter | journal = Psychopharmacology | volume = 135 | issue = 4 | pages = 319–23 | date = February 1998 | pmid = 9539254 | doi = 10.1007/s002130050517 | s2cid = 21227712 }}</ref><ref>{{cite journal | vauthors = Gloth FM, Alam W, Hollis B | title = Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder | journal = The Journal of Nutrition, Health & Aging | volume = 3 | issue = 1 | pages = 5–7 | year = 1999 | pmid = 10888476 }}</ref> However, studies did not show a link between vitamin D levels and depressive symptoms in elderly Chinese,<ref>{{cite journal | vauthors = Pan A, Lu L, Franco OH, Yu Z, Li H, Lin X | title = Association between depressive symptoms and 25-hydroxyvitamin D in middle-aged and elderly Chinese | journal = Journal of Affective Disorders | volume = 118 | issue = 1–3 | pages = 240–3 | date = November 2009 | pmid = 19249103 | doi = 10.1016/j.jad.2009.02.002 }}
*{{lay source |template = cite press release|url = https://www.sciencedaily.com/releases/2009/03/090317142847.htm|title = Vitamin D May Not Be The Answer To Feeling SAD|date = March 18, 2009 |website = Science Daily}}</ref> nor among elderly British women given only 800IU when 6,000IU is needed.<ref>{{cite journal | vauthors = Dumville JC, Miles JN, Porthouse J, Cockayne S, Saxon L, King C | title = Can vitamin D supplementation prevent winter-time blues? A randomised trial among older women | journal = The Journal of Nutrition, Health & Aging | volume = 10 | issue = 2 | pages = 151–3 | year = 2006 | pmid = 16554952 }}</ref> 5-HTP (an amino acid that helps to produce serotonin, and is often used to help those with depression) has also been suggested as a supplement that may help treat the symptoms of SAD, by lifting mood, and regulating sleep schedule for those with the condition.<ref>{{Cite web|title=Don't be SAD: seasonal affective disorder advice|url=https://www.medino.com/article/seasonal-affective-disorder-advice|access-date=2021-05-19|website=medino|language=en}}</ref> However, those who take antidepressants are not advised to take 5-HTP, as antidepressant medications may combine with the supplement to create dangerously high levels of serotonin – potentially resulting in [[serotonin syndrome]].<ref>{{Cite news|title=5-HTP Safety Concerns|url=https://www.poison.org/articles/5htp-safety-concerns-173|access-date=2021-05-19|website=www.poison.org|language=en}}</ref>