Key takeaways:
Seasonal affective disorder (SAD) is a common type of depression. It’s marked by episodes of depressive symptoms that typically occur in the gloomy fall and winter months.
Selective serotonin reuptake inhibitors (SSRIs) and bupropion (Wellbutrin XL, Aplenzin) are often recommended to manage SAD. Some people find vitamin D supplementation to be beneficial too.
Light therapy and cognitive behavioral therapy are non-medication treatment options for SAD. A healthcare professional may recommend those therapies on their own or in combination with an antidepressant.
When the weather gets colder and daylight hours become shorter, you may notice a shift in your normal mood and behavior. Informally, this phenomenon has often been dubbed the winter blues. But if you’ve been diagnosed with seasonal affective disorder (SAD), you know these seasonal changes can significantly impact your daily routine and outlook on life.
SAD is a type of depression that affects approximately 5% of U.S. adults. It’s marked by episodes of depression that last for weeks to months at a time. These episodes typically occur in the fall and winter months (they can happen in the spring and summer, too).
Symptoms of SAD are similar to other forms of depression. They often include feeling sad, having less energy or motivation, and feeling sleepier than usual. Women, young adults, and those with a history of depression are most vulnerable to SAD. Living in an area with less sunlight and shorter daylight hours also increases the risk of SAD.
There are several SAD treatment options to choose from — including light therapy, cognitive behavioral therapy, and medication. Here, we’ll discuss four types of medications used to manage SAD.
1. Selective serotonin reuptake inhibitors like Prozac
Selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressant for SAD — even though they’re generally taken off-label for this specific purpose. They increase the level of serotonin in your brain, which may help to improve your mood over time. Common SSRIs include:
Fluoxetine (Prozac)
Citalopram (Celexa)
Escitalopram (Lexapro)
Sertraline (Zoloft)
Paroxetine (Paxil)
SSRIs are generally taken once daily, and they’re available in a variety of formulations. They’re also effective for many people, but they don’t kick in right away. It can take some time to feel their effects. The majority of people respond to SSRIs within 4 to 12 weeks; this varies by person.
As with all medications, SSRIs can also cause side effects. Common SSRI side effects include stomach upset, headache, and sexual problems. These typically improve or go away after a few weeks.
2. Wellbutrin XL
The extended-release (XL) version of Wellbutrin (bupropion hydrochloride) is an antidepressant that’s used to treat depression. It’s also specifically FDA approved to prevent SAD. A type of norepinephrine and dopamine reuptake inhibitor (NDRI), it seems to work by increasing levels of norepinephrine and dopamine. These are also chemical messengers in the brain that influence mood.
Are you at risk for seasonal affective disorder (SAD)? GoodRx research shows that certain parts of the U.S. are more at risk for developing SAD than others.
Consider a light instead of a pill: Light therapy can be an effective treatment for SAD. Here are some of the benefits and risks.
Ways to treat depression without medication: Antidepressants can help, but they’re not your only option. Read these physician-backed tips of other ways to help manage depression symptoms.
If SSRIs aren’t a good option for you, Wellbutrin XL may be a good alternative to try. The typical starting dosage of Wellbutrin XL is 150 mg by mouth once daily in the morning. Your healthcare professional may raise your dose to 300 mg daily after 7 days. Like SSRIs, Wellbutrin XL takes a few weeks to start working.
Wellbutrin XL has some side effects of its own, but it’s less likely to cause sexual side effects compared to SSRIs and many other antidepressants.
3. Aplenzin
Aplenzin is another antidepressant medication that’s approved to prevent SAD. It’s very similar to Wellbutrin XL. While Wellbutrin XL contains bupropion hydrochloride, Aplenzin contains bupropion hydrobromide. These different salt forms (hydrochloride and hydrobromide) are absorbed by your body slightly differently. However, in practice, the two medications generally offer similar benefits and side effects. One isn’t widely considered better than the other.
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Aplenzin is made by a different manufacturer, though, and it’s only available as a brand-name medication. Wellbutrin XL comes as a lower-cost generic.
The typical starting dosage of Aplenzin for SAD is 174 mg by mouth once daily. Your healthcare professional may increase your dosage to 348 mg once daily after 7 days.
4. Vitamin D
Low levels of vitamin D — most likely caused by a lack of sunlight — have been linked to SAD. As a result, some people turn to vitamin D supplementation as another option for managing SAD.
Yet, research studying the relationship between vitamin D levels and SAD has had mixed results. For instance, one review found that supplementation with vitamin D appeared to have no effect on reducing depressive symptoms. Another review found that supplementation with 2,000 IU of vitamin D contributed to a slight improvement in depression symptoms. But people with SAD specifically didn’t see a significant difference.
With mixed evidence surrounding vitamin D supplementation and SAD, it’s important to talk to your healthcare professional for more information. They can tell you more about vitamin D’s potential benefits and risks.
Do any other antidepressants treat SAD?
SAD is a type of depression and it may be treated with other antidepressants. Your prescriber will help you figure out which antidepressant(s) would work best for you based on your medical history, personal preferences, and treatments you’ve tried before.
That said, other antidepressants aren’t generally considered first-choice options for treating or preventing SAD. But some people still benefit from them, especially if SSRIs or bupropion haven’t worked well.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are one option to consider. SNRIs work similarly to SSRIs; they increase the amount of serotonin and norepinephrine in the brain, which can help improve mood. Notable SNRIs include Effexor XR (venlafaxine), Pristiq (desvenlafaxine), and Cymbalta (duloxetine).
What about non-medication seasonal depression (SAD) treatments?
Medications aren’t the only way to treat SAD. Light therapy and cognitive behavioral therapy are also effective options for managing SAD. These treatments can be used by themselves, with each other, or in combination with antidepressants.
Light therapy is considered to be a mainstay therapy for managing SAD. It uses special light boxes — or “SAD lamps” — to compensate for a lack of sunlight during the fall and winter months. They’re especially useful if you live in an area that’s dark and gloomy during these seasons. Research estimates suggest that about 60% of people with SAD who use light therapy tend to see a reduction in SAD symptoms.
Cognitive behavioral therapy, a type of psychotherapy, may be similarly as effective as light therapy for some people — and might even have more long-lasting results. With help from a therapist or psychologist, you can learn to use coping mechanisms to manage difficult situations and come up with ways to promote positive thinking.
If you or a loved one are experiencing signs or symptoms of seasonal depression, ask your healthcare professional about treatment options like these. And since a specifically-designed lamp is required for light therapy, they could help you choose an appropriate light box.
How do you know which SAD therapy is right for you?
Light therapy, cognitive behavioral therapy, and medications are all considered first-choice options for people living with SAD. You can use them on their own or in combination with each other. They can all help alleviate SAD symptoms such as sadness, lethargy, and irritability. The right treatment for you depends on your symptoms, your mental and physical health, and your personal preferences.
What’s more, antidepressants can help prevent SAD rather than just treat it once it starts. This can come in handy if seasonal depression affects you on a recurrent basis. If you tend to develop symptoms around a certain time every year, your prescriber may recommend starting an antidepressant a few weeks in advance to give it time to kick in.
Ultimately, your healthcare professional is your best resource for determining the best treatment option(s) for you. Since everyone’s lived experience with depression is personal, your ideal course of action may be different from what’s outlined above.
Are antidepressants recommended seasonally or year round?
For the most part, antidepressants used to manage SAD are recommended seasonally. Because they can take some time to kick in, your prescriber may recommend starting an antidepressant in the fall. Then, you may be told to stop taking your medication in the early spring — especially if your symptoms tend to naturally get better during the warmer months.
Remember that this isn’t a one-size-fits-all approach. Some healthcare experts recommend taking antidepressants all year long. It all boils down to your symptoms and experiences.
Frequently asked questions
No, tanning beds aren’t an effective treatment for SAD. Tanning beds may provide temporary benefits for your mood — but light therapy generally works best when it enters through your eyes, not your skin. Visible light assists your body's internal clock during the cloudier and chillier months. Tanning beds also come with potentially serious risks with routine use, including skin cancer.
Researchers don’t know the exact cause of seasonal depression. But it’s thought to be related to changes in serotonin and/or melatonin. A lack of vitamin D due to the changing seasons may also play a role.
Feelings of sadness and hopelessness are common symptoms of depression. You may also notice changes in energy levels or motivation, fluctuations in appetite or weight, or increased sleepiness. The main difference between SAD and other forms of depression is that these symptoms may only be present or noticeable for 4 to 5 months out of the year.
No, tanning beds aren’t an effective treatment for SAD. Tanning beds may provide temporary benefits for your mood — but light therapy generally works best when it enters through your eyes, not your skin. Visible light assists your body's internal clock during the cloudier and chillier months. Tanning beds also come with potentially serious risks with routine use, including skin cancer.
Researchers don’t know the exact cause of seasonal depression. But it’s thought to be related to changes in serotonin and/or melatonin. A lack of vitamin D due to the changing seasons may also play a role.
Feelings of sadness and hopelessness are common symptoms of depression. You may also notice changes in energy levels or motivation, fluctuations in appetite or weight, or increased sleepiness. The main difference between SAD and other forms of depression is that these symptoms may only be present or noticeable for 4 to 5 months out of the year.
The bottom line
Several medications can treat seasonal affective disorder (SAD). Selective serotonin reuptake inhibitors (SSRIs) are the most popular medications for managing SAD. Wellbutrin XL (bupropion hydrochloride) and Aplenzin (bupropion hydrobromide) are also options to consider, and they’re even FDA approved for the condition. Some people turn to vitamin D supplementation, but there are mixed reviews on its effectiveness.
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References
American Psychiatric Association. (n.d.). Depression.
American Psychiatric Association. (2024). Seasonal affective disorder (SAD).
Galima, S. V., et al. (2020). Seasonal affective disorder: Common questions and answers. American Family Physician.
Gowda, U., et al. (2015). Vitamin D supplementation to reduce depression in adults: Meta-analysis of randomized controlled trials. Nutrition.
Mikola, T., et al. (2022). The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and meta‐analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition.
National Center for Complementary and Integrative Health. (2023). Seasonal affective disorder. National Institutes of Health.
National Institute of Mental Health. (2023). Seasonal affective disorder. National Institutes of Health.
Rohan, K. J., et al. (2015). Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: Acute outcomes. The American Journal of Psychiatry.
Salk, R. H., et al. (2017). Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychological Bulletin.
Venosa, A. (2022). Spotlight on seasonal depression: Why indoor tanning isn’t an effective treatment. The Skin Cancer Foundation.
