NOVEL TREATMENT MODALITIES FOR SAD

在冬季季节性实体的此分支中的描述之后 情感障碍，我们已经探索了使用光在治疗 这个条件。 由于光治疗并不是对所有人都有效， 对于SAD患者，我们还探索了其药理学方法， 治疗 Depue和其他人认为大脑多巴胺能 在SAD中可能会出现信号通路失调。 在以前的研究中，我们发现 SAD患者的小亚组可以从以下方面获得相当大的益处 多巴胺能激动剂 为了扩展我们早期的发现， 为了验证SAD的多巴胺能失调理论，我们进行了安慰剂治疗， 左旋多巴/卡比多巴联合治疗的对照双盲试验 冬天的悲伤 在过去的两年里，50名无毒健康的 符合SAD标准且抑郁的患者接受两周 安慰剂洗脱期。 那些仍然显著 抑郁症患者随机接受安慰剂治疗或 再服用两周的积极药物。 13名患者 随机分配至继续安慰剂组; 11例接受药物治疗。 活性药物包括约5 mg/kg/天的左旋多巴， 一周，第二周7 mg/kg/天，加100 mg/天卡比多巴 在这两周里。 盲法评估者通过给予 结构化面试。 数据采用方差分析。 为 作为一个整体，对这两个问题的回答没有区别。 条件 然而，在绝经前女性中， 左旋多巴的效果显著且显著优于安慰剂。 这项研究提出了多巴胺能前体治疗可能 在绝经前妇女中具有特定价值，她们占大多数， 冬季的人口。 需要进一步的研究来确定 绝经前妇女是否构成了一个生物学上不同的组成部分， 冬季的人口。

Following the description in this branch of the entity of winter Seasonal Affective Disorder, we have explored the use of light in the treatment of this condition. As light treatment is not universally effective for all patients with SAD, we have also explored pharmacological approaches to its treatment. Depue and others have suggested that brain dopaminergic pathways may be dysregulated in SAD. In previous studies, we have found that small subgroup of SAD patients can derive considerable benefit from dopaminergic agonists. In order to expand our earlier findings and further test the dopaminergic dysregulation theory of SAD, we undertook a placebo- controlled double-blind trial of a levodopa/carbidopa combination treatment for winter SAD. Over the past two years 50 drug-free medically healthy patients who met criteria for SAD and were depressed were given two-week placebo washout period. Those patients who remained significantly depressed were then randomized either to continued placebo therapy or to active medication for a further two weeks. Thirteen patients were randomized to continued placebo; eleven to the medication condition. Active medications consisted of approximately 5 mg/kg/day of levodopa for one week and 7 mg/kg/day for the second week, plus 100 mg/day of carbidopa throughout the two weeks. Blind raters assessed outcome by administering a structured interview. Data were analyzed by analysis of variance. For the group as a whole, there was no difference between responses to the two conditions. Nevertheless, among pre-menopausal females, responses to levodopa were dramatic and significantly better than those of placebo. This study raises the possibility that dopaminergic precursor therapy might be of specific value in pre-menopausal women, who make up the majority of the winter SAD population. Further research is necessary to determine whether pre-menopausal women make up a biologically distinct component of the winter SAD population.